Light of Life Rescue Mission had planned a vaccination clinic earlier this month to help vaccinate homeless people. The shelter, which runs short-term and long-term programs for the homeless as well as addiction recreation and employment support, planned to give the Johnson & Johnson single vaccine. Then, about three hours before the event began on April 13, it was announced that use of the vaccine had been suspended.
The shelter quickly switched gears and administered the Moderna vaccine instead, said Jerrel Gilliam, executive director. However, developments changed Light of Life’s vaccination strategy as doctors had to inform patients, many of whom were not staying, that they would have to return for a second dose.
“It’s very frustrating,” said Gilliam. “For homeless shelters across the country, because of the one shot, this was part of our strategy we were supposed to use in the camps. There is still no telling how long this will take and how it will affect it, but it is definitely a blow to those of us who work in this community. ”
U.S. health officials on Friday lifted Johnson & Johnson’s 11-day vaccination hiatus, but many of the challenges faced by emergency shelters and the homeless during the pandemic will remain. Since the beginning of the pandemic, the homeless have been particularly vulnerable to covid broadcasts. Living in shelters, the Congregation carries many of the same transmission risks as those in nursing homes and correctional facilities. Studies show that due to the frequency of various health problems and the difficulty of following public health guidelines, the homeless are more likely to develop severe cases that require hospitalization and death.
The spread of the virus in homeless communities creates an additional risk of overcrowding in hospitals and emergency rooms, Gilliam said, as homeless people are less likely to have health insurance or a family doctor.
Shelters have had to make significant changes to their processes to keep people safe. And as vaccine availability improves, these workers still face hesitation and difficulty reaching a transient population.
“These mass events that are taking place are wonderful, but when you are dealing with the population we are dealing with they have several obstacles to overcome,” said Gilliam.
Early on, shelter and healthcare providers in Pittsburgh worked together to take a proactive approach. Many revised the way meals were served, capacity limits, and contact strategies in homeless camps. Several have partnered with the Allegheny County Health Department, the area’s hospital systems, and state-qualified health centers to provide tests and, later, the vaccine.
However, shelter operators said vaccine distribution has been frustrating at times as they dealt with a bureaucratic system and changed the definitions of eligibility. For example, in December, several Pittsburgh homeless organizations said they had been told that their population would be included in Phase 1A. A few weeks later, a new definition of Phase 1A was published that did not include the homeless.
“We were a bit disappointed,” said Dr. Jack Todd Wahrenburger, chief medical officer at Pittsburgh Mercy, who not only ran its own shelter and outpatient services for the homeless, but also worked with several other shelters in the Pittsburgh area to administer Covid tests and vaccines. “Although when they expanded 1A … we found a lot of people in shelters to be qualified.”
Even now, with all Pennsylvanians over the age of 16 eligible, there are still challenges in vaccinating the homeless population. Many homeless people do not have adequate access to transportation, childcare or the internet – making it difficult for lawyers to raise awareness of clinics and register people. Outreach teams must regularly do rounds of homeless camps and communicate with community leaders to find neighborhoods with populations in need of vaccination.
“It was very difficult to get the word out, but we’re doing our best,” said Gilliam.
Annette Fetchko, executive director of Bethlehem Haven, an animal shelter that primarily provides services to women, said there is clear reluctance among the population about vaccines.
Fetchko remembers a woman in her fifties who came to Bethlehem Haven after living in her car. The woman had come to western Pennsylvania from Texas and unexpectedly lost her home. With a history of cancer, she was afraid of being in a community – like an animal shelter – during the pandemic. Bethlehem Haven was able to help the woman get a vaccine at the start of the rollout based on her health.
“But there are many people in shelters that we have the privilege of serving today who continue to disagree to receive the vaccine for a variety of reasons,” Fetchko said, citing suspected and mental disorders.
Vaccination is not required to stay in many shelters, but operators say they do everything they can to avoid misunderstandings and hesitation. They essentially launched public relations campaigns for the vaccine, sharing information from doctors, nurses, and community leaders with anyone they come in contact with while providing meals and accommodation.
The Johnson & Johnson vaccine promised a measure of ease. Individuals would not have to return to a clinic for a second dose, and the less stringent storage requirements would have made it easier for emergency teams to fire off shots in homeless camps.
“Often times we couldn’t find people to take the second dose,” said Fetchko. “That was absolutely an obstacle that we tried to overcome, but we weren’t successful in all cases.”
Wahrenburger said the same to Pittsburgh Mercy. Within the first group of homeless people Mercy vaccinated, he said they could only find about 50% to give the second dose.
“People will stay in a shelter for two or three days, but it’s rare for someone to stay for 28 days,” he said.
Wahrenburger said it appeared that many shelters, including Pittsburgh Mercy, had “held back” by that point, waiting for the Johnson & Johnson vaccine to become more readily available. But as cases increased among the homeless population – likely related to the presence of Covid variants and pandemic fatigue – he said it was more urgent than ever to encourage widespread vaccination.
While the shelters waited for the J&J break to end, the doctors encouraged people to take the Moderna and Pfizer shots – even if they can’t come back for a second dose.
After all, one attitude from Moderna is better than none at all, said Wahrenburger.
Despite the challenges, shelters and health officials are confident that they have made progress so far in vaccinating homeless people in the area.
More than 70% of residents on the Light of Life long-term program have been fully vaccinated, which provides some level of security, Gilliam said. But in a population with so much impermanence and turnover, he said the shelter couldn’t disappoint his guard.
These barriers – to health care, psychiatric care, nutrition, and other basic needs – will remain after covid-19 is resolved.
“We don’t want people, once this immediate crisis is over, to just think that everything is fine because it isn’t,” said Gilliam. “We know this population is vulnerable … There is some relief, but there is concern that this population will take a back seat again.”
Teghan Simonton is a contributor to Tribune Review. You can contact Teghan at 724-226-4680, firstname.lastname@example.org, or on Twitter.