When it came time for residents and staff at the New York Avenue homeless shelter in northeast Washington, DC, to receive their first doses of Moderna Covid-19 vaccine, it was David Durham, who has been in the men’s shelter for three years. living.
Like many people in the shelter, he was bombarded by misinformation about vaccines: controversial rumors and rumors turned into extensive conspiracy theories, many of which played out the distrust that homeless people have about government services.
But he got the chance.
“I’ve heard so many conspiracy theories, like they’re putting a chip in you, that they’re going to inject some kind of liquid into you, that you’re going to become a guinea pig,” said Durham, a 34-year-old DC native. “But I said, ‘You know what, I have to take it upon myself to set an example.’ ‘
Across the country, many cities and major urban centers have begun vaccinating homeless people housed in their shelter systems, but few municipalities have taken to the streets where the situation is exacerbated by mistrust, logistical barriers and limited resources.
However, the newly authorized Johnson & Johnson vaccine provided a timely solution for cities that have struggled to administer the two previously available vaccines to their protected homeless, and especially their unprotected homeless, who are more transient and at greater risk. amid the pandemic. .
So far, their methods have been as diverse as their readiness.
In Washington, city officials have implemented a multi-agency strategy for vaccinating homeless individuals, regardless of age or condition, but they have mostly not vaccinated those living on the streets. Durham was one of the first in his shelter to receive the vaccine, and then became a peer educator, one of about two dozen current or former homeless individuals assigned by the city to educate other homeless people about safety. and efficacy of the different vaccines.
Asked if the program was a success, Durham admits it was difficult to convince people when many people had already made up their minds. After all, Durham said only half of the peer educators in his program took the vaccine because the other half were too skeptical.
The vaccination of sheltered homeless people is supposed to be the easy part, said dr. Patrick Kachur, a public health expert at the Mailman School of Public Health in Columbia, said.
“Reaching people at a fixed point, such as a shelter for the homeless, is far more feasible than doing street outreach,” Kachur said, adding that both the Moderna and Pfizer BioNTech vaccines have prevented many cities from significant outreach, as they each require storage in freezing temperatures, second doses three to four weeks after the first, and can spoil if not used within a certain period of time.
In Los Angeles, grassroots organizations have paved the way by vaccinating those on the street based on age fitness and other conditions, as city officials decide on a more coordinated approach. The Los Angeles Christian Health Centers have been administering the Moderna vaccine to homeless people on the street for almost a month now and must now locate patients to administer second doses – an attempt laden with obstacles.
According to a spokesman for the Department of Homeless Services, about 4,300 residents and staff in the city’s extensive system of homeless shelters have received a vaccine. Prior to the Johnson & Johnson vaccine, no existing vaccine could be delivered in a mobile manner, and the city has not yet deployed outreach teams with the specific goal of vaccinating unprotected individuals, the spokesman said.
A city spokesman said Chicago had vaccinated about 2,000 residents and staff within its shelter system, while outreach teams could only vaccinate about 125 unprotected individuals. In Boston, 57 sheltered individuals received their first dose and street outreach teams hope to vaccinate the unprotected in the coming days, a spokesman for the city’s public health commission told NBC News.
Kachur said he thinks the Johnson & Johnson vaccine is a game changer and that it will eventually enable meaningful street issues.
For Laura Zeilinger, the director of the human services department in Washington, the situation can no longer be urgent.
“People who experience homelessness tend to have many risk factors due to their age and other health conditions that put them at particular risk for extremely poor health outcomes, should they contract COVID,” Zeilinger said.
Her department, in partnership with local healthcare providers, has used pop-up clinics, peer education programs and social media campaigns to vaccinate more than 900 sheltered individuals. They are preparing for the Johnson & Johnson vaccine, which will enable them to vaccinate those on the streets. Peer educators like Durham are condemning the group so that mistrust will not be so much an obstacle.
Like many cities on the West Coast, Portland, Oregon, will not start vaccinating homeless people before further phases open, but can do so based on age or condition. A Multnomah County spokesman said: “The province has sent vaccination teams to our shelter to provide vaccines to people who qualify due to age or medical condition.”
As in the case of Los Angeles and other California cities, San Francisco is awaiting state guidelines to begin widespread vaccinations of its large homeless population as the shortage of vaccines shifts the explosion and priority phases.
Homeless people were originally vaccinated along with emergency workers, child care workers, teachers and food workers, but have since been removed by the state without knowing when they will be added to other phases, a spokesman for San Francisco’s Covid Command Center said. Meanwhile, the city has vaccinated homeless people who are eligible according to state guidelines at Zuckerberg San Francisco General Hospital.
In cities like Dallas, officials are beginning to mention the Johnson & Johnson vaccine used specifically for the homeless.
“We want to get them vaccinated while we can,” Dallas judge Clay Jenkins told NBC subsidiary KXAS. “It is to our advantage that we vaccinate those who are willing to accept the vaccine in the population. It makes us all safer.”
Public health experts like Kachur are hopeful that the Johnson & Johnson vaccine, if prioritized for the homeless, will significantly alleviate many of the logistical challenges facing cities and that the meaningful vaccination of homeless people in the streets will become a reality. will be.
Kachur also welcomes efforts to, like Washington’s peer education program, suppress unbridled mistrust among homeless people. He believes it is necessary to prioritize this population in whatever way possible if the country ever wants to achieve herd immunity.
“Sometimes it makes sense to reach the hardest to reach populations first,” Kachur said, “just because it will take longer to get good coverage in the hard-to-reach populations.”