A group of health workers rushed a Boston hospital this morning and seized small red radiators filled with COVID-19 vaccines.
Their challenge: beating traffic, a looming snowstorm and the clock. They had to get shots in the arms of their patients before the vaccines expired within hours.
“The clock is on my mind all the time,” says Dr. Won Lee, a home care specialist at Boston Medical Center.
Millions of U.S. residents will need COVID-19 vaccines that are brought to them because they rarely or never leave the home. Doctors and nurses who specialize in home care are leading this step and starting to get help from state and local governments across the country.
But they have several challenges. Researchers say that many people who are not at home do not receive regular medical care, which makes it difficult to identify everyone who needs a vaccine.
Stock is also limited, and both the Pfizer and Moderna vaccines expire a few hours after the syringe has withdrawn the vaccine from the vials.
This makes it difficult for one doctor to see many patients when they also have to stay in someone’s home for at least 15 minutes after the admission if an allergic reaction occurs.
“They do not live next to each other,” says Dr. David Moen of Prospero Health Partners, which provides care to patients in various states. “It’s challenging to go to different places.”
Doctors and nurses who specialize in home care result in vaccinating millions of U.S. residents who rarely or never leave home. (February 19).
Nevertheless, health care providers report progress. Lee reckons she can deliver five or six doses in an average day. This will be her main focus for the next few weeks.
One of her recent stops was on the second floor apartment of an ordinary patient, 106-year-old Domingas Pina, who had not left home in about a year.
Lee sat with Pina at her dining room table, shrugged the patient’s shoulder and then quickly administered the shot as Pina looked away.
The patient then smiled under her surgical mask and flashed an inch up. Pina, who speaks mostly Portuguese-Creoles, is getting her second dose of vaccine next month, right around her 107th birthday.
“She misses all her grandchildren and her friends who always came on time,” said daughter Maria Lopes. “We do not want to lose her.”
After giving Pina the chance, Lee asks how she is doing and about her blood pressure medication. She then slipped off Pina’s Darth Vader slippers to examine her feet.
Before long, the doctor left for her next patient.
Lee’s office determines the appointments and explains the vaccine in advance. This helps the visit go smoothly, and Lee tries to see patients who live close by to save time.
She also says she can not stay too long after the shots “because I have to make sure I get these vaccines for all the patients who need them today.”
Dr. Karen Abrashkin hopes to follow a similar approach. She will use mapping software to plan stops among clusters of patients living close to each other in the New York City area.
But the director of Northwell Health’s House Calls program is still waiting for the vaccine.
“We get a lot of questions every day about when we are going to give vaccinations in the house,” she said. “The offer is just not there yet.”
One of her patients, 103-year-old Ida Sobel, has no plans to leave her apartment building before she is vaccinated.
While she waits, Sobel, who is legally blind and lives with a home health assistant, is delivered food. She walks down the hallway outside her front door for exercise and opens a window if she wants fresh air.
“I’m in a very busy environment,” said Floral Park, New York. “People are not conscious enough to avoid you and stay far away, so I avoid them.”
Christine Ritchie, a professor at Harvard Medical School, estimates that about 2 million American residents are at home. Another five million are struggling to leave home or need help to do so. Many of them may also need vaccines that are brought to them.
This population usually contains older people with lower than average income and serious medical problems such as dementia, advanced heart conditions or arthritis.
Ritchie noted that people who are at home attract less attention from public health officials than those who live in group settings, such as nursing homes, who receive vaccines from major pharmacy chains.
Home-bound people, Ritchie said, “tend to be invisible to society.”
On Staten Island, James De Silva became frustrated because he did not have a good vaccination for his 96-year-old mother, but people who are much younger than her can get shots when they leave home. Mary Stella De Silva is mostly bedridden and receives home care 24 hours a day.
The care does not include the vaccine, and De Silva will have to arrange an ambulance or special transport to take her to an appointment if he gets one.
“I think the homebound should enjoy a little more preference than someone who is only 65 and may not have an underlying illness,” he said. “Honestly, it does not get the attention it deserves.”
This seems to be changing. Firefighters across the country have begun delivering vaccines.
In the Gulf Coast city of Corpus Christi, Texas, the fire department has been using a list of Meals on Wheels recipients since the end of January to deliver more than 2,000 doses of Moderna vaccine. Chief Robert Rocha said they have also set up a hotline for anyone who needs another vaccination.
Last week, New York City Mayor Bill DeBlasio said his city will begin sending medical staff to the apartments of homemade people as soon as a vaccine vaccine available through Johnson & Johnson becomes available. Federal regulators may approve the vaccine within a few weeks.
Deliveries like these cannot start fast enough for De Silva and his mother.
“If she had been in a nursing home or a long-term care facility, she would have been vaccinated by now,” he said. “She’s really in the same situation, but she’s home.”
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Associated Press video journalist Rodrique Ngowi contributed to this report.
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The Associated Press Health and Science Division receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.