Homeless Americans who have not been left out of priority lists for coronavirus vaccinations – or have even been pushed aside because countries have shifted their suitability to older age groups – will eventually get their shots as the vaccine supply increases.
While the U.S. government has only incomplete data on infections among homeless people, it is clear that stress, unhygienic conditions at shelters and underlying ill health increase the risk of COVID-19 infections, serious complications and death.
COVID-19 outbreaks have been documented at homeless shelters in cities such as Boston, San Francisco and Seattle. Vaccination in vulnerable areas is a key to achieving herd immunity, the goal of building a barrier of protected people to stop uncontrolled spread.
“It was important to me to protect myself and the health and well-being of others,” said Cidney Oliver, 39, who received her first dose of Moderna vaccine on April 7 at the YWCA shelter in Seattle.
Wanona Thibodeaux-Lee, 43, has lived in several shelters in Seattle while trying to get back on her feet, most recently at WHEEL, a 26-bed women’s shelter in a church basement. On April 5, she received the single-dose Johnson & Johnson vaccine.
“I feel like I can move around without anyone getting sick of me,” she said. “It’s good to know I’m not having to go back for a second one.”
The single-vaccine is preferred by many clinics that serve the homeless and by the homeless themselves, said Bobby Watts, chief executive of the National Health Care for the Homeless Council.
The U.S. government on Tuesday recommended a “pause” in using the Johnson & Johnson vaccine to investigate reports of rare but potentially dangerous blood clots. This is a temporary setback in the attempt to vaccinate homeless people, forcing organizers this week to switch to other vaccines or postpone events.
Watts said he was concerned that the break would lead to more hesitation with the vaccine.
“Assuming it’s ultimately safe and effective, it’s going to be harder to convince people – especially people who are homeless – that it’s safe,” Watts said.
In Seattle, with the third largest homeless population in the U.S., at least 1,400 of them have tested positive for COVID-19 and 22 have died since the pandemic began. More than 100 shelters and other premises for homeless services have broken out. The Seattle Department of Health will switch to the Moderna vaccine for its planned events on the homeless.
Watts has a greater risk of becoming infected and a greater risk of hospitalization and death than the average person. Shorter lifespan – chronic homelessness can take 20 to 30 years of a person’s life – should they qualify for vaccination sooner, Watts said.
Instead, political pressure to vaccinate older adults has moved them to the back of the queue. Watts said that clinics that serve them put ‘in the unreasonable position:’ I know all of you are at high risk, but I can only vaccinate the singles or you who are over 70. ‘
Now, that’s changing. As suitability widens, homeless service providers are mobilizing to get vaccinated to shelters and campsites.
In Nashville, 19 organizations set a goal to bring the vaccine to all homeless people by Memorial Day. In Salt Lake City, incentives offer incentives, such as gift cards from $ 5 grocery stores or gift pizza. The Los Angeles Fire Department is delivering vaccine in the tent cities of Skid Row, MacArthur Park and other neighborhoods.
“To look people in the eye and tell them the truth about the vaccine … I like what I do every day,” Melanie McConnaughy said. Her job is to answer questions and build trust.
She describes a homeless woman, covered in tattoos, who initially said she did not want the shot because she did not like needles. When we pointed to her tattoos, ‘we said,’ How can you say you’re afraid of needles? “She said, ‘You’re right, you’re right. I’m going to tell my brother. He’s there. ” Both brothers and sisters were vaccinated that day.
Vaccinating homeless people is good for everyone’s health, Los Angeles Deputy Mayor Jose “Che” Ramirez said.
“We are all together. The more shots in the arms, the better, “Ramirez said. The more people are vaccinated, the stronger we are with building herd immunity and the faster we can reopen our city and enter into conversation with each other as we used to. ”
It was important in Nashville to give outreach workers a uniform message, where organizers compiled a one-page fact sheet about the vaccines in English and Spanish.
“Please let’s all sing the same songs,” said Brian Haile, CEO of Neighborhood Health in Nashville. “It’s Music City, so we have a vaccination page.”
All homeless adults in Washington, DC, were eligible for the vaccine in January, long before most states and before the J&J vaccine became available. The city has completely vaccinated more than 1,300 by issuing yellow bracelets printed with the second dose of appointment dates as reminders.
The district also trained residents of important shelters ‘so that they can be ambassadors for the vaccine and talk to their peers about it’, said dr. Catherine Crosland of Unity Health Care, a clinic system that serves the homeless, said.
Organizers say stepping-up vaccine events are crucial for a population with limited access to cars, cell phones or WiFi.
In Salt Lake City, the Department of Health and a homeless clinic gave more than 1,000 doses of vaccine to homeless people. Janida Emerson, chief executive of Fourth Street Clinic, says pizza, candy bars, “whatever we can donate,” help people wait when there’s a queue.
‘In our area there are 10,000 people who are homeless. We have a way. This is a start, ‘Emerson said.
Even before the pandemic, homelessness increased in the US, with the largest increases outside the shelter system – people living on sidewalks, under bridges and in abandoned buildings.
The economic downturn of the pandemic has uprooted people from their homes despite a moratorium on evictions. Cities closed pressure shelters to prevent contamination and offered rooms in motels, but some shelter users who did not want to move to unfamiliar neighborhoods joined the streets.
How much the pandemic further increases the number of homeless Americans is not entirely clear. Many cities have canceled their annual homeless count this year, according to their home orders.
In January 2020, 580,000 homeless people in the United States showed up in one night. Lawyers say the total needs to be multiplied by three to get the true extent of Americans using shelters and living on the streets.
In Seattle, it will take at least two months to get the vaccine to 575 housing, shelter and service sites, 85 sanctions-free campuses and nine youth service sites.
For Oliver, the pandemic was the least of her worries when she arrived in Seattle last month without family, friends or work.
“Abuse, unemployment, losing everything,” Oliver said. ‘My life, it was not so wonderful. I experienced things before COVID that prepared me to deal with this pandemic. ”
She says Seattle has been a good step so far. She got a job and is learning about housing options from the staff at Angeline’s, the YWCA facility, where she tidied up her top pile.
She sums up her philosophy: ‘You wake up and you’re still alive. You breathe, you have two legs, you have two feet. Be thankful. “
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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.