How to Vaccinate Homebound Seniors? Take the Shots to Them

Source: NY Times

Doctors at Northwell Health, the largest heath care provider in New York State, set out last week to solve one of the most vexing medical and logistical challenges of the campaign to get Americans vaccinated against the coronavirus: how to inoculate millions of seniors who live at home and are too frail or disabled to go to a clinic or queue up at a vaccination site.

Vaccination rates among seniors have risen quickly, with at least 60 percent inoculated so far. But there is no system in place for reaching the homebound, Dr. Neuman noted: “Some people simply cannot get themselves to a vaccination site, so the challenge is getting the vaccine to them, where they live.” In the absence of a centrally coordinated campaign targeting the homebound, local initiatives have sprung up around the country.

Fire Department paramedics are administering vaccines to homebound seniors in Miami Beach, Fla., and in Chicago. A visiting nurse service vaccinates older adults located through the Meals on Wheels program in East St. Louis, Ill. Several health systems, like Geisinger Health in Pennsylvania and Boston Medical Center, have identified hundreds of homebound Americans and sent vaccines to them. In Minnesota, nonprofits have started pop-up vaccination clinics at senior apartment buildings and adult day care centers.

New York City announced that it was expanding efforts to go door to door vaccinating homebound seniors, with plans to reach at least 23,000 residents. The visiting doctors program at Mount Sinai in New York, which cares for 1,200 homebound residents, has vaccinated 185 patients and has been given the greenlight to vaccinate the seniors’ caregivers as well, according to Dr. Linda DeCherrie, the clinical director of the Mount Sinai at Home program.

Northwell’s house calls program, which cares for patients in Queens, Manhattan and Long Island, plans to vaccinate 100 patients a week over the next 10 weeks, a timetable that could be accelerated if nurses are allowed to carry rescue medications in case patients develop adverse reactions like anaphylactic shock.

When public health officials drew up plans for distributing vaccines, priority was given to the roughly five million residents and employees of congregate settings like nursing homes, where the coronavirus spread like wildfire during the early days of the pandemic. The virus killed at least 172,000 residents and employees, accounting for about one-third of all Covid-19 deaths in the United States.

A vast majority of Americans over 65, however, do not live in nursing homes or assisted living facilities, but in the community, where it’s more challenging to reach them. There is no central registry of the homebound elderly. Geographically dispersed and isolated, they are often difficult to find.

While Dr. Abrashkin was administering vaccines on Long Island last week, Dr. Konstantinos Deligiannidis, a colleague, was vaccinating five elderly women in the Brentwood, N.Y., area over the course of four hours.

“They were so relieved,” he said. “They had all been worried — how could they get the vaccine since they couldn’t get out of the house?”

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