Will Bay Area homeless shelters be a priority?

Homeless community should be near top of list, advocates say

The COVID-19 vaccine is finally here, raising questions about who will get access, and when.

The COVID-19 vaccine is finally here, raising questions about who will get access, and when. People who work with some of the Bay Area’s most vulnerable residents — those with nowhere to call home — are anxiously wondering when it will be their clients’ turn.

As the latest coronavirus surge continues and the South Bay reels from a recent outbreak at its largest homeless shelter, the boxes of deep-frozen vaccines arriving throughout the Bay Area are a spot of hope for those struggling to protect unhoused people from the virus.

The state expects to receive about 2 million vaccine doses by the end of the month, and the early doses already are spoken for — health care workers and nursing home residents get first dibs. After that, officials will have to make tough decisions about who is next in line for the potentially life-saving shots and where unhoused communities fall on the priority list.

Shelters are pressing for their staff to be inoculated, too.

Essential workers will be high on the list, but which workers will get priority? Is it more important to vaccinate staff at homeless shelters or people stocking grocery store shelves or farmworkers? Teachers unions already are lobbying for educators to get moved up on the list.

“Everybody has a different idea about what essential means,” said Dr. John Swartzberg, a clinical professor emeritus of infectious diseases and vaccinology at the UC Berkeley-UCSF Joint Medical Program. “So you’re going to see a lot of fights about that.”

At HomeFirst, which operates several shelters in Santa Clara County, the majority of clients are 55 and older, with multiple health issues.

“It’s really really important for those people to get the vaccine so they don’t die,” said HomeFirst CEO Andrea Urton.

Her staff members need the shots too, she said, so they don’t unknowingly spread the virus within the shelters.

Tom Myers, executive director of the Community Ser vices A gency, wants to make sure his workers — who distribute food to hundreds of people in Mountain View in a day — aren’t forgotten.

“W hen you hear people talking about essential workers,” he said, “you seldom hear nonprofit workers mentioned.”

It remains to be seen how nonprofits and marginalized communities, including unhoused people, will fare against groups backed by powerful unions and companies, Swartzberg said.

Bay Area health officials are waiting for guidance from the state.

In Santa Clara County, a committee of local stakeholders is meeting to discuss best practices for distributing the vaccine. Members include several organizations that work with unhoused residents, including Destination: Home and Life Moves.

In San Mateo County, health officers are just starting to discuss vaccines with local homeless services programs, said Dr. Anand Chabra, section chief of the county’s COVID vaccination effort.

“Residents in homeless shelters will receive COVID vaccination, but the timing and methods are still being worked out,” he said in an emailed statement.

Alameda County pointed to a framework from the National Academy of Medicine that recommends high-risk health workers be vaccinated first, older adults living in congregate or overcrowded settings next, followed by residents and staff at homeless shelters, prisons and jails.

An outbreak reported at a San Jose homeless shelter this month underscores the need for the vaccine. The virus spread to 55 people staying at HomeFirst’s Boccardo Reception Center, including four staff members, according to Urton. The county initially reported 60 cases, but Urton says that was an overestimate.

A f ter shutting dow n briefly and moving all residents into motels, the shelter is slowly reopening for medically cleared guests. The building that once held 250 people had been capped at 140 earlier in the pandemic. Now, Urton expects to have to cap occupancy at between 80 and 100, further reducing the county’s already inadequate number of shelter beds.

Even with precautions, congregate shelters aren’t safe without a vaccine, said Dr. Margot Kushel, UCSF professor of medicine at Zuckerberg San Francisco General Hospital and director of the UCSF Center for Vulnerable Populations.

“I would certainly hope that this population would be seen as a high-priority population,” she said.

When vaccines become available to the homeless community, Kushel expects people to line up. Her team recently surveyed unhoused people in Oakland and San Francisco and found they were more likely than the general population to want the vaccine.