Feeling left behind
State works to ensure homebound seniors get vaccinated
When Gov. Ralph Northam issued an order telling people to stay home during the coronavirus pandemic, Tom Miller’s in-laws, in their late 70s, already were.
His mother-in-law is unable to leave her Yorktown home without medical transport, and his fatherin-law usually only goes out to get groceries.
The couple are now eager to get a vaccine protecting them against the virus. But they’re part of an overlooked corner of the community that isn’t mobile enough to go out and get shots; they need the vaccine to come to them. While new vaccine clinics pop up every week, the homebound feel left behind, family members say.
“What is the plan for these folks?” Miller said. “It would’ve been nice (for officials) to say, ‘we haven’t forgotten about them.’ ”
At least 2 million Americans are homebound, many suffering from multiple chronic conditions that can leave them particularly vulnerable to the coronavirus, the New York Times reported.
According to a University of Virginia report, nearly a quarter of the state’s older homebound adults also live in harder-to-reach rural areas.
So what are the options in Hampton Roads? The answer, so far, is not much. But officials are working on it.
The Johnson & Johnson vaccine, which requires only one shot and can be stored at regular temperatures, is ideal for vaccinating the homebound population. But there is less of it than the other two in Virginia — and a recent factory mixup is delaying shipments.
Officials at the state and local level also have been working to get proper permissions to go into people’s homes during a pandemic.
The Virginia Department of Health is working to identify the homebound population in need of a coronavirus vaccine, spokesperson Logan Anderson said in an email last week. Included in the effort is the state’s Department of Medical Assistance Services, which administers Medicaid. Officials have also reached out to Meals on Wheels affiliates and local community service boards to find people.
“These individuals are, for the most part, unable to get to a Community Vaccination Center or a vaccination event staged by their local health districts,” Anderson wrote.
It then falls to local health departments to get the vaccines to those identified. Virginia Beach is planning to send Medical Reserve Corps volunteers to people’s homes.
But many health officials in Hampton Roads told The Virginian-Pilot their efforts have been hampered while waiting for the Johnson & Johnson vaccine.
The state’s supply of it will be dealt a blow this week. Instead of receiving an expected 125,000 doses, the state will get just 15,000. A mistake ruined millions of doses recently at a Baltimore factory.
“Right now, VDH’s visibility beyond next week on J&J is limited,” Anderson said.
Sentara Healthcare is developing plans to vaccinate people who are homebound or in hospitals through its home health services, said spokesperson Kelly Kennedy. But they’re planning to use the J&J vaccine, which the health system hasn’t yet received.
Irene Ferrainolo, with the Hampton and Peninsula health districts, said officials there just received some J&J doses and are trying to get their homebound vaccination plans off the ground. They’ve been coordinating with Meals on Wheels to replicate existing routes the organization uses.
The J&J vaccine poses its own challenge aside from the supply issue, Ferrainolo added. At room temperature, once you open a vial, which contains five doses, it is only active for two hours — leaving “not a lot of travel time in between” shots.
Her districts plan to use an EMT as the vaccinator, with a public health nurse along to monitor a cooler storing the vaccine.
There are about 100 people on the Peninsula on their list so far.
“It’s almost always a family member calling on behalf of an older parent or neighbor that they’re concerned about,” she said. “This is a problem that’s been nagging us and I know is important to the community.”
The Chesapeake Health Department has a group working on a homebound vaccine program, but logistics of managing the vaccine and post-vaccination observation make it difficult, said director Dr. Nancy Welch.
“So in the interest of a more expeditious response we are looking at how we can, in essence, create herd immunity, or a safe surroundings, in the home environment of the homebound individual,” Welch said in an email, referring to getting caregivers and family members in the home vaccinated. “If we can keep the virus from going into the home then we are protecting the homebound.”
For seniors who mostly stay at home but can leave with assistance, there are organizations that can help.
Senior Services of Southeastern Virginia started offering transportation to vaccine and routine medical appointments in early March, said transportation director Tabitha Smith.
The requests have poured in such that the nonprofit organization has to refer many people elsewhere, such as Black and White Cabs, Hampton Roads paratransit and Uber Health.
“Across Hampton Roads, what we have identified is transportation is a barrier to people getting the vaccine,” Smith said.
“That’s our number one call right now.”
Most seniors taking the service can board on their own while about a third are in wheelchairs, Smith said.
“Seniors are a very vulnerable population,” she said. “We feel like it’s not only our job but the job of the community to take care of them. Be mindful that there are seniors that live in certain parts of the area that don’t get the socialization and the access to transportation that they deserve.”
Up in Yorktown, Miller said he’s feeling more comfortable now that his in-laws are on a list for when local officials start home vaccinations.
“I felt like, ‘I don’t know what to do. They want to get the vaccine but don’t know how,’ ” Miller said. “I think they’d be willing to take whatever is offered.”