Vaccinations to expand for jailed, unhoused people
Expansion occurs alongside various Bay Area efforts to ramp up access to shots in jails, encampments, homeless shelters
People who are in county jails or unhoused in the Bay Area will be getting more access to COVID-19 vaccines in the coming days and weeks as public health officials answer longawaited calls to protect two populations they recognize have profound disadvantages in following physical distancing and hygiene directives.
That stands to become most evident in Santa Clara County, which starting Sunday plans to make vaccines available to its entire jailed population and unhoused people staying in encampments or shelters in the South Bay.
Currently, residents who are unhoused or incarcerated and fit one of the existing criteria for vaccination — being 65 or older or being deemed significantly medically vulnerable — have been eligible to receive vaccines. Alameda, San Francisco and San Mateo counties have started vaccinating those groups within their jails.
Santa Clara County, however, is going beyond that, moving into phase 1B, tier 2 of the state’s vaccination priority framework, which offers broad vaccine eligibility to incarcerated and unhoused people, as supplies allow. Santa Clara County jails have experienced a series of outbreaks dating back to December and that surged at the start of the year.
“Given the heightened risk of transmission in congregate settings, the county will be offering COVID-19 vaccines to all individuals in custody at the county’s Jails,” the county said in a statement to this news organization. “Additionally, the county will be offering vaccines to unhoused individuals in encampments and congregate shelters for the unhoused over the age of 16 through the Valley Homeless Healthcare Program.”
HomeFirst CEO Andrea Urton said she has been waiting eagerly for her shelters to get access to the vaccine and was “thrilled” by the news that the county will begin vaccinating homeless residents. HomeFirst was hit with a virus outbreak in December that infected dozens of people staying at its Boccardo Reception Center in San Jose.
“Every day we’re knocking on wood that we’re avoiding yet another outbreak,” Urton said. “It could happen at any point in time.”
Valley Homeless Healthcare will focus on the county’s largest shelters first, including Boccardo, South Hall in San Jose, Sunnyvale Shelter and Gilroy Armory, with the intent to offer vaccines to all eligible homeless residents as soon as possible, according to spokeswoman Joy Alexiou.
Public Defender Molly O’Neal, who with her rankand-file attorneys successfully pushed the county for vaccine prioritization given they represent the majority of jailed and unhoused people charged in criminal court, called the county’s announcement “a bold move that is equitable and will make the entire community safer.”
“These two very vulnerable populations live in environments that make exposure to the virus more likely and avoidance nearly impossible,” O’Neal said Wednesday. “This will also improve courthouse safety so that all incarcerated clients who have a court date are healthy enough to be transported, and counsel for those same folks can freely and safely communicate in close proximity to each other.”
Contra Costa County has gotten to a similar vaccination stage in its jails. Health department spokesperson Karl Fischer said many inmates got vaccines in response to a December jail outbreak, with the county exercising discretionary powers to “temporarily adjust prioritization in certain situations.”
He added that the county has “continued vaccinating our detention population as residents of high-risk congregate residential facilities,” after health officials used their latitude to classify jails similarly to nursing homes and long-term care facilities. But Contra Costa has not yet broadened its vaccine offerings to unhoused people beyond those who already qualify because of their age or medical status.
It should be noted that Contra Costa County has an average daily jail census of less than 800, about one
third of Santa Clara and Alameda counties, where jail populations have moved steadily upward after pandemic-driven amnesty and early-release initiatives and $0 bail policies ordered by the state judiciary sharply decreased those totals last year.
Alameda County saw its daily jail population drop from about 2,600 to under 1,800, a 30% decrease, but it is now around 2,200. Santa Clara County took its jail census from about 3,200 to under 2,200, a 34% drop, but that had ticked above 2,300 as of Wednesday.
In that light, the vaccination urgency couldn’t be higher for advocates like Urton and O’Neal, who noted how often the incarcerated and unhoused populations often intersect, making their safety the community’s safety.
Urton said the majority of her clients are 55 and older, with multiple health issues caused or exacerbated by years of living on the street, and that some shelter guests, especially those suffering from mental health or addiction issues, don’t consistently keep their masks on or follow social distancing rules. She added that the county told her shelter workers will also be offered vaccines starting Sunday, and that HomeFirst has 200 unvaccinated shelter workers who will qualify.
Homeless shelters throughout the Bay Area are operating at reduced capacity because of the virus, worsening what already was an acute shortage of shelter beds. If residents are vaccinated, shelters may be able to open their doors to more people, said Dr. Margot Kushel, a UCSF professor of medicine at Zuckerberg San Francisco General Hospital and director of the UCSF Center for Vulnerable Populations.
“It’s a little bit a of a headscratcher to me that California is not prioritizing vulnerable populations living in congregate settings, including people living in shelters, people in (singleroom occupancy hotels) that share bathrooms, people in jails and prisons,” Kushel said. “It is a head-scratcher to me that we’re not putting those populations front and center in our efforts.”