Richard Dilworth works with people experiencing homelessness on a daily basis. This week, he received his first dose of the COVID-19 vaccine at a pop-up clinic hosted by the Volunteers of America Durango Community Shelter.
“It’s scary when you don’t know when, how, what contact, who is going to end up with it,” Dilworth said. “I’m very thankful that VOA offered up a place to do this, and they did a very professional job.”
Whether it’s through pop-up clinics or regular outreach, La Plata County service providers are finding ways to help people experiencing homelessness access COVID-19 vaccines.
Vaccinating the group is complicated. The state does not prioritize people based on their housing situation; rather, people become eligible based on other criteria, such as age and pre-existing conditions. The effort also involves myriad community partners, navigating barriers to accessing the vaccine and expanding the number of vaccine providers , according to San Juan Basin Public Health.
Some of that work has already started, like the VOA clinic.
“This is a great way to bring more vaccine to the region and to vaccinate high-risk, eligible people,” said Brian Devine with SJBPH.
The clinic was run by the state but hosted locally. It doesn’t use the region’s standard vaccine allocation, but draws from additional supplies, Devine said.
In addition to people staying at the shelter, first-round vaccines were administered to eligible VOA employees and about 45 staff members of partner nonprofits and agencies that also provide services to homeless and other vulnerable populations in the area, said Rachel Bauske Frasure, VOA senior director for Southwest Colorado.
Staff members who work with the homeless population will be able to receive vaccinations through the region’s standard allocations in Phase 1B.3, which could open as soon as March 5. The phase includes about 1.15 million Colorado residents, or about a quarter of Colorado’s adult population, SJBPH said.
“Because we live in a smaller community, and it’s a smaller population than something like Denver, we’ve been chipping away at it one individual at a time as people have become eligible,” said Liane Jollon, SJBPH executive director. “The concern is when we move to 1B.3 it’s going to take a much larger coordinated effort.”
Some enrolled providers already have a history of serving vulnerable populations, like La Plata Integrated Healthcare, part of Axis Health System. The health center is prioritizing its own client list, which includes people with insecure housing.
“If they know which of their own clients are eligible today, we can work with them to make sure they get appointments,” Devine said.
One concern is that people with insecure housing often have less access to transportation, the internet and phone service. But community partners will be able to arrange transportation or mobile clinics as needed, Jollon said.
The most effective way to get information to the homeless community is by posting written notifications at camps or around Durango, Dilworth said.
SJBPH provides vaccine eligibility information while doing weekly COVID-19 testing at the temporary homeless camp on La Posta Road (County Road 213) near Purple Cliffs, south of downtown Durango. The health department has been operating an Equity in Emergency Preparedness Program for years to help communicate information to vulnerable populations.
“These are all the things that are in place, and when the time comes, we will mobilize all of those things,” Jollon said. “It’s a shotgun approach.”
Vaccination priority changedWhile staff members have a specific designation, the state’s phased vaccination plan does not include a housing-based classification for homeless people.
Many people without secure housing have underlying medical conditions that can make them more vulnerable to severe cases of COVID-19. They also might live in congregate settings, like shelters or camps, where it is hard to maintain social distancing, according to the Centers for Disease Control and Prevention.
The county’s designated homeless camp at Purple Cliffs has seen low levels of coronavirus transmission for most of the pandemic, but an outbreak started Jan. 5. As of Wednesday, five cases were associated with the outbreak.
Beverly Moody, 69, who lives at Purple Cliffs, already had COVID-19 in January. She’s not sure if she will get the vaccine.
“I’m going to wait 90 days and get the antibody test,” she said, expecting to take the test in mid-April. If she has immunity, she said she won’t get the vaccine. If not, she’s not sure. She is hesitant because of her age and chronic obstructive pulmonary disease.
“I’d have to talk to a physician,” said Moody. “I’d recommend the vaccine though.”
Initial drafts of the state’s vaccination timeline included the homeless population in Phase 2. But in early December, the state removed the housing-based classification, according to news reports.
Denver, which has seen increased homelessness since the beginning of the pandemic, has objected to the distribution phases. Twice, the city has (unsuccessfully) pushed for the ability to deviate from the phases to better protect communities of color and the homeless.
“The state’s prioritization is guidance to our providers on how to manage our constrained supply of vaccines with demand in order to save the most lives possible and end the pandemic as quickly as possible,” said a spokesperson for the Colorado Emergency Operations Center in an email to The Durango Herald. The center declined to share the spokesperson’s name.
“People experiencing homelessness are eligible to get the vaccine according to the existing phases,” the spokesperson said.
There are consequences for going outside of the phases, including losing eligibility to distribute vaccines, Jollon said.
SJBPH is focused on coordinating resources and expanding the provider network to prepare for the next vaccination phase. Once that larger network is up and running, SJBPH can help communities access vaccines, Jollon said.
“Sometimes, that’s going to be arranging transportation. Sometimes, it’s going to be calling people one at a time on a landline. Sometimes, that may look like bringing a mobile van out to a place where people are camping,” Jollon said. “All of this is happening. But that’s what our role is, it’s not to change the phases.”
firstname.lastname@example.orgThis story was updated to correct the name of La Plata Integrated Healthcare.