We Need To Start Bringing The COVID Vaccine Directly To People’s Homes

If you’re anything like me, you’ve likely been impatiently waiting your turn to get the COVID-19 vaccine now that it’s available. I admit to being somewhat clueless to the process because where I live, I’m nowhere near the top of the line — which is a fine. I don’t really go anywhere anyway, and I know essential workers and high risk people should get priority.

However, while my mild case of asthma doesn’t qualify me for a vaccine at the moment, there are many folks who do not have access to the coronavirus vaccine despite being qualified. Millions of the elderly, low income families, and disabled folks who do not have their own transportation, do not have access to public transportation, or are physically unable to leave their homes — they need the vaccine more than ever.

Denny Chan, senior staff attorney at Justice in Aging, a national legal organization advocating for low-income seniors, told the Pew Charitable Trusts that many seniors and low-income folks may not have friends or family who can drive them to vaccination sites. In some cases, they live in rural locations too far from vaccination sites.

Whatever the reason, it’s time for door-to-door vaccinations.

Lack of federal support

For some reason, I had assumed that once the vaccines were available, it would be a relatively easy task to vaccinate the over 330 million people in the U.S. This is why they don’t put me in charge of planning things, I guess. It’s been a mess due to a multitude of reasons such as our country’s hodgepodge pastiche of a healthcare system, severely underfunded public health systems, and — no surprises here — no federal government plan for vaccine rollout under former President Trump.

President Joe Biden’s Chief of Staff Ron Klain told NBC News, “The process to distribute the vaccine, particularly outside of nursing homes and hospitals out into the community as a whole, did not really exist when we came into the White House.”

As a result, state and local governments have largely been left holding the bag. Though Biden has recently signed many executive orders regarding COVID relief and vaccine dispensation involving billions of federal dollars and a model involving 10,000 active-duty troops as well as additional members of the National Guard, however it will still require time to implement.

Unfortunately, state and local governments are not only experiencing high demand and low supply for vaccines, they’re also overwhelmed responding to the coronavirus and the budgetary shortfalls the pandemic has caused.

As a member of the California Community Vaccine Advisory Committee, Chan also advises state officials on methods of equitable vaccine disbursement. “We have, unfortunately, not spent as much time talking about how we are actually going to get the vaccine to people,” Chan said. “You’re creating a situation where you’re building the plane while you’re trying to fly it.”

Why door-to-door vaccinations?

It’s pretty obvious why we need to get as many people vaccinated with the COVID-19 vaccine as quickly as possible. According to certain models, to reach temporary herd immunity in the general population with some social distancing measures, we will need to be at a 55% vaccination rate. For zero social distancing measures, the vaccine will need to reach approximately 67% of the population. Others, like Dr. Fauci, estimate that reaching herd immunity will require 70-90% of Americans to be vaccinated.

While many folks have been trying to grab a coveted vaccination appointment online, queuing up in long lines for vaccines, or on the waitlist for unused vaccine doses, many people do not have the privilege to do so. There are millions of people such as disabled folks, low-income neighborhoods, and seniors who even if they could snag an appointment somehow, would not be able to make it.

Homebound adults

Approximately 2 million adults 65 and older are unable to leave their home while an additional 5 million people either need assistance leaving their residence or cannot do so easily. Unfortunately, these folks constitute what is often an “invisible” segment of our society. Many counties have started mobile units to treat seniors and disabled adults who cannot easily leave their homes.

Low-income neighborhoods

Another major issue is that low-income communities of color are disproportionately affected by COVID-19. Not only are vaccines distribution sites more concentrated in wealthier neighborhoods, higher income folks are lining up in poorer neighborhoods to get the vaccine. Beyond that, many cities have decreased their public transit operations — limiting the mobility for residents who do not have access to a car.

Private ride-sharing services like Uber and Lyft have offered free or discounted rides to low-income communities of color, but that is a bandaid at best and not a tenable, long-term solution.

Rural communities

As for rural communities, some residents often live very far away from vaccination sites. Despite big chain stores and pharmacies being available, they often don’t exist in rural areas. Mobile units in combination with partnering with the smaller, local pharmacies, will be key to providing access in the harder to reach areas of the country.

We need to make it a lot easier for folks to get vaccinated — and right now, it is very difficult. However, some cities and counties are now starting to implement door-to-door

In cities like Boston and New York, there are specialized healthcare workers administering COVID-19 vaccines at home for homebound patients. Unfortunately, because many homebound people don’t have ready access to medical care, it’s often difficult to identify which patients need the vaccine.

It’s currently a complicated process because both the Pfizer and Moderna vaccines require special storage temperatures to remain effective, and adding a mobile aspect to the process makes it more difficult. Experts are hoping the new Johnson and Johnson vaccine will make mobile distribution easier because it doesn’t have as stringent storage guidelines.

Also, vaccines expire within hours of being drawn into syringes for administering. In addition, healthcare workers need to stay and observe patients for 15 minutes in case there is an allergic reaction. Between the waiting period, commute times, and the looming expiration of the vaccines, many doctors will try to cluster appointments within the same general neighborhood or geographic area.

If we’re not in these situations ourselves, we tend to think of getting the vaccine as a cut-and-dried scenario: you offer up your arm, you get the jab (or two), you’re officially vaccinated. But for folks who have trouble gaining access even if they’re eligible, it isn’t that easy, and we need to remove all the roadblocks that we can.