National Coalition for the Homeless Statement on Vaccinating People who are Unhoused

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Dr. Anthony Fauci, the director of National Institute of Allergy and Infectious Diseases appeared on Meet the Press on Sunday February 28, 2021, to discuss the third vaccine approved for emergency use against the spread of the COVID-19. He provided the grim reality of this highly infectious and dangerously adaptable virus, and he urged Americans to take whichever vaccine becomes available to them when they become eligible.

The National Coalition for the Homeless supports experts like Dr. Fauci and the health care professionals at the National Healthcare for the Homeless Council (NHCHC) who are recommending that all those experiencing homelessness and those serving homeless people take whichever vaccine is available as soon as possible. COVID-19 has decimated fragile populations in the United States especially members of minority populations such as African Americans, Latinx, and Native Americans.  Any level of protection against this killer is going to be essential to protect the homeless community. 

NCH Executive Director, Donald Whitehead, receiving his first COVID vaccine dose.

To that end most of our staff are people with previous experience with homelessness, many either have been, or are in line to be immunized against the coronavirus. We trust the scientists and hundreds of thousands of hours of research, oversight and testing that went into developing these vaccines. It is not worth the risk waiting for the one shot from Johnson and Johnson. We urge our friends who we serve every single day to get the first shot offered. We implore that all those working in the shelters and social service networks in the United States seek out the first vaccine available to them. We need everyone to get the vaccine as soon as possible so that we can return to finding solutions to all the other barriers facing the population.  We need you to be healthy and capable of receiving that key to the front door of a brand new apartment when it is ready for you.  

In the words of our friends at the National Healthcare for the Homeless Council (NHCHC), experts who have the trust of the homeless community,

COVID-19 vaccines are an essential part of ending this pandemic, but there are many challenges to ensuring successful and equitable vaccination campaigns. A number of key factors will influence the success of these campaigns for people experiencing homelessness and the providers who serve them. Health centers and homeless service providers should be taking action steps now to create an intentional operations plan, an effective communication and engagement strategy, and broad community partnerships to ensure COVID-19 vaccines are available to everyone.

Click here for more information from the NHCHC. There is an easy to use dashboard and local resources available to local doctors and health care professionals.

Please do your part to keep our community safe: get the vaccine as soon as you can!

As we enter (hopefully) the final phase of the COVID pandemic with vaccinations, it is unclear in many states if there is a plan to inoculate every resident of the state facing a housing emergency. 

California has the nation’s largest homeless population and has yet to clearly define their plan to distribute the vaccine to the hundreds of thousand people experiencing homelessness, or frontline homeless services workers. The is not just an issue of reaching folks who are homeless. The narrow Federal definition of homelessness prevents many from being clearly defined as vulnerable.

The National Coalition for the Homeless is asking the California Department of Public Health to prioritize vaccinations for all those without a stable place to live, those living outside or in a shelter, and those who work in service to these folks.

While the statewide plan issued by the Department of Public Health makes some mention of homelessness, direction on how to vaccinate all people who do not have permanent housing is vague. There are huge numbers of people sleeping outside in California and no real plan to reach this difficult to serve population. In addition, it is unclear if those who were recently relocated into housing meet the definition of homeless. We are asking for California officials to provide a clear plan that local communities can implement that takes into account the diverse needs of all of those experiencing homelessness.  

Very few states, in fact, have published comprehensive plans to get COVID vaccines to the entire population of people who are unhoused.  We are urging our advocacy network throughout the United States to reach out to their state health departments to ask if there are detailed plans to vaccinate homeless people. We hope that the media begin to ask these questions as well.  We would ask that these plans be published on the state health department websites so that they can be implemented on the local level.  

The National Coalition for the Homeless is hearing mixed messages from social service providers and there is a great deal of confusion in the field about the vaccination program and how homeless people fit into the plans. Now, as the country prepares to vaccinate the population, in most states there is no sign yet that homeless people, those who serve homeless people, are a priority to access to the vaccine. 

TAKE ACTION

For those in California: Contact Dr. Tomás Aragón, the State Director of Public Health, at 516-553-1784. Tag @CApublicHealth in a tweet with the hashtag #VaccinateHomeless, or drop them a note on Facebook @capublichealth. “Please clarify when all homeless people, homeless and hunger social service providers (including those serving homeless people in permanent housing programs), throughout the state will be vaccinated.”

For those outside of California, please contact your state health department with a similar message to be made public.  

Sean Cononie of COSAC Foundation and the Homeless Voice newspaper wants communities throughout the United States to not forget about people experiencing homelessness in the face of the COVID-related tragedy around us. He is especially concerned that there is no strategy for the distribution of vaccinations within the homeless community among community leaders.

The population of people experiencing homelessness is diverse and may need different strategies to best serve their individual needs. For example, two dose vaccines pose a challenge for people who live unsheltered on the streets in cars or encampments, as they often are forced to move and therefore cannot always be found by outreach workers, and therefore might never receive the second dose of the Moderna or Pfizer vaccines. Cononie is encouraging communities to wait a couple of weeks and use the new Johnson & Johnson vaccine when it is approved for use. The Johnson & Johnson vaccine will be administered in just one dose, plus, it is easier to transport to those on the streets, and does not require the extreme cold storage that the other two vaccines require.  (Please note, NCH encourages all to access whatever vaccine is available to them.)

Picture of Sean Cononie
Sean Cononie

Cononie has worked on the streets for decades in South Florida and currently travels the streets of Broward County assisting those largely forgotten by the rest of society.  He has set up a firehouse model of emergency responders who go out on the street around the clock to provide personal protective gear, masks, water, and COVID tests. He can help house individuals if they are interested and can work to quarantine individuals who are recovering. 

Unfortunately, Cononie, a board member of the National Coalition for the Homeless, reports that the response in South Florida to the pandemic has been scatter shot at best.  He has seen mistreatment of those experiencing homelessness at some of the local hospital emergency rooms, and Cononie said some of the hospitals have given up on serving homeless people altogether.  Many people who are homeless report that hospitals will just give them a blanket, some food and then send them on their way saying, “Come back if it gets worse.”

Some cities have been successful in housing vulnerable and quarantined unhoused folks in hotel rooms, or other temporary housing. Cononie believes that his local health care system needs to find safe accommodation for those without housing to recuperate even if their symptoms are mild.  The risk of them passing the virus to a large number of people at meal programs or shelters is significant and has deadly consequences for the fragile population served by the homeless continuum.

In South Florida, as in many communities, systems have either forgotten the population or have set up bureaucracies that make it impossible for those without an address to participate in programs that would keep them safe. The religious community has stepped up to help with meals and other basics, but the need is continually increasing as the pandemic has worn on. Broward County has a relatively high unemployment rate of 7.3%, and 14.6% of the Southern Florida population do not have health insurance, both of which can lead to increases in homelessness. Cononie is committed to bringing resources to people often forgotten to get them through this global health crisis.

As states roll out vaccinations, we encourage public health officials to make vaccinating people experiencing homelessness and homeless service front-line workers a top priority. Click here to view current state vaccination priority lists. 

Here are some specifics from the Centers on Disease Control & Prevention (CDC) on the COVID-19 vaccines in the U.S.: 

  • There are two COVID-19 vaccines currently authorized and recommended for use in the United States, and three other vaccines are currently in large-scale clinical trials. To learn more about the different vaccines for COVID-19 and how vaccines work, visit: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html
  • COVID-19 mRNA vaccines teach our cells how to make a piece of a protein to trigger an immune response and build immunity to the virus that causes COVID-19. mRNA does not affect or interact with a person’s DNA, and the cell breaks down and gets rid of the mRNA as soon as it is finished using these instructions.Learn about mRNA vaccines and how they work: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html
  • None of the COVID-19 vaccines currently authorized for use in the United States uses the live virus that causes COVID-19. You may have symptoms like a fever after you get a vaccine. This is normal and a sign that your immune system is learning how to recognize and fight the virus that causes COVID-19. Learn more about the facts behind COVID-19 vaccines: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html
  • How many people need to get a COVID- 19 vaccine for herd immunity?Herd immunity means that enough people in a community are protected from getting a disease because they’ve already had the disease or they’ve been vaccinated. Herd immunity makes it hard for the disease to spread from person to person, and it even protects those who cannot be vaccinated, like newborns. While experts don’t yet know what percentage of people would need to get vaccinated to achieve herd immunity, vaccination is a safer way to build protection than getting sick with COVID-19.Have a question about COVID-19 vaccines? See answers to our most frequently asked questions:  https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html

If your community or organization is in need of face masks for the personal protection of people experiencing homelessness from COVID, please contact us at info @ nationalhomeless.org to request free shipments of between 100-5,000 masks. 

Updated 3/10/2020

With any public health or natural disaster emergency, those who are unhoused are often more at risk for poor health outcomes or other trauma. We understand that spread of communicable disease is much easier without adequate access to hygiene facilities or a safe home, so we wanted to share a few resources for those experiencing homelessness or service providers. 

The current outbreak of the novel corona virus that started in China spreads much the same way as the flu, through person to person contact, especially through droplets in the air produced when an infected person coughs or sneezes. Symptoms can include: fever, cough and shortness of breath.

The Centers for Disease Control (CDC) believes at this time that symptoms of COVID-19 may appear in as few as 2 days or as long as 14 days after exposure. Most infections in healthy children and adults are mild, the greatest danger is with those who have health conditions that limit the capacity of one’s immune system.

While there are no confirmed cases of COVID-19 infection in someone experiencing homelessness in the U.S., we are concerned that people who already lack ready access to hygiene facilities, a safe home and in many cases, adequate health care, will be especially vulnerable to complications from the spread of the virus. To prevent spread of the virus, the CDC recommends washing your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty. 

But what if you don’t have anywhere to wash your hands, or a home to stay away from crowds?
 Read: What if you can’t stay home?

Our recommendations:

  • More broadly realize that everyone who may be experiencing homelessness would not be in as great a risk of poor health outcomes, or spread of COVID-19, if they had access to safe, decent, affordable and accessible housing. We still have a lot of work to do to address the underlying income inequality and lack of low-cost housing that has perpetuated homelessness for decades.
  • Ensure that national, state and community-level public health/pandemic planning and response includes the homeless population and homeless service agencies.
  • Cities should provide hygiene facilities (port-a-potties, hand-washing stations) and trash pickup for residents of encampments – during and after any pandemic has passed.
  • There should be a moratorium on encampment sweeps that displace already displaced households and that often cause the loss of personal property that includes medication and other life-sustaining items.
  • All tests, treatment and quarantine locations should be offered without cost for all members of the community – housed or not, with or without health insurance.
  • Each community should identify space that those who do not have a permanent home can access in case of quarantine. Any costs should come out of community-level public health resources.
  • Federally, we would discourage homeless dollars being used to provide quarantine, testing or treatment. Homeless services are already woefully underfunded, and widespread homelessness was ALREADY a public health emergency!
  • Finally, we are concerned for the safety of unhoused folks who may be discharged from medical care to make room for COVID-19 treatment. This has happened in other emergency settings.  

If you are:

  • Experiencing symptoms? Please go to your nearest hospital or healthcare facility. Click here to find your closes Healthcare for the Homeless clinic. 
  • A service agency administering to vulnerable folks? Click here for CDC Posters to post in public areas about the spread of COVID-19, and see the additional resources below. 
  • An outreach worker or concerned citizen, consider stocking up on bottles of hand sanitizer or wipes to hand out to folks staying in encampments or other outdoor locations. 

Resources: