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NACHC Vaccine Presentation at P&I
How are you reaching homeless populations with your vaccines?
The Colorado Coalition for the Homeless (Coalition) has done a great job working to vaccinate homeless. People experiencing homelessness are often difficult to locate, but the Coalition finds that seniors in this group are even more isolated and hidden.
The Coalition’s multi-point strategy consists of:
- twice-weekly COVID-19 vaccination clinics at their Stout Street Health Center where they administer up to 100 doses per day
- vaccination administration during regularly scheduled patient visits
- a mobile vaccination team who goes out to residential sites or where the Coalition provides housing and support services to vaccinate clients in their homes or temporary housing sites
- running medical clinics in lobbies of Denver’s six hotels that serve as a protected active site for members of Denver’s homeless community. These sites serve as a safe housing alternative for the city’s homeless community in an effort to reduce COVID-19 transmissions.
Outreach by nurses searched for the chronically ill and those who had not been seen in the center for 18 months. COVID-19 testing in the clinic portion of hotels set up as shelter sites allowed vaccine education and access to interface with that existing service. No transportation was required, other than leaving one’s hotel room. The vaccination team made appointments for immunization delivery. They kept a waiting list in case of no shows. More than that—they went and knocked on clients’ room doors if they thought the person might be hesitant to come down to the clinic! Their efforts resulted in over 50% of their clients agreeing to receive vaccine, a great success for a first time vaccine to a traditionally under immunized population. Not a single dose of vaccine has been wasted. The Colorado Coalition for the Homeless daily exemplifies its mission to promote health through access to housing as well as medical care, modeling a comprehensive understanding of equity that prizes personal connection, active listening, and persistent collaboration.
Do you have any strategies geared to address vaccine hesitancy amongst the African American community, one who may be especially hesitant due to the Tuskegee experiment which was carried out by our own federal government?
One of the ways to address vaccine hesitancy American African including concerns related to the Tuskegee experiment is to consider partnering with a local community organization who is well known, trusted and respected among the African American community you are serving. Together with them, you can take a very grassroots "boots to the ground" approach to educating the community about the vaccine, how it works, the research behind it, its safety and benefits. We recently spoke with Appalachian Mountain Community Health Center (AMCHC) a community health center in Asheville, NC and this was the approach they recently took to speak with members living in one particular African American neighborhood in Asheville. They learned that people just needed someone they trusted to talk to and with them and answer their questions. With their partner, they went "boots to ground" by knocking on doors and making phone calls. This approach was very successfully and resulted in getting 300 people registered for a recent vaccine clinic and more on a waiting list. They also had volunteers from their partnering organization onsite at the vaccine clinic which reassured people in the community.
The CDC and its partners the Ad Council and COVID Collaborative have recently released COVID communications toolkit with audience research and vaccine message guidance specifically for African Americans. You can find the toolkit here: https://blackcommunityvaccinetoolkit.org/messaging.
How are you framing messaging when offering J&J to vulnerable populations (due to concerns of lower efficacy)?
We are framing the messaging to highlight the facts- the Johnson & Johnson vaccine is effective against COVID-19. All of the current COVID-19 vaccines are safe and prevent severe COVID-19 illness, hospitalization and death. The Johnson & Johnson COVID-19 vaccine was developed using the same process as some of their other vaccines. The Johnson & Johnson vaccine is FDA authorized and is recommended by the CDC for use in people 18 and older. The right vaccine to take is the vaccine that is available to you.
How does reimbursement for the COVID-19 vaccine work?
COVID-19 vaccine is provided at 100% no cost to the vaccine recipient. COVID-19 vaccination providers cannot charge vaccine recipients for the vaccine (which is provided free by the U.S. government to enrolled providers) or charge recipients any administration fees, copays, or co-insurance. COVID-19 vaccination providers cannot deny vaccination to anyone who does not have health coverage, is underinsured, or is out of network. If a vaccine recipient has health coverage, providers may seek appropriate reimbursement from the recipient’s plan or program (e.g., private health insurance, Medicare, Medicaid) for a vaccine administration fee. However, providers cannot balance bill the recipient. Providers may also seek reimbursement for uninsured vaccine recipients from the Health Resources and Services Administration’s COVID-19 Uninsured Program. COVID-19 vaccination providers cannot charge an office visit or other fee to the recipient if the only service provided is a COVID-19 vaccination. Additional healthcare services can be provided at the same time and billed as appropriate. However, providers cannot require additional services in order for a person to receive a COVID-19 vaccine.
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