How a Bay Area clinic is helping provide vaccines to people experiencing homelessness

Lifelong Medical Care goes directly to homeless encampments to administer Covid-19 vaccines.

Oakland (CNN)While some people nationwide have successfully booked their vaccine appointments online, many others -- including people who are experiencing homelessness -- are struggling to even get access to the booking sites.

That's why in Oakland and Berkeley, California, one clinic is working with local officials to bring Covid-19 vaccines directly to unhoused people.
"We've really seen Covid infiltrate ... this population that's so marginalized from society," said Dr. Jason Reinking, a street medicine doctor with Oakland's LifeLong Medical Care, which has partnered with Alameda County to provide health care and vaccines to those experiencing homelessness.
      Heshimu Courtney, who lives in a homeless encampment in Oakland, receives a vaccine dose from a LifeLong Medical Care nurse.
      "We flipped the medical paradigm on its head. We essentially bring care directly to people instead of waiting for people to come to care."
        LifeLong Medical Care originally administered Pfizer and Moderna vaccines, until Johnson and Johnson ones became available, according to Reinking. The clinic said it is now administering the one-dose J&J vaccine to unsheltered people in the community.
          The clinic has vans -- essentially health clinics on wheels -- that are equipped with all the necessary equipment, including refrigerators to keep the vaccines at the appropriate temperature.

          'Nice and simple' process

          Before the clinic began offering vaccines, it had also mastered administering tests to those who need it. Early in the pandemic, Reinking said clinic employees were asking, "how do we bring testing to these communities that live on the street?"
          "So entirely from spring through winter during the Covid pandemic, we were really working hard on doing Covid tests," he said, adding that they administered about 1,000 tests during that time.
          Dr. Jason Reinking educates homeless residents about the Covid-19 vaccines.
          The clinic has spent over six months visiting a West Oakland encampment to build relationships with people who live there and get to know them.
          Now, offering the one-dose vaccine has helped with getting some people who are more hesitant about vaccinations on board. Accepting the vaccine can be a big step for those experiencing homelessness, Reinking said.
          "The Covid vaccination effort is in some ways built on all that foundation of ... talking to people about Covid and being safe," he said.
          "It's one thing for just a general outreach worker to come out here who might know somebody and say, 'hey, I think you should get the Covid vaccine' and then bring a nurse out who may not know these folks and try to administer that. But the nice thing about what we do from a very specific medical perspective is that we built trust ... and then we have better rates of being able to actually vaccinate people on the street."
          Hesitation about getting the vaccine can be common -- but clinic staff members said they know how to approach it.
          "If someone tells me they're not interested, my goal is not to change their mind," Audrey Fisher, a LifeLong Medical Care Nurse, told CNN. "It's just to give them the information that is medically and scientifically sound so that they can make the best decision for their health."
          Heshimu Courtney, 49, who sleeps in an abandoned car, said he was initially reluctant about getting the vaccine.
          "I never took a flu shot," he told CNN. "This, I guess, is a must."
          Courtney said he changed his mind after speaking to the clinic staff, and learning about other homeless residents who got the vaccine.
          "I don't like needles," he said. "I thought it was going to hurt but it was easy. Nice and simple. It was worth going through ... I guess I'm part of history now."
          Posche Jones receives the Johnson and Johnson vaccine.
          Porsche Jones, 27, said she was also nervous about getting the vaccine. But Jones, who recently became homeless, told CNN, "I'm happy I did it. It was fast -- over really quick."
          Now, the mother of two said she feels good -- just her arm is sore.
          As of March 26, LifeLong Street Medicine Program and LifeLong Trust have vaccinated 511 patients so far, according to LifeLong spokesperson Helen Pettay. These patients are either unhoused or in some sort of transitional housing, she said.
          LifeLong Medical Care as a whole has vaccinated a total of 13, 905 patients so far.

          Cities, counties stepping up to help homeless people nationwide

          While there are no reliable statistics on how many homeless people have died after contracting Covid-19, a recent UCLA study found that across the country, those who did contract Covid-19 were 30% more likely to die than the general population.
          "People experiencing homelessness are more susceptible to getting Covid because they have less control over the ability to socially distance, or to wash their hands," Bobby Watts, CEO of the National Healthcare for the Homeless Council, told CNN.
          A homeless encampment in Oakland.
          The council is a network of more than 10,000 doctors, nurses, social workers, patients and advocates who share the mission to eliminate homelessness, according to its website. Its 200 organizational members include Health Care for the Homeless programs, respite programs and housing and social service organizations across the country.
          The pandemic hit the homeless population "really hard," Watts said.
          "We know that one people experiencing homelessness are more likely to get infected and because of underlying poor health and chronic health conditions, or more likely to have a more serious effects of being infected," he said. "And again, we don't have a lot of good data on the number of homeless people and homeless deaths, but where we do, we have seen that the increase is higher or that the death rate is higher among people who are experiencing homelessness."
          At least 29 states and Washington, DC, are now explicitly vaccinating the unsheltered (or all adults in general), according to the National Academy for State Health Policy.
          A homeless encampment in Oakland.
          Like Alameda County, however, other cities and counties have also been making their own decisions regarding vaccine eligibility.
            For instance, Philadelphia has been vaccinating its homeless -- even though Pennsylvania as a whole has not yet expanded its eligibility requirements to include that group as of yet.
            "Many states have discretion and they have really pushed people experiencing homelessness far down the chain," Watts said. "It's important that we give people experiencing homelessness equitable access to the vaccine because they are at high risk and we want to prevent premature death. We want to prevent suffering. And also from an epidemiological point of view, we don't want there to be reservoirs of disease existing in society. So that's why we have to go the extra mile to reach hard-to-reach populations."