Getting Shots in Arms

Working toward access, working against hesitancy

BY HANNAH HERNER

Nashville has set a lofty goal for vaccinating people experiencing homelessness against COVID-19. By Memorial Day, the city wants every single person living on the streets to have access to the COVID-19 vaccine.

Heading up the plan to achieve this goal is Brian Haile, CEO of Neighborhood Health, a series of medical clinics that offer care on a sliding scale in Nashville. In order to reach that ambitious goal, area homeless service providers are getting on the same page by educating their clients about the vaccine with shared fliers and messaging.

Perhaps the most controversial part of this plan is that Neighborhood Health’s stock of the Johnson & Johnson vaccine will be reserved just for people experiencing homelessness.

Haile says Neighborhood Health has received more calls than ever from more affluent areas of town, like Belle Meade and Green Hills, asking about the Johnson & Johnson vaccine. If housed people try to come and get it, they’ll be turned down, though the clinic does offer the Moderna two-dose vaccine for anyone who may want it.

“There are a lot of good reasons to prioritize [the Johnson & Johnson vaccine] for persons experiencing homelessness, just because it doesn’t require a return trip,” Haile says. “And so what we’ve decided to do is to take the limited stock of that vaccine we have and give people experiencing homelessness first dibs.”

When a severe ice storm hit Nashville in mid-February, health officials took extra doses of vaccine to give to residents of area shelters Room In The Inn and Nashville Rescue Mission. Until mid-March, all vaccines were appointment-based, and required a phone call or internet to set up — things that a lot of people experiencing homelessness don’t have.

Thanks to the more low-maintenance storage requirements of the Moderna and Johnson & Johnson vaccines, Neighborhood Health’s Downtown location near Room In The Inn began offering walk-up vaccinations.

Haile’s tagline is “the best vaccine is the one you can get today.” So he wants to encourage people to get it as soon as they can, no matter which one.

“The message here is, Fridays are your day,” Haile says. “Just come to the Downtown clinic, and we’ll get you vaccinated. Now, are there going to be other opportunities? Sure. But what we don’t want is people delaying vaccination, because they could get very sick with COVID between the time that they could have gotten vaccinated and the time they actually do. Speed is of the essence here.”

Neighborhood Health is also offering vaccine appointments at its various locations throughout the week. While those appointments are typically made and confirmed over the phone, if a person doesn’t have a phone, they can walk up and be given an appointment for a following day.

In April, Neighborhood Health will partner with Metro Public Health and St. Thomas Medical Group to take vaccines to the largest area encampments and hotspots where people experiencing homelessness get meals and other services.

Haile feels it’s important to empower those outside of the medical field to share information about vaccines. Allergies should be discussed, but beyond that, the answers are pretty black and white, he says.

“This is not a clinical moment. This is a human moment. So there’s not that much specialized medical information that anybody needs to have in order to know whether the vaccine is right for them,” Haile says. “The answer is, yes. If you’re an adult and your heart’s beating, the vaccine is right for you.”

Even with a simple message like this, processing the hesitations of people experiencing homelessness will be no simple task for an outreach worker like India Pungarcher with Open Table Nashville.

“Our friends on the streets, they are facing disease and death literally every day,” Pungarcher says. “So they kind of perceive it as it’s either not a threat to them, or they have bigger things to worry about. They just have hesitancy, they don’t trust the vaccine. And they’ve been fine without it so far, and they don’t want to take the risk.”

Ahead of the vaccine outreach, Open Table is organizing for medical professionals to visit encampments so residents can ask questions, and providing aspirin for any aches and pains following the vaccination. Plus, they’ll be distributing Neighborhood Health fliers that answer frequent questions.

Haile urges that the best way to start a conversation about the vaccine is, “when I got the vaccine.”

“We’re trying to say, ‘Hey, I already got this vaccine, I’m fine,’” Pungarcher adds. “I’m standing here before you like, this is something that I trust, and hopefully, whoever I’m talking to, I already have some sort of relationship with them. So I can be one person that they know, and either already trust, or they see, hey, this person got a vaccine, and they’re doing fine.”

The goal is access, but it remains to be seen how many people experiencing homelessness will utilize that access.

Pungarcher says, “The plan is only going to be as successful as you know how many arms we actually get this vaccine into.”

VACCINE STATS

By April 5, Tennessee plans to make vaccines available to anyone who wants one. Though the state says this is in part because of vaccine hesitancy among residents, it comes as good news to folks ready to get vaccinated against COVID-19.

More than 20 percent of the state is either partially or fully vaccinated against COVID-19.

As of press time, almost 2.5 million people had received at least one COVID-19 vaccine.

70 percent of people vaccinated in Tennessee as of March 26 were white and just over 9 percent were Black.

Only 2 percent of those vaccinated were Hispanic.

Nashville vaccinated more than 10,000 people at a mass vaccination event at Nissan Stadium on March 20.

In Nashville, more than 265,000 people were vaccinated as of March 26.

The State of Tennessee reported than more than 80 percent of available vaccine appointments in rural areas remained open.

Tennessee was ranked 44th in the nation in March for its vaccination rollout.

More women than men are vaccinated — 58 percent of those vaccinated are women and 41 percent are men.