Image showing a person preparing a vaccine. Perspective is from behind the subject
Photo courtesy of Steven Cornfield/unsplash.com

D.C. began distributing COVID-19 vaccines to people experiencing homelessness in low-barrier shelters and Pandemic Emergency Program for Medically Vulnerable Individuals, or PEP-V, centers this month. 

The D.C. Department of Human Services is collaborating on the rollout with Unity Health Care, a nonprofit that offers medical services to people experiencing homelessness in D.C. This distribution is part of Phase 1B of the vaccine rollout in the District, which includes essential workers and at-risk populations. 

The nonprofit vaccinated residents in all PEP-V centers the first week of February, said Dr. Anne Cardile, the medical director for healthcare for the homeless at Unity Health Care. Vaccines are now being administered at low-barrier shelters beginning with locations with the largest number of residents and continuing to locations with the fewest people. Unlike most vaccine appointments in the District, a photo I.D. is not required to receive the vaccine at the shelter clinics. 

Unity announced COVID-19 vaccinations and in-person appointments were delayed due to inclement weather Feb. 1. But, according to Cardile, no vaccine delays occurred because no appointments were scheduled for Feb. 1. Vaccinations began on Feb. 2 in PEP-V centers. 

Allocation of the vaccine to the Department of Human Services is based on estimated demand and availability and will be determined over time, according to DHS. In the first week of vaccinations, 400 doses were given, including about 340 for PEP-V clients and30 staff members.

Unity will travel to two shelters per week and remain at each location for one to two days. The names of everyone who receives the vaccine will be put into a digital system, where residents can opt-in to receive calls and texts as reminders for the second dose if able, Cardile said. In addition, people will be given a waterproof wallet with a vaccination card. 

“We wanted to give something to folks when they’re being vaccinated that would be practical and help them not only in their daily life, but in something else,” she said. “A reminder to come back with a second vaccine.”

Those who receive the vaccine will also get a wristband that provides the date and time of second dose administration, according to DHS. 

Unity plans to return to the same shelter location exactly four weeks later on the same days of the week in order to follow up with as many people as possible who were there when they offered the first shots, Cardile said.  

Vaccine schedule for February. Week of 2/1 will be PEP-V sites. Week of 2/8 will be 801 East and CCNV. Week of 2/15 will be New York Avenue, Harriet Tubman, and residents from St. Josephine, Sherwood and Greenleaf. Week of 2/22 will be Adam's Place, Pat Handy, and residents from Langdon, Trinidad, Kennedy and Banneker. Week of 3/1 to 3/29, the second dose will be administered following the same pattern.

Schedule of vaccinations for the first two months of the rollout, which is dependent on supplies and staff. Screenshot courtesy of the D.C. Department of Human Services.

Non-sheltered District residents experiencing homelessness may also coordinate inoculation through their case manager or an outreach team worker, according to DHS. Free transportation is also available from the District’s seasonal shelters to the clinics at low-barrier shelters. After residents of low-barrier shelters receive vaccinations, residents of family shelters, youth shelters, and other locations, as well as unsheltered individuals, will have an opportunity to receive the vaccine. DHS said it will take about four months to administer both doses to residents of low-barrier shelters and other locations. And those processes are dependent on supplies and staff. 

DHS and Unity are focused on effective communication around the COVID-19 vaccine, Cardile said. The organizations now hold weekly town halls on Wednesdays in low-barrier shelters to facilitate sign-ups and answer questions. In addition, DHS is establishing a COVID-19 peer educator program, which is composed of residents experiencing homelessness, to share information about COVID-19 and the vaccine.

After getting vaccinated, side effects are common, Cardile said. Especially after the second dose, one can expect headaches, body aches or a low-grade fever. “That is totally normal,” she said. 

Catholic Charities D.C., which oversees several low-barrier shelters in the District, noted the importance in prioritizing vaccines for people experiencing homelessness.

“We are pleased that the city has prioritized shelter residents and staff and will make the vaccine available to them,” said Amanda Chesney, the executive director for housing and homeless services, in an emailed statement. “This is indeed good news during a dark time.”

Residents cite technological barriers and poor communication 

 

On Jan. 29 and Feb 1, the D.C. Health Committee held an oversight roundtable focusing on the District’s COVID-19 vaccination process. On Jan. 29, public witnesses testified before councilmembers, sharing their personal experiences and thoughts on the District’s communication, prioritization, and the technology surrounding vaccine appointments. 

Witnesses cited hours-long holding times, website crashes, and appointment slots becoming fully booked within minutes. Several said there is a need for better communication around the vaccine, especially for older residents. Announcements about the vaccine are mostly communicated online and on social media, which can be a barrier, said Ward 1 Councilmember Brianne Nadeau. Phone calls, physical mailers, and radio and cable announcements to remind people to book appointments would alleviate confusion, Nadeau said.  

At-large Councilmember Christina Henderson said there is a need to “do better” when it comes to communication about the vaccine. 

“For some people just pointing … to a website FAQ is not going to cut it,” Henderson said in an interview. “They need the opportunity to talk to someone that they trust and ask questions.” 

Deputy Mayor for Health and Human Services Wayne Turnage acknowledged shortfalls in communication at the Feb.1 government witness testimony, especially when it comes to communities of color in the District and vaccine hesitancy. 

Image showing statistics on vaccine hesitancy in the District. White people are 96% said they plan to receive the vaccine, while 61% of Black residents plan to get the vaccine. Asian residents reported at 83% likely and Hispanic residents reported at 86% likely to get the vaccine.

Deputy Mayor for Health and Human Services Wayne Turnage presented as a government witness at the D.C. Health Committee oversight roundtable on vaccine distribution. Screenshot courtesy of the D.C. Office for Health and Human Services.

“Minority communities, especially African Americans, continue to express a stubborn resistance in vaccination programs,” Turnage said. “And it is born out of some  justifiable reasons.”

According to a survey by D.C. Health, 61% of Black residents reported they would seek out vaccination, while 96% of white residents plan to get vaccinated. An inhumane past of medical experiments on minorities, like the Tuskegee Syphilis Study, causes this hesitancy, Turnage said. “It gives them a jaundiced view of any type of vaccine program that’s been administered by the government.” 

Strategies to alleviate this include direct contact with physicians, marketing campaigns, multilingual talking points, and a pilot program to partner with local faith communities

Several public witnesses compared the vaccine sign-up to the dystopian novel and film series “The Hunger Games” at the Jan. 29 hearing. 

“Access to vaccines is not a game,” said Sia Barbara Ferguson Kamara, the chief strategy officer for the D.C. Early Learning Collaborative, during the testimony. “It is life or death. Those with the access and skills live; those without die.” 

Before the roundtables, Ward 7 Councilmember and Chairman of the D.C. Committee on Health Vincent Gray sent a letter to Turnage demanding technological changes to the vaccine process, including the establishment of a waitlist instead of the current weekly enrollment process, as well as improvements to the vaccine appointment site. 

“These recommendations seek to ensure that we are providing equal access to our most vulnerable populations, such as seniors and those with unreliable access to technology, and that we are proactively educating and easing access to vaccines with the goal that all District residents will participate and we can end this public health crisis,” Gray wrote.  

Co-signers includeNadeau, Henderson, and Ward 2 Councilmember Brooke Pinto. 

When asked if other states or cities had a model of distribution of the vaccine that D.C. should consider, Pinto noted the need to consider an area’s population, electronic infrastructures, and other unique factors when evaluating effective distribution. 

“We can look towards other major cities to see what they are proposing, but I believe that we must continue implementing and perfecting a tailored approach that ensures an equitable distribution among District residents that addresses our unique needs within the region,” she said.