Thousands of Philadelphians with health conditions and physical limitations who haven’t been able to get their COVID-19 vaccine will be getting long-asked-for help as the city announces Wednesday a new plan to ensure doses are brought to their doors.
Advocates for people with disabilities and seniors say the new city registry is overdue, especially since vulnerable people have been taking serious risks to leave their homes and brave lines, access issues, and potential infection to get vaccinated.
“They just decided to go to the FEMA site,” said Lauren Alden, manager of the independent living services department for Liberty Resources, a Philadelphia-based disabled advocacy organization. ”That’s why it’s been kind of frustrating too because [the city initiative] just seems a little bit late to the game.”
The city health department has identified about 7,400 Philadelphians through insurers and service organizations that can’t leave their homes because of disabilities or health problems that would make a COVID-19 infection potentially fatal. Though piecemeal efforts have gotten doses to some people at home for months, the new initiative is the first time the city, health-care service organizations, and vaccine providers are working together to create a list of people who need vaccine at home, and then connect them with help.
“I think it’s incredibly important,” said Julia DeJoseph, chief medical officer at Delaware Valley Community Health, a health-care provider in underserved communities and an organization expected to participate. “Anything that gets vaccine out there is lifesaving.”
Jennifer Garman, Disability Rights Pennsylvania’s government affairs director, said her group will be sharing information across their listserv, social media, and with other disability advocacy organizations to pull the registry together.
“It’s a long time coming,” she said. “We want people with disabilities to be able to return to normalcy as well, and that might unfortunately be a longer timeline.”
Personal care attendants, family members, caregivers, and anyone else living in the same household are also eligible to be vaccinated through this program.
“There has been frustration about how people can access these services. It’s understandable frustration,” said Jessica Caum, the health department’s public health preparedness program manager. “We’re excited that all of the pieces of this have come together.”
The homebound population is diverse, spanning all ages, racial, and economic groups, said Ala Stanford, a doctor and founder of the Black Doctors COVID-19 Consortium, which has been conducting home vaccinations since March on top of its mass clinics. The organization is doing 200 to 300 a week now, she said, seeing patients ranging from those in hospice care or suffering from dementia, dialysis patients, and women on the cusp of giving birth. There are up to 1,000 on the group’s waiting list, she said.
Vaccination visits can be emotional, with the vaccinator bringing relief from the pandemic and, for some, a rare moment of human interaction.
“People are so appreciative and just love the fact that people came,” Stanford said.
Anna Perng, the founder of the COVID-19 Health Equity Coalition, and other community leaders have been pressuring the city since vaccines arrived last winter to establish an equitable vaccine program.
More than a dozen advocacy groups, along with Councilmembers Derek Green, Mark Squilla, and Helen Gym, sent a letter in March to the Kenney administration demanding changes including a home program related to vaccine eligibility for those with disabilities and their caregiver.
Germán Parodi, co-executive director of the Partnership for Inclusive Disaster Strategies and a Juniata resident, has used a wheelchair for two decades due to quadriplegia, and his condition makes him particularly susceptible to respiratory illnesses like COVID-19. He and his partner and co-executive director, Shaylin Sluzalis, had hoped to find a drive-through vaccination center that would allow them to get shots in their car, but couldn’t. They finally got their first doses in late April from the Black Doctors COVID-19 Consortium.
The couple were deeply frustrated by a lack of engagement with the disability community, which too often is left out of disaster planning, he said.
“There is a wall where people with disabilities could only be seen as recipients of services during this disaster, not part of the delivery,” Parodi said. “We know our community, we know our people’s needs, and we know where we are.”
Jim Garrow, the health department’s spokesperson, said the city did not have enough resources to launch a program like this months ago. So it focused on vaccinating home health workers so they would not expose homebound clients to the virus.
“Earlier in the year when we were giving out vaccines, there was a resource allocation problem,” he said. “The number of man-hours to vaccinate 500 people at a community clinic was about the same to vaccinate 10 to 15 people during a homebound program.”
Meanwhile, caregivers have scrambled to get their loved ones protected.
Linda DiMichele’s 84-year-old mother, Florence Donato, has not been able to leave her bed in South Philadelphia since a brain tumor five years ago. DiMichele called Donato’s physician, who did not have any vaccine. She called the Black Doctors COVID-19 Consortium, who told her she lived outside their priority zip codes.
Finally, she was able to get in touch with Tarik Khan, a Philadelphia family nurse-practitioner who has been doing home vaccinations.
“When they vaccinated senior homes and things like that they should have been getting vaccine in the homes at the same time,” Donato said. “That’s where I think it went wrong.”
Jacqueline Graham’s daughter, Kasha, 43, has cerebral palsy, cannot walk, is visually impaired, and due to her condition cannot understand wearing a mask. Graham, 59, of Strawberry Mansion, got her first vaccine dose back in February through her work, but she struggled to find a dose for her daughter until connecting with Khan.
Graham was afraid her daughter would get COVID-19 and have to be hospitalized. She worried that if that happened, Kasha would be isolated and confused without her mother due to pandemic restrictions on hospital visitations.
“She wouldn’t understand that the hospital wouldn’t let me come see her,” she said.
The health department is also working on training for providers on cultural competency at the recommendation of community stakeholders.
Conducting home vaccinations is complicated, providers said. They must be planned well to ensure vaccine doses don’t degrade once removed from freezers. They’re also time-consuming, as providers have to travel to patients, and wait with them after injection to ensure there are no serious side effects. On average, a single vaccination team can get 10 injections done a day, Stanford said.
Contacting those eligible for home vaccinations may be a challenge too, DeJoseph said. Of the first 10 calls her organization made, eight didn’t answer and one had already been vaccinated. If phone contact doesn’t work, she said, her organization will send out letters or knock on doors.
It’s unclear how many of the more than 7,000 homebound people the city has identified still need shots, or found other ways to get them.
Still, Perng said the formal launch of the health department’s centralized vaccine program after a short pilot period, developed with input from community leaders, feels like a meaningful step.
“This is a really important change in approach to ensure vaccine equity and an important recognition that vaccine equity has to include the disability community,” Perng said. “I just wish it hadn’t been so hard for people.”
Sign up for yourself or someone else in need of a home vaccine visit by calling 215-685-5488 or following this link: https://bit.ly/3b7kKBb