COVID-19 Vaccination for People Experiencing Homelessness: Frequently Asked Questions

The goal is for everyone, including people experiencing homelessness, to be able to easily get a COVID-19 vaccine as soon as possible. However, because it is anticipated there will be a limited supply of vaccine at first, in December 2020, CDC adopted the Advisory Committee on Immunization Practices (ACIP) recommendation that healthcare personnel and residents of long-term care facilities receive COVID-19 vaccine first. These groups were chosen because health care settings in general, and long-term care settings in particular, can be high-risk locations for getting the virus that causes COVID-19. Healthcare personnel and residents of long-term care facilities will likely receive vaccine at the end of 2020 and in early 2021. Public health professionals at state and local health departments are now working on how to further distribute COVID-19 vaccines in a fair, ethical, and transparent way for additional groups, including considerations for people experiencing homelessness. People experiencing homelessness have many additional characteristics, such as age and employment in certain jobs, that will also influence when the vaccine will be available to them.

People who are experiencing homelessness may have difficulty accessing medical services in traditional settings, such as a clinic or pharmacy. Therefore, state and local vaccine distribution plans should include strategies to bring vaccines to people experiencing homelessness, including homeless service sites like shelters, day programs, or food service locations. The COVID-19 vaccination program implementation plans should also include strategies to offer vaccination in areas frequented by people experiencing unsheltered homelessness. These areas could include encampments or other known locations where people experiencing unsheltered homelessness spend time.

Homeless services are critical and have continued during the pandemic. Homeless service staff and outreach teams have frequent close contact with coworkers and clients, which puts them at risk of getting and spreading the virus that causes COVID-19. Therefore, homeless service staff should strongly consider getting vaccinated when vaccine is available to them. Furthermore, because homeless shelter staff members are considered essential workerspdf iconexternal icon, they may have the opportunity to be vaccinated earlier than the general population.

Recording whether people experiencing homelessness received a COVID-19 vaccine will be important for two reasons. First, it will be necessary for the person vaccinated to keep a record of their vaccination status and when they need to follow up for a second dose. Second, it will be important for vaccination programs to record housing status to estimate coverage among people experiencing homelessness. All COVID-19 vaccination providers are required to report vaccine administration data to the jurisdiction’s immunization information system (IIS) or other identified program. The address field can be used to provide information about homelessness status. Vaccine providers are also required to provide vaccine recipients with a vaccination record card. It might also be possible to include COVID-19 vaccination status in Homeless Management Information Systemsexternal icon. Finally, vaccination coverage data from vaccination campaign events at homeless service sites can be entered into the CDC and National Health Care for the Homeless dashboardexternal icon for inclusion in an aggregated dashboard.

People experiencing homelessness might have a hard time following up to get a second dose of COVID-19 vaccine. This may be a particular challenge because the same vaccine product must be used for both doses. Public health workers, healthcare workers, and homeless service staff should work together to promote follow-up by recording up-to-date contact information, ensuring dose information is available to vaccine providers across sites and geographic areas, providing multiple and easy-to-access opportunities to get a COVID-19 vaccine, integrating reminders into routine interactions, and conducting outreach to connect with individuals who might otherwise be lost to follow-up.

Organizations or healthcare providers who have agreed to participate in the COVID-19 Vaccination Program and signed the COVID-19 Vaccination Healthcare Provider Agreement will receive COVID-19 vaccines for their constituencies. Therefore, it may be possible for medical personnel at homeless service sites to administer COVID-19 vaccine through this program. Non-medical staff, such as community health workers and shelter staff, may be helpful in providing support services during vaccination events. Homeless service administrators should coordinate closely with their localexternal icon and state health departments to provide vaccination for their clients and staff.

Vaccination is an important tool to control the COVID-19 pandemic. However, because homeless services are critical to survival and well-being, service providers should take all steps possible to ensure that providing vaccination does not create a barrier to entry into homeless service sites. Building relationships and providing consistent, transparent information will be important to ensuring that clients feel comfortable receiving the COVID-19 vaccine.

People experiencing homelessness may have a history of trauma and may have had negative experiences with medical services. To improve vaccine confidence, work with staff members and community navigators who have trusted relationships with the clients you serve. Additionally, make sure vaccination providers hold multiple vaccination events to allow clients time to consider receiving the vaccine. Provide clear, consistent, and transparent vaccine information to staff, community organizers, and people experiencing homelessness.

Vaccination is just one tool to control the COVID-19 pandemic. Homeless service providers should continue taking all precautions possible, including mask wearing, social distancing, and hand hygiene, to prevent staff, volunteers, and clients from spreading the virus that causes COVID-19. Continue to follow the prevention recommendations for homeless service providers and related to unsheltered homelessness.