In Philadelphia, the COVID-19 vaccine rollout was a massive undertaking largely coordinated by the Philadelphia Department of Public Health (PDPH). Many vulnerable groups were identified to be among the first to receive access to the vaccines, including people experiencing homelessness (PEH). There were several challenges that made it uniquely difficult for many PEH and supporting organizations to access vaccine. Philadelphia does not have a central provider for all homeless services throughout the city. This posed a particular challenge to ensuring all organizations that work with this population were included and able to provide vaccines to their clients. There was no mobile vaccine provider that was dedicated to increasing vaccine access to unsheltered persons. To address this, PDPH developed a plan that coupled direct vaccination services with meaningful partnership building to increase accessibility for PEH and their service providers. PDPH developed a mobile team that would be able to meet individuals where they are—whether that be on the street or in a shelter.
Lessons Learned and Key Factors for Success
The PDPH Homeless Outreach Mobile Vaccine team was developed to address barriers to access that were identified early in the vaccine distribution process. This mobile vaccine model was able to serve programs that did not have active relationships with Federally Qualified Health Centers or Pharmacies and aid them in developing partnerships or providing vaccine on-site. The team held 138 vaccine clinics and successfully matched 19 sites with pharmacy partnerships. Onsite vaccine clinics provide low to no barrier vaccine access, meet patients where they are, and eliminate the need for transportation. Utilizing a mobile model, the team has been able to reach unsheltered individuals and those with limited or no access to healthcare. Outreach has led to in-depth conversations with community members to address vaccine reluctance, and the team provided materials related to disease prevention and available community resources. While J&J was the recommended vaccine for PEH early on, the team expanded to include all vaccine products to allow for patient autonomy and began offering additional routine vaccines to address other public health concerns for this population. Offering multiple services in one location increases engagement and is a best practice when working with PEH. This population has many competing needs, so including other resources to address urgent medical needs, housing, and other social services is crucial. The team also provided other information about public health concerns to increase awareness about vaccine-preventable diseases, such as Hepatitis A and B. Through this work, the team was able to establish and strengthen meaningful partnerships with programs that serve PEH and provide vaccine access for many individuals who may have otherwise experienced significant barriers to getting vaccinated.