Mobile COVID-19 vaccination units expanding to meet homebound needs from Crain’s Detroit Business

“We are deploying our vaccine clinics in those areas where more people are testing positive, hotspotting the vaccine for the most vulnerable populations, the elderly, developmentally disabled, non-English speaking language people,” Korzeniewski said.

While the state has done a good job expanding eligibility to those above the age of 50, Korzeniewski said there is a danger in missing vulnerable populations by “self-selection bias.”

“When you open up eligibility, you introduce self-selection bias. These people (getting vaccinated) are more mobile, have fewer chronic conditions. They are the ones who find it easier to come in for appointments,” he said. “There needs to be more community engagement and a targeted approach to reach the vulnerable populations.”

Cristine King, a nurse and chief clinical officer with Jackson-based Careline Health Group, said the home health company has been vaccinating homebound seniors in homes and assisted living facilities for the past two months. Since Feb. 4, Careline has vaccinated about 400 seniors.

“We are working with the Jackson County Health Department and with Gratiot County to vaccinate people who can’t get out to clinics,” King said. “We were contacted because of our testing outreach. We have tested 18,000” since the pandemic began last year.

“There is a need because they fall between the crack in the long-term care (vaccination) partnership and the health department (and hospital) clinic” system, King said. “We have done all Moderna. We have no trouble handling it.”

Over the past two weeks, mobile vaccination units operated by the Federal Emergency Management Agency have been sent out to neighborhoods to give up to 7,000 doses per week to homebound people who can’t make to the mass vaccination Ford Field site.

Dr. Mark Hamed, medical director of health departments in eight Thumb and Northeast Michigan counties, said there is a need for more mobile units, which could include getting doses to ambulances and emergency medical service paramedics and technicians.

“It should be all hands on deck to get the pockets of people who don’t have immediate access to vaccines,” said Hamed, who also is president of the Michigan Academy of Family Physicians. “If we had more primary care offices with vaccines, we could do better outreach.”

DiAnna Solomon, director of fund development, communications and advocacy with the Detroit Area Agency on Aging, said there are many homebound seniors in Wayne County who want vaccine appointments. They just don’t have transportation to hospitals, pharmacies or health departments or feel comfortable in those environments, she said.

Of the agency’s 4,300 clients who are 60 and older, Solomon said a recent survey found 400 clients who would like to have a vaccine delivered to their home. The agency is working on a plan, which she said still requires funding, to contract with nurses and a driver to deliver the vaccines.

“We are working through a couple partnerships, all through local health departments, the city, county and the state, to get them vaccinations,” said Solomon, adding the agency hopes to start the program within two weeks.

“We have a list of (registered vaccine providers) nurses who can deliver six to eight doses per day” to reach our homebound seniors,” Solomon said. “We are hearing from our clients every day and expect the list to grow.”

Elizabeth Hertel, director of the state Health and Human Services Department, acknowledged that funding health providers seeking to deliver vaccines to the homebound has been held up somewhat by the reluctance of the state Legislature to approve a funding plan to help with the outreach effort.

“This has been a central part of the discussions that we were having with the legislature on the federal funding and the authorization,” Hertel said. “We know that there are dollars available to help support this. And we want to be able to get those out to our partners as quickly as possible.”

Solomon said the DAAA doesn’t have any complaints with the state’s vaccination plan of first reaching the most accessible people and expanding the eligibility to 16 and older, she said.

“We feel the state is doing a good job with partnering with us and others about availability of vaccines,” Solomon said. “The state is relying on us to get information out to seniors. As far as homebound, it has taken a little extra effort. We haven’t been promised, but I feel confident when we are ready for the vaccines we will receive them.”

Hertel said the state also is working with county health departments and rescue agencies to get vaccines to agricultural workers coming into the state for harvesting.

But primary care physicians say if they were supplied with vaccine doses they could reach many people who are hesitant or for whatever reason haven’t been able to get an appointment.

Dr. Bobby Mukkamala, president of the Michigan State Medical Society, said primary care physicians stand ready to help get vaccines to underserved populations.

“Last week my (physician) wife and I applied to get a supply of vaccines. It is not an easy process,” Mukkamala said. “We asked Genesee County and they said we could if we could do at least 50 doses a day. We could do 10, so collectively we are trying to get five offices to work with us.”

Mukkamala said he is recommending physicians who want to give out COVID-19 vaccines work together and apply with their local health department to become vaccinators.

“Doctors can be one of the solutions because many of these underserved people will have relationship with a primary care physician,” he said.

Hertel said the state hopes to begin allocating more vaccine doses to primary care physicians in the next two weeks. She said the state hasn’t decided whether to ask hospitals or health departments to work directly with primary care offices to increase vaccination efforts, or whether the state will direct doses directly to some primary care offices.

“We continue to see greater quantities of the vaccine coming into the state, which allows us to bring on more providers, and we will continue to do so as we get more vaccines,” she said.