A group of health workers rushed out of a Boston hospital last morning of the week, grabbing small red refrigerators full of COVID-19 vaccines.
Your challenge: to overcome the traffic, an approaching snowstorm and the clock. They had to receive shots in the arms of their patients at home before the vaccines expired in a few hours.
“This watch is in the back of my mind all the time,” said Dr. Won Lee, a home care specialist at Boston Medical Center.
Millions of U.S. residents will need COVID-19 vaccines that carry them because they rarely or never leave home. Home care doctors and nurses are leading this drive and are starting to get help from state and local governments across the country.
But they face several challenges. Researchers say many people at home do not receive regular medical care, making it difficult to identify all people who need a vaccine.
Supplies are also limited and the Pfizer and Moderna vaccines expire a few hours after the syringes extract the vaccine from the vials.
This makes it difficult for a doctor to see many patients when they also have to stay at someone’s home for at least 15 minutes after the vaccine in case an allergic reaction occurs.
“They don’t live side by side,” said Dr. David Moen of Prospero Health Partners, which offers care to patients from several states. “It’s a challenge to go to multiple locations.”
Home care doctors and nurses are pushing for the vaccination of millions of U.S. residents who rarely or never leave home. (February 19).
However, health care providers report progress. Lee estimates he can administer five or six doses over an average day. This will be his main focus in the coming weeks.
One of his last stops was on the second floor of a regular patient, Domingas Pina, 106, who has not left home for about a year.
Lee sat with Pina at the dining room table, wiped the patient’s shoulder, and then quickly administered the shot as Pina looked away.
The patient then smiled under the surgical mask and raised her thumbs. Pina, who speaks mostly Portuguese Creole, will get her second dose of the vaccine next month, around her 107th birthday.
“She misses all of her grandchildren and friends who used to come all the time,” daughter Maria Lopes said. “We don’t want to lose her.”
After giving Pina the shot, Lee asked her how she was doing and about her blood pressure medication. He then slipped off Pina’s Darth Vader sneakers to examine his feet.
Shortly afterwards, the doctor had left his next patient.
Lee’s office sets appointments and explains the vaccine in advance. This helps the visit go smoothly and Lee tries to see patients living close to each other to save time.
He also tells them he can’t stay too long after the shots “because I have to make sure I get these vaccines to all the patients who need them today.”
Dr. Karen Abrashkin hopes to take a similar approach. It will use mapping software to plan stops between groups of patients living close to each other in the New York City area.
But Northwell Health’s House Calls program director is still waiting for the vaccine.
“Every day we have a lot of questions about when we will have vaccines to administer at home,” he said. “The supply is not there yet.”
One of her patients, 103-year-old Ida Sobel, has no plans to leave her apartment building until she is vaccinated.
While waiting, Sobel, who is legally blind and lives with a health aide, distributes food. He walks down the hallway through the front door to exercise and opens a window when he wants fresh air.
“I’m in a very busy area,” said the resident of Floral Park, New York. “People aren’t aware enough to avoid you and keep you away, so I avoid them.”
Dr. Christine Ritchie, a professor at Harvard Medical School, estimates that about 2 million American residents are at home. Another 5 million have trouble getting out of the house or need help to do so. Many of them may also need vaccines.
This population generally includes older people with below-average income levels and serious medical problems such as dementia, advanced heart conditions, or arthritis.
Ritchie noted that people traveling home draw less attention from public health officials than those living in group settings, such as nursing homes, who receive vaccines from major drugstore chains.
Ritchie said people at home, “are usually invisible to society.”
On Staten Island, James De Silva has been frustrated because she doesn’t have good vaccine options for her 96-year-old mother, but people much younger than her can get shot if they leave home. Mary Stella De Silva is mainly bedridden and receives home care 24 hours a day.
This care does not include the vaccine and De Silva will have to arrange an ambulance or special transport to take her to an appointment, if she lands.
“I think a little more priority should be given to the home home than someone who is only 65 years old and may not have an underlying illness,” he said. “He’s not getting the attention he deserves, frankly.”
That seems to be changing. Fire departments across the country have begun administering vaccines.
In the Gulf Coast city of Corpus Christi, Texas, the fire department has used a list of wheeled food receivers to administer more than 2,000 doses of the Modern vaccine since late January. Chief Robert Rocha said they have also created a hotline for anyone who still needs a vaccine.
Last week, New York City Mayor Bill DeBlasio said his city would begin sending medical personnel to people’s apartments at home as soon as a unique vaccine manufactured by Johnson & Johnson is available. Federal regulators can approve this vaccine in a few weeks.
Deliveries like this may not start soon enough for De Silva and his mother.
“If she was in a nursing home or a long-term care center, she would have already been vaccinated,” he said. “He’s really in the same situation, but he’s at home.”
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Associated Press video journalist Rodrique Ngowi contributed to this report.
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The Associated Press Health and Science Department is supported by the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.