A group of health workers rushed out of a Boston hospital on a recent morning during the week, collecting small red coolers filled with COVID-19 vaccines.
Their challenge: the traffic blows, a approaching snowstorm and the clock. They had to receive fire in the arms of their patients at home before the vaccines expired in a few hours.
“This watch is on my mind all the time,” said Dr. Won Lee, a home care specialist at Boston Medical Center.
Millions of US residents will need COVID-19 vaccines that have been brought to them because they rarely or never leave home. Doctors and nurses specializing in home care are driving this momentum and are beginning to receive help from state and local governments across the country.
But it faces several challenges. Researchers say that many people at home do not receive regular medical care, which makes it difficult to identify all those who need a vaccine.
Consumption is also limited and both Pfizer and Moderna vaccines expire a few hours after the syringes draw the vaccine from the vials.
This makes it difficult for a doctor to see many patients when they have to stay at someone’s home for at least 15 minutes after the shooting, if an allergic reaction occurs.
“I don’t live next door,” said Dr. David Moen of Prospero Health Partners, which provides care to patients in several states. “It’s hard to go to multiple locations.”
Doctors and nurses who specialize in home care lead to the urge to vaccinate millions of US residents who rarely or never leave home. (February 19).
Even so, health care providers report progress. Lee thinks he can take five or six doses in an average day. This will be her main goal in the next few weeks.
One of his recent stops was at the second-floor apartment of an ordinary patient, 106-year-old Domingas Pina, who had not left home for about a year.
Lee sat down with Pina at the dining room table, dabbed on the patient’s shoulder, and then quickly administered the shot as Pina looked away.
The patient then smiled under the surgical mask and threw her thumb up. Pina, who speaks mostly Portuguese Creole, will receive her second dose of vaccine next month, just around the 107th anniversary.
“She misses all her grandchildren and friends who came all the time,” said daughter Maria Lopes. “We don’t want to lose her.”
After giving Pina a shot, Lee asked what she was doing with her blood pressure medications. Then he dropped his Darth Vader slippers from Pina to examine his legs.
Soon the doctor had gone to her next patient.
Lee’s office sets the appointments and explains the vaccine in advance. This helps the visit go smoothly, and Lee tries to see patients living next to each other to save time.
He also tells them that he can’t stay long after the beatings “because I have to make sure I get these vaccines for all the patients who need them today.”
Dr. Karen Abrashkin hopes to take a similar approach. She will use mapping software to plan stops among groups of patients living next to each other in the New York City area.
But Northwell Health’s House Calls program director is still waiting for the vaccine.
“We have a lot of questions every day about when we will have vaccines to give at home,” she said. “The supply simply doesn’t exist yet.”
One of her patients, 103-year-old Ida Sobel, is not going to leave her apartment building until she is vaccinated.
While waiting, Sobel, who is legally blind and lives with a nurse at home, receives food delivered. He walks down the hall to the front door for exercise and opens a window when he wants fresh air.
“I’m in a very crowded area,” said Floral Park resident New York. “People are not aware enough to avoid you and stay away, so I avoid them.”
Dr. Christine Ritchie, a professor at Harvard Medical School, estimates that approximately 2 million US residents have gone home. Another 5 million have problems leaving home or need help with this. Many of them may need vaccines.
This population generally includes older people with below-average income levels and serious medical problems such as dementia, advanced heart disease or arthritis.
Ritchie noted that people at home attract less attention from public health officials than those living in group settings, such as nursing homes, who receive vaccines from major pharmacy chains.
Ritchie said people living at home “tend to be kind of invisible to society.”
On Staten Island, James De Silva has become frustrated because he does not have good vaccination options for his 96-year-old mother, but people much younger than her can get gunshots if they leave home. Mary Stella De Silva is mostly bedridden and receives non-stop home care.
That care does not include the vaccine, and De Silva will have to arrange an ambulance or special transport to take her to a meeting if she lands one.
“I think at home he should be given a slightly higher priority than someone who is only 65 years old and may not have a basic illness,” he said. “He’s not being given the attention he deserves, honestly.”
It seems to be changing. Fire departments across the country have begun delivering vaccines.
In the Gulf Coast town of Corpus Christi, the fire department used a list of wheelchair recipients to deliver more than 2,000 doses of the Modern vaccine as of the end of January. Chief Robert Rocha said they had also set up a helpline for anyone who still needed vaccination.
Last week, New York City Mayor Bill DeBlasio said his city would begin sending medical personnel to the homes of people living at home as soon as a unique Johnson & Johnson vaccine became available. Federal regulators can approve the vaccine in a few weeks.
Deliveries like this can’t start soon enough for De Silva and his mother.
“If she had been in a nursing home or a long-term care unit, she would have been vaccinated so far,” he said. “He’s really in the same situation, but he’s home.”
___
Associated Press video journalist Rodrique Ngowi contributed to the report.
___
The Associated Press Department of Health and Science receives support from the Howard Hughes Medical Institute’s Department of Science Education. AP is solely responsible for all content.