CURRENT/EMERGING ISSUES & STRATEGIES FOR SUCCESS

1. Determining vaccination rate among people experiencing homelessness is difficult without access to consistent data and ability to do data matching.
2. Ongoing vaccine reservation among parents is preventing newly eligible children from getting vaccinated.
3. Continuing belief in vaccine conspiracy theories has remained a barrier to vaccine acceptance for some clients.
4. Impending closure of alternate care site shelters without transitioning clients to medical respite care, permanent housing, or even shelter beds.
5. Struggling to balance providing care and doing vaccines has left providers feeling pulled between critical needs.
6. Increasing presence of encampments has some communities taking a more aggressive approach to sweeps, which is contradictory to best practices and CDC guidance.
7. Increasing concern about returning to pre-pandemic homeless service delivery approaches, which were inadequate and unjust.
8. Lifting mask mandates in communities while still requiring them in congregate shelters creates tension and confusion between residents and staff.
9. Expiring CDC eviction protections on June 30 is creating uncertainty about the possible wave of evictions and number of people who will experience homelessness.
10. Reallocating expiring vaccines to non-health center partners can be difficult.
    
    

1. Advocate to local leaders and CoCs to use the lessons learned from COVID-19 response and available funding to reimagine how they address homelessness in the community.
2. Use trusted providers to offer education and repeated opportunity for vaccination to newly eligible youth.
3. Offering multiple vaccines and flexible access to them remains fundamental to improving vaccine acceptance.
4. Integrate questions about COVID-19 vaccines into the standard queries that medical assistants ask of patients during visit prep.
5. Offer education, outreach, and vaccination during every encounter in the community to capitalize on anyone who becomes vaccine-ready.
6. Use mobile vaccination teams to more quickly respond to same-day requests in the community.
7. Combine nurses and community health workers to provide outreach to shelters and encampments.
8. Combine vaccine ambassador positions with street paper vendor positions to demonstrate efficacy of peer educators.
9. Develop lived experience workgroups on CoCs to ensure that their experience is incorporated in homeless intervention strategies.
10. Convert alternative care sites into medical respite programs in order to provide a broader range of care to patients and improve systems of care.
    

POLICY DEVELOPMENTS

• In efforts to get 70% of the country vaccinated by July 4, the Biden/Harris administration has announced a “Month of Action” campaign. This effort will include free child care while a person gets vaccinated; expanded vaccine clinic hours at pharmacies; community canvassing, phone, and text banking; and “Shots at the Shop," a collaboration with Black-owned barbershops and beauty salons.
•  A U.S. Appeals Court upheld the ban on residential eviction, protecting residents for now. Without further action by the government, the CDC eviction restrictions are set to expire on June 30.
• The CDC has updated its guidance for unsheltered populations to guide changes to COVID-19 prevention measures that local jurisdictions might be considering. They recommend taking a phased approach and considering multiple factors while keeping permanent housing as the primary goal.
  

NEW RESOURCES

• HHS-HUD: COVID-19 Vaccinations and Testing Toolkit
• HUD: COVID-19 HMIS Resources
• CDC: Considerations for a Long-Term Infection Prevention Strategy for People Experiencing Unsheltered Homelessness
• CDC: COVID-19 State of Vaccine Confidence Insights Report
• CDC MMWR: Decrease in COVID-19 Cases, Emergency Department Visits, Hospital Admissions, and Deaths Among Older Adults Following the Introduction of COVID-19 Vaccine – United States, September 6, 2020-May 1, 2021
• New England MHTTC: Motivational Interviewing for COVID-19 Vaccine Hesitancy
• HRSA: FY2021 American Rescue Plan – Health Center Construction and Capital Improvements (C8E) Resources
• NASEM: Addressing Disaster Vulnerability among Homeless Populations during COVID-19
  

RESEARCH

• Science Direct: The Health Impact of Eviction: Evidence from the National Longitudinal Study of Adolescent to Adult Health
  

WHAT WE'RE READING

• HHS: HHS Secretary Xavier Becerra to Insurers and Providers: COVID-19 Vaccines and Testing Must be Free for Patients
• Politico: Foster and Migrant Kids Shut Out from COVID Vaccinations
• KFF: COVID-19 Vaccine Monitor: May 2021
• KHN: COVID Was a Tipping Point for Telehealth. If Some Have Their Way, Virtual Visits Are Here to Stay
• KHN: With Roots in Civil Rights, Community Health Centers Push for Equity in the Pandemic
• KHN: In Missouri and Other States, Flawed Data Makes It Hard to Track Vaccine Equity
• STAT: As COVID Dissipates in the U.S., Cold and Flu Viruses May Return with a Vengeance
• Politico: Moderna Seeks Full FDA Approval of Its COVID-19 Vaccine
• NPR: Indiana Needle Exchange That Helped Contain An HIV Outreach To Be Shut Down
• AP: WHO: High Vaccination Rates Can Help Reduce Risk of Variants
• AP: US Extends Expiration Dates for J&J COVID Vaccine by 6 Weeks
• CBS News: Companies Can Mandate COVID-19 Vaccine, Incentivize Workers to Get Shot, EEOC Says