CURRENT/EMERGING ISSUES & STRATEGIES FOR SUCCESS

1. Balancing client/staff concerns around safety of Johnson & Johnson vaccine with desire for and ease of one-dose vaccine.
2. Needing education and additional consent (in some states), around possible side effects of Johnson & Johnson vaccine.
3. Offering options of vaccine types is important to rebuild confidence but logistically challenging and administratively burdensome.
4. Finding ways to use remaining doses of vaccine without waste has become one of the greatest challenges.
5. Already exhausted staff are further demoralized by having to waste vaccine when they are unable to find people to vaccinate.
6. Decreasing vaccine uptake rates increasingly negates the need for larger vaccine events, but increases the need for single/smaller-dose vials.
7. Assessing equity can be challenging because demographics are not collected consistently.
8. Determining what proportion of clients have been vaccinated is challenging without interface between HMIS and EHR, or another method of data matching.
9. Engaging those who are not as confident in receiving a vaccine is an increasing focus.
10. Planning for continuity of non-congregate hotel/motel programs is an ongoing challenge given expiration of contracts and re-opening of businesses.
    

1. Take time to explain the risks of Johnson & Johnson vaccine and compare it to other known and accepted risks (i.e., commonly prescribed medications, car accidents, COVID-19, etc.).
2. Develop printed material to provide during educational efforts to address specific concerns, especially materials that put the J&J risks into perspective.
3. Encourage clients to return if they feel any symptoms post-vaccination and have in place a low-threshold process for medically evaluating them. This is an opportunity to engage people in care.
4. Offer vaccinations to the staff at businesses around you to build relationships in your community and use up end-of-day doses to prevent waste.
5. Support vaccine choice by scheduling separate appointments, providing transportation, and/or returning at an alternate time with a different vaccine.
   

POLICY DEVELOPMENTS

• Last week the CDC and FDA lifted the pause and added a safety warning on the use of the Johnson & Johnson COVID-19 vaccine. Read the Council’s statement.
• The CDC issued new guidance on wearing masks outdoors. Individuals who are fully vaccinated are now able to be maskless outdoors unless they are in crowded situations.
• The CDC has also revised guidance for fully vaccinated individuals stating that they do not need to isolate or quarantine if they are exposed to a person with suspected or confirmed COVID-19; however, testing is still encouraged.
• HHS announced $1 billion for health centers to be used for construction and renovations projects. This funding is available to all HRSA-funded health centers for COVID-19 related capital needs, constructing new facilities, renovating and expanding existing facilities, and purchasing new equipment.
  

NEW RESOURCES

• CDC MMWR: Updated Recommendations from the Advisory Committee on Immunization Practices for Use of the Janssen (Johnson & Johnson) COVID-19 Vaccine After Reports of Thrombosis with Thrombocytopenia Syndrome Among Vaccine Recipients – United States, April 2021
• CDC MMWR: Postvaccination SARS-CoV-2 Infections Among Skilled Nursing Facility Residents and Staff Members – Chicago, Illinois, December 2020-March 2021
• CDC MMWR: COVID-19 Outreach Associated with a SARS-CoV-2 R.1 Lineage Variant in a Skilled Nursing Facility After Vaccination Program – Kentucky, March 2021
• CDC MMWR: COVID-19 Outbreaks in Correctional Facilities with Work-Release Programs – Idaho, July-November 2020
• CDC MMWR: Health Care Utilization and Clinical Characteristics of Nonhospitalized Adults in an Integrated Health Care System 28-180 Days After COVID-19 Diagnosis – Georgia, May 2020-March 2021
• CDC MMWR: Effectiveness of Pfizer-BioNTech and Moderna Vaccines Against COVID-19 Among Hospitalized Adults Aged ≥65 Years – United States, January-March 2021
• CDC: J&J/Janssen Vaccine Questions and Answers
• CDC: Fully Vaccinated Adults 65 and Older Are 94% Less Likely to Be Hospitalized with COVID-19
• CDC: Equitable Vaccine Implementation: Reaching People Where They Are
• National Law Center on Homelessness & Poverty: Racism, Homelessness, and COVID-19
• American Society of Hematology: Thrombosis with Thrombocytopenia Syndrome (also termed Vaccine-induced Thrombotic Thrombocytopenia)
• California Department of Public Health: FACT SHEET: Johnson & Johnson COVID-19 Vaccine Benefits and Risks
• NHCHC: Trust or Trustworthiness: Which Comes First? Webinar Series
• NHCHC: Increasing Access to COVID-19 Vaccines Among Homeless Populations: Success Partnerships Series
  

RESEARCH

• National Academy of Science: A Guideline to Limit Indoor Airborne Transmission of COVID-19
• National Library of Medicine: Assessment of Contact Tracing for COVID-19 Among People Experiencing Homelessness, Salt Lake County Health Department, March-May 2020
• National Library of Medicine: Hand Hygiene During the COVID-19 Pandemic Among People Experiencing Homelessness-Atlanta, Georgia, 2020
• National Library of Medicine: Factors Associated with SARS-CoV-2 Positivity in 20 Homeless Shelters in Toronto, Canada, from April to July 2020: A Repeated Cross-Sectional Study
  

WHAT WE'RE READING

• CNN: Phoenix Nonprofit Plans to Vaccinate 500 Homeless People in 5 Days
• US News & World Report: Trust, J&J Shot Key to Vaccinating Homeless People
  

• The Commonwealth Fund/VOX: The Pandemic Playbook
• CIDRAP: Study: B117 Variant 45% More Transmissible than Wild-Type COVID-19
• NEJM Catalyst: Health Equity as a System Strategy: The Rush University Medical Center Framework
• KFF: KFF COVID-19 Vaccine Monitor: Vaccine Attitudes Among Essential Workers
• The 19th: We Don’t Really Know If Vaccines Have Been Distributed Equitably
• CNN: Six-Foot Social Distancing Rule Misses Bigger Risk, MIT Experts Say