CURRENT/EMERGING ISSUES & STRATEGIES FOR SUCCESS

1. Increasing staff burnout as demand for vaccines increases.
2. Utilizing new health center funding opportunities for improving systems of care by considering innovative post-pandemic service provisions.
3. Continuing variance in vaccination allocations makes scheduling and planning difficult and presents the risk of over-promising and under-delivering (or worse—cancelled vaccine clinics).
4. Assigning vaccine vials as “first dose” or “second dose” limits flexibility and increases administrative burden.
5. Expanding eligibility makes vaccination efforts easier but increases demand and urgency to get doses and conduct vaccination events.
6. Varying vaccine acceptance rates across the country are improved by frequent client engagement, which is important but time-consuming.
7. Building a long-term vaccination approach by transitioning outreach from vaccine events to engagement efforts that include offering vaccination.
8. Expanding the geographic locations of vaccine distribution increases the logistical and administrative burden of organizing events and documenting vaccinations.
9. Managing complex and chronic care conditions of patient panels has been challenging due to staff being pulled for vaccination (and/or testing) efforts.
10. Having multiple vaccine types complicates vaccine events as clients wait for their “preferred” vaccine brand. 
    

1. Offering walk-in vaccination clinics allows for clients who are ready to get it “now."
2. When possible, staff community vaccine clinics with the same providers who conduct outreach to those sites so there is a familiarity.
3. Employ the “grouchy doctor” approach to advocate for vaccine supply or other needed changes.
4. Integrating vaccination into scheduled clinical appointments instead of requiring a separate appointment at different date/time.
5. Engaging shelter/agency staff prior to vaccine event to provide resources, help with client registration lists, and build vaccine acceptance.
6. Partnering with state or federal vaccinators (such as National Guard or volunteer clinicians) allows HCH staff to serve as community liaisons and focus on trust building. This relieves staff of the administrative burden while assuring client confidence from the presence of known providers.
7. Implement standing orders for testing employees, non-clients, travelers, and congregate facilities to prepare for surges in testing needs.
8. Staff vaccination events with MAs, EMTs, dental hygienists, and nursing students with RN oversight so providers can maintain regular caseloads.
9. Partner with other FQHCs when you do not have vaccines to secure appointments for highest-need patients.
10. Regular “COVID partnership coordination” calls with other service providers going to the same sites help track new vaccine interest and unmet needs.
    

POLICY DEVELOPMENTS

• New health center funding of $6.1 billion for health centers from the American Rescue Plan Act (see text box above!).
• The Biden Administration announced an extension of the federal eviction moratorium to June 30, 2021. In addition, the Consumer Financial Protection Bureau (CFPB) and the Federal Trade Commission (FTC) will enforce penalties against landlords who violate the order.
• In efforts to boost vaccine acceptance, the Biden Administration launched the COVID-19 Community Corps. This all-volunteer network of faith leaders, health care professionals, and local leaders will be using social media, their social networks, and participating in virtual events to share fact sheets, FAQs, and talking points.
• Through the expansion of the pharmacy vaccination program and increasing the number of mass vaccination sites, the Biden Administration states that 90% of American adults will be eligible to receive COVID-19 vaccines and will have a vaccine site within 5 miles of home by April 19.
  

NEW RESOURCES

• CDC MMWR: Counties with High COVID-19 Incidence and Relatively Large Racial and Ethnic Minority Populations – United States, April 1-December 22, 2020
• CDC MMWR: Symptoms of Anxiety or Depression Disorder and Use of Mental Health Care Among Adults During the COVID-19 Pandemic – United States, August 2020-February 2021
• CDC MMWR: Interim Estimate of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers – Eight U.S. Locations, December 2020-March 2021
• CDC MMWR: County-Level COVID-19 Vaccination Coverage and Social Vulnerability – United States, December 14, 2020-March 1, 2021
• CDC MMWR: Community-Associated Outreach of COVID-19 in a Correctional Facility – Utah, September 2020-January 2021
• CDC: Interim Clinical Considerations Summary
• CDC: COVID-19 Vaccine Quick Reference Guide for Health Care Professionals
• CDC: COVID-19 Questions and Answers: For People Who Use Drugs or Have Substance Use Disorder
• CDC: People With Certain Medical Conditions and Risk for Severe COVID-19 Illness
• NACHC: COVID-19 Vaccine Distribution Clinic Operations Toolkit
• UNC Institute for Best Practices: 13-Minute Motivational Interviewing and COVID Vaccine Hesitancy Webinar
  

WHAT WE'RE READING

• WBUR: Rate of Second Vaccine Doses In Boston’s Homeless Community Higher Than Expected
  
• Public Health Management and Practice: Establishment of Isolation and Noncongregate Hotels During COVID-19 and Symptom Evolution Among People Experiencing Homelessness – Atlanta, Georgia, 2020
• Culpeper Star Exponent: Daily Planet Health Services Has Given 3,800 COVID-19 Vaccine Doses to Homeless Population, Shelter and Support Staff
  

• Big News Network: Entire Hotels Across America Being Leased for Homeless Shelters
• Slate: We Could Solve Homelessness If We Wanted
• KFF: Vaccination is Local: COVID-19 Vaccination Rates Vary by County and Key Characteristics
• KFF: COVID-19 Vaccine Monitor: March 2021
• KHN: Stop Blaming Tuskegee, Critics Say. It’s Not an ‘Excuse’ for Current Medical Racism.
  
• KHN: COVID Vaccine Hesitancy Drops Among All Americans, New Survey Shows
• KHN: ‘It Didn’t Really Stick With Me’: Understanding the Rural Shrug Over COVID and Vaccines
• NBC News: Among Homeless Population, a Deep Mistrust of Vaccines. Here’s How Cities are Intervening
• STAT: A User's Guide: How to Talk to Those Hesitant About the COVID-19 Vaccine