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When will people affected by homelessness get a Covid-19 vaccine?

The renewed commitment to the Everyone In scheme means more rough sleepers will be registered with GPs to receive the Covid-19 vaccine in England
Image credit: SELF magazine/Flickr

The latest national lockdown means that the UK is now in a race between the fast-spreading new strain and distributing the Covid-19 vaccine – and there remains a danger that those experiencing homelessness will end up being left behind.

Boris Johnson and devolved leaders have been forced to introduce the most stringent Covid-19 measures since the pandemic began last year as the desperate need to stop the new strain of the virus spreading through the public became more urgent than ever.

The vaccine rollout is being accelerated in a desperate bid to keep the public health emergency under control, with 350,000 ‘jabs in arms’ a week and growing, according to the Prime Minister. But even if the rollout hits its target of two million vaccinations a week, it will still take until February 2022 for everyone to receive two doses, according to a Channel 4 News analysis.

In the meantime, the virus continues to spread out of control. The Office for National Statistics figures revealed that one in 50 people in private homes were infected with the virus over Christmas.

But people without a permanent home are at even greater risk of catching the virus, with nowhere to isolate away from others. That makes this winter the most dangerous for those living on the street who must contend with the threat of the virus alongside the freezing conditions that make this time of year already potentially lethal.

Add to the mix the fact that people experiencing homelessness are more likely to have underlying health conditions, and on average die at almost half the age of the rest of the population – 46 for men and 43 for women – and there is a strong argument for prioritising them for Covid-19 vaccination.

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Getting to a GP also poses a problem with many rough sleepers facing barriers to accessing healthcare.

The Westminster Government has moved to solve this issue through a renewed call for councils to accommodate rough sleepers through Everyone In. The scheme protected almost 15,000 rough sleepers at its peak in hotels and emergency accommodation.

Communities Secretary Robert Jenrick called on local authorities to ‘redouble their efforts’ to reach rough sleepers during the latest national lockdown. Through the scheme, those brought in off the streets will be registered with a GP and offered a Covid-19 vaccine in line with the priority groups set out by independent advisory group, the Joint Committee on Vaccination and Immunisation.

But while this move stops people from falling through the cracks, it is no guarantee of priority access to the live-saving vaccines. At the moment homelessness is not considered a factor when deciding the pecking order for who receives a Covid-19 vaccine.

Age is currently the key factor when determining priority following recommendations from the JCVI.

Homelessness and other inequalities are not taken into account in current guidance, with a JCVI report from last year warning of “reinforcing negative stereotypes and increasing experiences of stigma and discrimination” by prioritising marginalised groups for vaccination.

The age-based approach has a “sensible balance of risk” says England’s Chief Medical Officer Chris Whitty, and the NHS is racing to inoculate the 13 million people in the top four priority groups by mid-February.

A Government spokesperson said: “This advice is put forward by independent experts and has been developed with the clear aim of preventing as many deaths as possible, and protecting the health and social care system.”

So far, the UK has ordered 367 million vaccine doses, including 40 million doses of the Pfizer-BioNTech vaccine and a further 100 million of the AstraZeneca/Oxford University vaccine introduced at the start of this year and 17 million doses of the recently approved Moderna vaccine.

In our opinion, there is no question of this need for priority status

But while stock is developed, the short supply of available vaccines currently means that rollout is rightly focused on the elderly and frontline staff working hard to treat them.

Those without a home must be next in line. For the almost 1,500 Big Issue vendors off their pitches and unable to work due to the Covid-19 pandemic, a Covid-19 vaccine is more than an assurance of health, it is a signal that they can return to communities throughout the country. Every moment spent waiting for a vaccine leaves them at great risk.

The Big Issue is not alone in calling for a change.

Chief executive of homelessness charity Crisis Jon Sparkes responded to Johnson’s lockdown announcement with a fresh call for a rethink, saying: “People who are homeless face severe health inequalities and, as such, we call on the government to ensure that they are prioritised for Covid-19 vaccines, something that will be aided greatly by having a safe and stable home.”

The national membership charity for frontline services Homeless Link took that demand a step further. It has written to minister for Covid vaccine deployment Nadhim Zahawi to demand not only people experiencing homelessness be given priority access but also the key workers who support them.

Chief executive Rick Henderson insists the move would be a sensible one.

He says: “In our opinion, there is no question of this need for priority status. People experiencing homelessness are prone to a higher than average number of long-term health conditions and are old before their time.

“Furthermore, their use of communal accommodation such as homeless hostels increases their risk of contracting Covid.”

While national charities are hoping to change health chiefs’ minds, there has been urgent action at a local level.

Oldham Council has become the first local authority to declare it will offer people without a home priority access.

While 3,700 people, starting with those aged over 80, have been vaccinated in the Greater Manchester town since December, plans will be drawn up to reach people on the streets in the coming weeks and months.

That commitment is the work of Oldham councillor Dr Zahid Chauhan – a 44-year-old GP who has been treating patients on the front line throughout the pandemic and is also the founder of charity Homeless Friendly.

Dr Chauhan insists that the urgent crisis means he is forced to “find local solutions to national problems”. He believes that the work done to vaccinate homeless people against flu in the past means that local councils and charities are well-placed to reach those who struggle to register with a GP or those who distrust services.

He wants other local authorities to follow suit. “I’m hoping that will set an example and I’m trying to do my bit,” Dr Chauhan says. “They are as much citizens of this country as anyone else and just because no one is speaking up for them they should not be left to die alone in cold weather with Covid where no one will notice. This is inhumane.”

In other areas of the world, homelessness is considered among the criteria for prioritising vaccinations.

The World Health Organization counts people experiencing homelessness among “sociodemographic groups at significantly higher risk of severe disease or death” and recommended vaccination in phase two of a rollout in its guidance.

Similarly, people without a home in the United States will also be considered for vaccination in the second stage of the process.

As The Big Issue has done throughout the pandemic, vendors will be supported while they are unable to sell the magazine, with frontline teams working hard to help them with income and looking out for their welfare.

Big Issue vendors and vulnerable people everywhere must not be left behind in the race to protect society from this deadly virus with the Covid-19 vaccine.