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

Some countries have already placed people who are homeless near the front of the queue when it comes to receiving the vaccine.
Image credit: SELF magazine/Flickr

Breakthroughs from pharmaceutical companies have raised global hopes that a Covid-19 vaccine is in sight, and with it the end of all the pain and worry caused by the pandemic and its economic impact.

Now, while the potential treatments continue to undergo clinical trials, attention is turning to the massive logistical operation required to administer them. And people affected by homelessness could be left out when it comes to the Covid-19 vaccine because of the sub-zero conditions required to store it, experts have warned. 

The Pfizer/BioNTech vaccine, which has proved to be 95 per cent affective in trials, must be stored at -70C and that has left logistics giant DHL warning that two-thirds of the world’s population may face problems accessing the drug.

“Because of the storage issues and large batches they will need people to come to a central venue so lots of people can be vaccinated together,” Dr Nigel Hewett, the medical director of homeless healthcare charity Pathway, told The Big Issue.

“Priorities are by age and clinical vulnerability so there will be an issue for those homeless patients who are in the shielding group and are considered vulnerable but can’t get to the vaccination centre.

“Presumably they will have to have a mobile option for care homes – so this could be used for hostels/hotels, if this was permitted.”

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Calls for homelessness to be prioritised when distributing vaccines are nothing new. A 2013 study by Canadian academics Kristy Buccieri and Stephen Gaetz argued that this approach “protects a medically vulnerable population while reducing the chances of transmission to others as they move through populated urban spaces” when studying influenza vaccination.

But people who are homeless are not currently considered a priority for the 40 million doses of the Pfizer/BioNtech vaccine reportedly ordered by the UK government.

The Joint Committee on Vaccination and Immunisation, a group of doctors and professors who advise UK health departments on vaccination, is prioritising elderly people before working down the age groups. Care home residents and staff are first in line, followed by people over 80 and health and social workers, before younger age groups are considered. How anyone under 50 will be prioritised has yet to be determined.

The committee insists this plan will “likely result in faster delivery and better uptake in those at the highest risk”.

The advice is in keeping with WHO recommendations, which suggest people who are homeless or experience “extreme poverty” should be among the second stage of vaccinations. But elsewhere the urgency to vaccinate people on the streets is more apparent. 

In the US, people staying in homeless shelters are also being given priority status and are set to be vaccinated in phase two of the roll-out, according to The National Academies of Sciences, Engineering, and Medicine’s plan. Health-care workers and elderly Americans as well as those with underlying health conditions are first in the queue for a vaccine before people without a home are targeted alongside others in prisons, jails and detention centres.

The German Ethics Council (Deutscher Ethikrat) has advised that people who live in communal accommodation settings should be among the first to be vaccinated due to underlying health conditions, according to street paper Hinz&Kunzt.

And European homelessness network FEANTSA has echoed that call. In a statement, they warned that “Vaccine strategies must prioritise homeless people” as European Commission president Ursula von der Leyen confirmed a contract for 300 million doses of the Pfizer/BioNTech drug.

A FEANTSA spokesperson said: “People experiencing homelessness are a medically vulnerable group, often with pre-existing health issues. Furthermore, they are often forced to live in places where social distancing and other precautions are impossible. They should be prioritised in vaccine strategies to protect them and to limit their role in transmission.

“Homeless services should be involved in delivering vaccination programmes: to ensure homeless people are prioritised as a vulnerable group, to ensure they get the vaccine, and to inform or prepare homeless people so that vaccine hesitancy is not a barrier. The shelter system can be particularly useful in terms of outreach and information sharing.”

The UK Government’s response to homelessness and rough sleeping through the pandemic has demonstrated urgency this year – as the rush to protect people with the Everyone In scheme has shown.

Some 15,000 people were placed in hotels and emergency accommodation through the first national lockdown in England, a move which recognised  many without a home live with under-lying health conditions. University College London academics estimated that Everyone In prevented 266 deaths, 1,164 hospital admissions and 338 intensive care unit admissions from March to May 2020.

But, as for 2020, there are finally signs of hope for all of us. The news of Covid-19 vaccine breakthroughs have given the world a reason to be optimistic that the end of the pandemic is starting to come into view. 

There is still a long way to go with the potential vaccines but that hope must be felt by everyone in society, even people without a home.

Additional reporting by Benjamin Laufer with translation from INSP/Peter Bone

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