A group of health professionals hurriedly left a Boston hospital on a recent weekday morning, holding small red refrigerators filled with COVID-19 vaccines.
Their challenge: beat traffic, an impending snowstorm and the clock. They had to receive injections in the arms of their patients who were at home before the vaccines expired in a few hours.
“That clock is on my mind all the time,” said Dr. Won Lee, a home care specialist at Boston Medical Center.
Millions of US residents will need COVID-19 vaccines, because they rarely or never leave the home. Doctors and nurses specializing in home care are leading this effort and starting to get help from state and local governments across the country.
But they face several challenges. The researchers say that many people living at home do not receive regular medical care, making it difficult to identify all people who need a vaccine.
Supplies are also limited and Pfizer and Moderna vaccines expire a few hours after the syringes remove the vaccine from the vials.
This makes it difficult for a doctor to see many patients, when they must also stay at someone’s home for at least 15 minutes after the injection, in case they develop an allergic reaction.
“They don’t live side by side,” said Dr. David Moen of Prospero Health Partners, who cares for patients in several states. “It is a challenge to go to several places.”
Doctors and nurses specializing in home care are spearheading the movement to vaccinate millions of U.S. residents who rarely or never leave home. (February 19).
Even so, health professionals report progress. Lee estimates that he can administer five or six doses during a normal day. That will be your main focus in the coming weeks.
One of his recent stops was at the second floor apartment of a normal patient, Domingas Pina, 106, who has not been out of the house for about a year.
Lee sat with Pina at his dining table, rubbed the patient’s shoulder, then quickly administered the injection while Pina looked away.
The patient then smiled under the surgical mask and gave a thumbs-up. Pina, who speaks mainly Portuguese Creole, will receive her second dose of the vaccine next month, around her 107th birthday.
“She misses her grandchildren and friends who came all the time,” said daughter Maria Lopes. “We don’t want to lose it.”
After giving Pina the injection, Lee asked how she was doing and about the pressure medications. She then removed Pina’s Darth Vader slippers to examine her feet.
Before long, the doctor left to pick up his next patient.
Lee’s office makes appointments and explains the vaccine in advance. This helps the visit to go smoothly, and Lee tries to see patients who live close to each other to save time.
She also tells them that it can’t be long after the injections “because I have to make sure the vaccines are applied to all the patients who need them today”.
Dr. Karen Abrashkin hopes to take a similar approach. It will use mapping software to plan stops between groups of patients who live close to each other in the New York City area.
But the director of Northwell Health’s House Calls program is still waiting for the vaccine.
“Every day we receive a lot of questions about when we will have vaccines to give at home,” she said. “The stock isn’t there yet.”
One of her patients, Ida Sobel, 103, has no plans to leave her building until she is vaccinated.
While she waits, Sobel, who is legally blind and lives with a home health assistant, delivers food. She walks down the hall in front of the front door to exercise and opens a window when she wants fresh air.
“I’m in a very busy area,” said the resident of Floral Park in New York. “People are not aware enough to avoid it and stay away, so I avoid them.”
Harvard Medical School professor, Dr. Christine Ritchie, estimates that about 2 million residents in the United States are trapped. Another 5 million have difficulty leaving home or need help to do so. Many of them may need vaccines to be brought to them as well.
This population generally includes elderly people with below-average income levels and serious medical problems, such as dementia, advanced heart disease or arthritis.
Ritchie noted that people who live at home draw less attention from public health officials than those who live in groups like asylums, which receive vaccines from major drugstore chains.
People who live at home, said Ritchie, “tend to be invisible to society”.
On Staten Island, James De Silva is getting frustrated because he doesn’t have good vaccine options for his 96-year-old mother, but people much younger than she can get vaccines if they leave home. Mary Stella De Silva is almost always bedridden and receives home care 24 hours a day.
This care does not include the vaccine, and De Silva will need to provide an ambulance or special transport to take her to the appointment, if he can.
“I think someone who is stuck at home should have a little more priority than someone who is just 65 and may not have an underlying disease,” he said. “It’s not getting the attention it deserves, frankly.”
This seems to be changing. Firefighters across the country began distributing vaccines.
In the city of Corpus Christi, on the Gulf Coast, Texas, the fire department used a list of Meals on Wheels recipients to deliver more than 2,000 doses of the Moderna vaccine since late January. Chief Robert Rocha said he also set up a hotline for those who still need a vaccine.
Last week, New York City Mayor Bill DeBlasio said his city would start sending medical personnel to the apartments of people who live at home as soon as a single vaccine made by Johnson & Johnson is available. Federal regulators can approve this vaccine in a few weeks.
Deliveries like this cannot start soon for De Silva and his mother.
“If she had been in a nursing home or a long-term care facility, she would have already been vaccinated,” he said. “She is really in the same situation, but she is at home.”
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Associated Press video journalist Rodrique Ngowi contributed to this report.
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The Associated Press Department of Health and Science receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.