In northern California, a mobile “strike team” is bringing vaccines to some of the state’s most vulnerable residents along with a message: This is how you avoid dying from COVID-19.
So far, that message has been met with both nervous acceptance and outbursts of joy from a population that has been ravaged by the disease. One 68-year-old pastor, who lives in a racially diverse, low-income senior housing complex, rolled down his sleeve after his shot and said he wants to live to see 70 — just to spite the government.
The team of county nurses and nonprofit workers is targeting Contra Costa County residents who are eligible for COVID vaccines but have been left out: residents of small assisted-living facilities that haven’t yet been visited by CVS or Walgreens, and occasionally people who live in low-income senior housing.
The retail pharmacy giants have a federal government contract to administer vaccines in most long-term care facilities.
Credit: contributed
Credit: contributed
Launched a few weeks ago, the strike team moves through each vaccination clinic with practiced choreography.
On a recent day at a small group home in Antioch, Calif., a nurse filled syringes while another person readied vaccine cards and laid them on a table. An administrative assistant — hired specifically for these clinics — checked everyone’s paperwork and screened them for symptoms and allergies before their shots, logging them into the state’s database afterward. After the shots, a strike team member told each person when their 15 minutes of observation was up.
In a little over an hour, 14 people had a shot in their arm, a card in their hand and their data in the system. Nurses wiped down the chairs and tables and packed up supplies.
Small long-term care facilities, usually with no more than six beds, are the strike team’s main target.
These “six-beds” are a major source of residential care for older Californians, as well as others who need care and supervision but don’t want to live in nursing homes.
These homes are typically in residential areas, with little to distinguish them from other houses on a suburban block. They are small businesses, often owned by families, that offer a “social” model of care, not a medical one. There is no doctor or director of nursing on staff.
Long-term care residents were in line to be vaccinated right after front-line health workers, starting in nursing homes. Theoretically, residents of small facilities like six-beds should get their shots from the same federal program vaccinating most nursing homes, which is administered through CVS and Walgreens.
‘the most vulnerable’
It has been difficult to coordinate with these homes because there are so many. Because these aren’t large corporate chains or 500-bed facilities with everyone’s medical records on hand, it takes time and local knowledge to reach them all.
The residents at Above All Care, a six-bed in Orange County, finally got their first shots on Feb. 4, according to owner Nicolas Oudinot. But that came after weeks of confusion and silence.
“From November to mid-January, I had no information,” Oudinot said. “I went from nothing to getting a call every day. They tried to schedule the same facility two or three times.”
In late December, when it became clear that many long-term care facilities wouldn’t get clinics scheduled for months, Contra Costa County decided the federal program needed to be supplemented with local resources, said Dr. Chris Farnitano, the county health officer.
“This is where we’re seeing the most dying happening,” Farnitano said. “These are the most vulnerable people. We’ve got to protect them sooner.”
The mobile vaccine strike team emerged from a collaboration among the county, local home health agencies, advocates for long-term care residents and nonprofit groups. It was created without additional public funding when Choice in Aging, a local nonprofit that provides community-based support to older residents, paid its own administrative workers to staff the clinics alongside county public health nurses.
‘liquid gold’
Several days a week, the team of five or six people heads out, hauling rolling carts packed with syringes, bandages and a special vaccine cooler.
The team might spend one day vaccinating 100 people in six-bed and other small facilities for older people or those with disabilities. The next, it might visit 50 seniors and their caregivers gathered from a few low-income apartments.
The vaccines are treated like a precious resource. Nothing goes to waste and there’s a list of caregivers on standby if the team finds itself with extra shots. Nurses say they can almost always squeeze a sixth dose of what they call “liquid gold” out of the vials, intended to contain five.
When defrosted vials aren’t in the cooler, they’re carried gingerly, sandwiched between two egg cartons so they don’t tip or break. Often, the team’s biggest problem is running too far ahead of schedule.
Its efforts seem to be working: 810 people in 50 facilities had been vaccinated as of late February.
Choice in Aging CEO Debbie Toth said she originally got into this line of work to give people a choice of where to spend their last years. But the pandemic has given her work new urgency: saving lives.
“These are people who would die” if they got COVID, she said. “We have an opportunity to make sure they don’t. That’s our North Star.”
Rachel Bluth writes for Kaiser Health News. This story is part of the Solutions Journalism Network, a nonprofit organization dedicated to rigorous reporting about responses to social problems. This story originally appeared online here.
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