Helping High-Risk, Homebound Older Adults Get Vaccinated

The Lighthouse project is addressing vaccine distribution disparities by prioritizing overlooked, homebound older adults who often lack access to resources and technology.

The COVID-19 pandemic has laid bare the lack of health infrastructure necessary to reach homebound older adults, who are at a higher risk of infection and therefore, a priority population in vaccine distribution efforts. This group is often overlooked and typically lacks access to critical resources to help them access care, including vaccines. In partnership with the CITRIS Lighthouse project, Eskaton, a non-profit aging service provider, is leading the effort to bring vaccines directly to homebound older adults in the Sacramento, California area.

“There are many older adults in our region who are unable to leave their homes due to a variety of challenges, many of which were further complicated by the arrival of a global pandemic. These individuals meet the age and health requirements for vaccination, yet feasible access to the vaccine didn’t exist. That’s why we developed these mobile vaccine clinics, to ensure these older adults were not overlooked.”

Darlene Cullivan, Senior Manager of Outreach and Impact at Eskaton

How It’s Working

High-risk, homebound older adults are finally gaining access to the widely-sought vaccines. Since late March 2021, more than 300 individuals have been vaccinated through this program to increase resiliency against the COVID-19 virus. It took many groups to come together to identify high-risk individuals, coordinate appointments, educate patients, deploy the vaccine, care for the patients and keep their information secure.

“I’m stuck at home and have been in a wheelchair for 25 years . . . It’s been impossible for me to get out to get the shot. I am so thankful for Eskaton and what you are doing. Most places you have to go to and you actually come here and help me get the shot. I’d been praying to get it and you guys have been so helpful. You are my angels.”

Kitty Torda, recipient of the vaccine via the mobile clinic

Partners Key to Success and Scalability

Partnerships require a lot of coordination, and they allowed this program to be successful and scale. Eskaton identified individuals within the Meals on Wheels program. Recipients of Meals on Wheels received their meal and a flyer about the vaccine, which helped get the word out. Eskaton was responsible for scheduling and confirming each appointment, and then coordinating with the other partners to procure and deploy the vaccine to individuals in their own home.

Pucci’s Pharmacy, a local business serving Sacramento for over 90 years, procured the vaccine and was responsible for safeguarding the vials throughout the distribution process. The AlphaOne Medical Response Team was responsible for deploying the vaccine and making home visits – serving approximately 10 people a day – and caring for each patient before and after the shot.

Lessons Learned

Coordinating distribution of the vaccine requires creativity.

Thinking in multiples of five or six was paramount. As each vaccine vial contains five or six doses, delivery routes needed to be tailored to maximize distribution and ensure no vaccines went to waste.

The local pharmacy had to carefully evaluate the logistics of protecting the vaccine during the distribution process carried out by the city’s paramedics, maintaining the proper temperature of the vials throughout the long days of planning and coordination.

Remote gathering of patient information needs to be addressed on the front end.

Mobile medical teams were responsible for gathering and securely logging the patient information for the pharmacy. The electronic portal, Dragonfly, was used to keep patient information safe and secure.

Delivering one-on-one services is time intensive.

Since these homebound older adults are typically isolated and lack social access, getting patient consent at the outset posed a challenge. Many patients were afraid and hesitant to receive the vaccine, suggesting a greater need for education at the beginning of a home visit. After the vaccine, post-care for patients took longer than anticipated.

Overall, this effort underscores the importance of improving access to services and personalized care for older adults in order to ensure greater well-being for all.