Feb. 21—A central Missouri health department has unveiled a program designed to get COVID-19 vaccines in the arms of people who might need them most, and it's a model that health departments in this area should consider replicating.
The Columbia/Boone County Public Health and Human Services Department is gathering information on individuals in that community who are homebound and unable to travel to mass vaccination clinics. Health officials there are using Medicare's classification of homebound, which includes individuals who need the help of another person or medical equipment such as a walker or a wheelchair to leave home, individuals whose doctor believes their health or illness could get worse if they leave home and individuals who typically cannot leave home because it is difficult.
Residents in Boone County who are homebound and fall in Phase 1B, Tier 2 — which includes individuals 65 and older and adults with certain medical conditions — could qualify to receive the vaccine at home, the Columbia Missourian reported. All they need to do is sign up on a waiting list with the local health department, which will then contact them when vaccines are available and schedule an appointment.
If they don't already have a plan specifically for vaccinating homebound residents, our local health departments should devise one.
Such a plan could take care of our most vulnerable population: senior citizens, who have been disproportionately affected by COVID-19, dying at higher rates than the general population, and who are more likely to be homebound than the general population as well. And being homebound doesn't completely eliminate their risk of infection, as they likely still receive grocery or Meals on Wheels deliveries, family and friend visitors, and medical appointments.
It's difficult to know precisely how many homebound residents live in the U.S. But an estimated 1 in 6 seniors living alone in the U.S. face physical, cultural or geographical barriers that isolate them from their peers and communities, preventing them from receiving benefits and services that could otherwise improve their lives, according to the National Council on Aging.
And research from 2011, published in the medical journal JAMA Internal Medicine, estimated that 5.6% of the elderly, community-dwelling Medicare population, or about 2 million people, were completely or mostly homebound. Completely homebound individuals, according to the study, were more likely to be older, to have more chronic conditions and to have been hospitalized in the past 12 months — potentially putting them more at risk of becoming infected and all the more reason vaccines should be delivered to them posthaste.
Reaching homebound residents is critical as the vaccine rollout continues. In order to fully make the vaccine available to everyone who wants one, we must consider ways to get it in the arms of those who can't get out.