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LA County Health Official On Getting Vaccines To The Unhoused


Here in Los Angeles, there are about 66,000 people now experiencing homelessness. Many of them have health problems already, which puts them at even greater risk of getting seriously ill from the coronavirus. And though the state of California initially prioritized vaccinating unhoused individuals, that changed last month when the state shifted to prioritize vaccinating people based on age. Dr. Heidi Behforouz has gone out with teams to vaccinate people who are experiencing homelessness. She's with the LA County Department of Health Services, and she joins us now with an update. Welcome.

HEIDI BEHFOROUZ: Thank you, Ailsa. Happy to be here.

CHANG: Do you have a sense right now how many of LA's 66,000 people who are without homes right now, how many of them have been vaccinated so far?

BEHFOROUZ: At the Department of Public Health Services, we've vaccinated about 1,200 individuals.

CHANG: Twelve hundred - that doesn't seem like very much.

BEHFOROUZ: It isn't. However, we do think that there are other federally qualified health centers and hospitals that have vaccinated people experiencing homelessness. But our numbers are still small relative to the total number of people we need to vaccinate.

CHANG: Because this population - or so much of this population is on the move, how does that play into trying to track people down for the second dose of a vaccine?

BEHFOROUZ: Much of the care of people experiencing homelessness is opportunistic and relational in the sense that you have a therapeutic alliance with someone, and you leverage that relationship and that understanding of that person to track them down, which makes that work so much harder, but also allows us to have success. So for instance, everyone who comes to a pop-up unit to get vaccinated gets a card telling them, show up here - same place, same time - in a month, and we'll vaccinate you. If they don't have a phone, we'll help get them a phone.

We also then will log information into an app with their picture. Where do you tend to hang out? Who are some people we might call if we're having trouble finding you? And then we also are entering them into universal data system called HMIS where if they, let's say, register in a shelter for the night, that shelter provider can look them up in HMIS and say, hey, Joe, you know, you missed your second dose and give us a call so we can go to Joe and give him the vaccine.

CHANG: As I mentioned, California initially put people experiencing homelessness in a prioritized tier along with factory workers, bus drivers, the incarcerated, so on. But then the state abandoned that plan in favor of an age-based structure. Do you think that was a mistake in this case?

BEHFOROUZ: I understand why they've done it given the resource scarcity. I do think that we need to have a different approach. When you do an age-based strategy, what that can mean is when you go out into an encampment or into a shelter and you're only able to vaccinate a subset of the individuals there, it can diminish trust. It's logistically inefficient. What I'll say is that I'm also heartened by the fact that sometimes when we've gone back, the people who were hesitant the first time will come up with their sleeves rolled up.

CHANG: But in many ways, it does make your job harder because not only do you have to locate these people who are experiencing homelessness, you have to then find out how many of them make the age cut right now.

BEHFOROUZ: It is more complicated.

CHANG: So how long do you think it will be before LA gets anywhere close to vaccinating all 66,000 some people who are without homes right now?

BEHFOROUZ: My hope would be that assuming we can get to 50- to 60% acceptance rate, that we would be able to vaccinate 35- to 40,000 people experiencing homelessness by the early fall. I do think it's going to take us time to vaccinate the whole population, make sure that they have the second dose and to be sure that we're getting into all of the areas that wouldn't necessarily show up to a clinic or a pharmacy to get the vaccine.

CHANG: Dr. Heidi Behforouz is the medical director of Housing for Health at the LA County Department of Health Services. Thank you very much for joining us today.

BEHFOROUZ: Thank you, Ailsa. It was a pleasure.

(SOUNDBITE OF JAM DA SILVA'S "DIA SANTO") Transcript provided by NPR, Copyright NPR.