As the Johnson & Johnson single-dose vaccine against the coronavirus arrives in California, some homeless advocates are urging the state to prioritize getting it to unhoused residents, who can be harder to reach for second doses.
“This population often lacks access to transportation and cellular devices to schedule appointments and can be very hard-to-reach,” said Joel John Roberts, head of People Assisting The Homeless, one of the largest homeless services providers in the state. “This provides an opportunity to prioritize specialized distribution to those most in need who have been heavily impacted by the pandemic due to job loss, eviction and economic inequities.”
The single-dose Johnson & Johnson vaccine only requires normal refrigeration, which makes it easier to transport and distribute than the Moderna vaccine, for instance, which needs to be stored at super-cold temperatures. The one-dose shot could be critical to get to populations who can’t easily make appointments to get vaccinated.
People experiencing homelessness are particularly at risk during the COVID-19 pandemic, since living in congregate settings like shelters or encampments can make it difficult to socially distance. They also have more barriers to health care and report higher rates of health conditions like asthma or chronic bronchitis, which can place them at greater risk for severe COVID-19.
California is set to receive 320,000 doses of the Johnson & Johnson vaccine over the next several days, according to Gov. Gavin Newsom’s office.
A spokesperson for the governor said the Johnson & Johnson vaccine would be distributed along with the vaccines from Pfizer and Moderna without prioritizing any specific vaccine for harder-to-reach groups, but that “discussions with our federal partners and others are ongoing.”
“Many people experiencing homelessness move frequently from place to place, camp to camp. Many struggle to keep track of important paperwork and documentation due to a variety of factors including weather [and] law enforcement sweeps,” said Angela Hassell, executive director of the homeless services group Sacramento Loaves & Fishes.
The single-dose vaccine would be “ideal” for unhoused residents, she noted, and would “ease the stress of the pandemic.”
Some advocates, however, are pushing for all three vaccines to be rolled out to homeless populations simultaneously. Sarah Tower, the chief programs officer at Union Station Homeless Services in Los Angeles County, said that discussions with the county have landed so far on using all three vaccines in order to increase access.
On Thursday, Newsom announced that California would set aside 40% of vaccine doses for the hardest-hit communities. The doses will be distributed to zip codes where residents are considered most vulnerable to being infected and dying from the virus based on data on health care access, housing, transportation, environmental justice and more.
In the list of prioritized areas, there was no specific mention of homeless populations. Newsom’s office did not immediately respond to a request to clarify.
Troy Vaughn, president of the Los Angeles Mission homeless services organization, said that the Johnson & Johnson single-dose vaccine is a “game-changer.”
“We can actually go now into encampments, we can create outreach teams, we can set up different types of sites where the vaccines can be provided more quickly,” said Vaughn, who was once homeless himself and living on the streets of Los Angeles’ Skid Row in the 1990s.
“When it comes to inoculating some of our unhoused neighbors, we have one shot to get this right.”
California has long faced an affordable housing crisis and has seen its rates of homelessness spike in recent years. Yet homeless people are still generally not eligible for the vaccine in the state unless they are over 65 or have health conditions placing them at high risk for COVID-19.
A spokesperson for People Assisting The Homeless noted that while the group has been able to vaccinate clients at their senior housing sites, many of their other clients are still not eligible.
There have notably been steep racial disparities among vaccinated Californians so far: Only 3% of those who have received vaccines are Black (Black people make up 7% of the state population) and only 17% are Latinx (Latinx people make up 39% of California residents). Meanwhile, Black and Latinx people are disproportionately hospitalized and dying from the virus.
Erika Hartman, chief program officer for Downtown Women’s Center, which works with unhoused women living in Skid Row, said that “unequivocally the Johnson & Johnson single-dose vaccine should be prioritized for people experiencing homelessness.” Hartman noted that Black people are disproportionately represented in California’s homeless population.
“Providers are faced with the added barriers of relocating individuals for a second dose and communities where people often lose important documents, like immunization records, during sanitation street sweeps or have their valuables stolen,” Hartman said, adding that such barriers could be reduced by prioritizing the single-dose vaccine for the unhoused community.
“When it comes to inoculating some of our unhoused neighbors, we have one shot to get this right,” said Roberts of People Assisting The Homeless.