Rate Of Second Vaccine Doses In Boston's Homeless Community Higher Than Expected

Doctors and nurses administering COVID-19 vaccines to people experiencing homelessness in Boston say they're pleased with the level of vaccine acceptance so far — particularly the rate of second doses administered — but they caution there's more work to do to get the numbers higher.

Boston Health Care for the Homeless Program (BHCHP) says about 61% of people aged 18 and older staying in shelters in the city have received at least one vaccine dose since the organization started offering the shots at shelter-based vaccine events two months ago.

The program's medical director, Dr. Denise De Las Nueces, says outreach to shelter guests is helping to ensure the majority of people complete the vaccination process once they start it.

"Seventy-seven percent of guests who were due for their second doses have received them so far, which is really astounding. It's much higher than what we had anticipated," De Las Nueces said, adding that staff has also begun vaccinating eligible patients who are living on the street, or who are housed but still receiving care from the organization.

The outreach within the shelters — which includes posters and one-on-one conversations — has also helped many people who were originally hesitant about the vaccine become more comfortable getting it, according to registered nurse April Donahue, BHCHP's associate director of clinical operations.

Some took a "wait and see" approach, observing and talking with fellow shelter guests, staff and medical teams about the shots and their effects before deciding to proceed, she said.

"I do think there's been a lot of power in the narrative. I can't tell you how many vaccine clinics [someone would] come up and say, 'Well, did you get your vaccines?' and when you're able to say, 'Yes,' and they ask more about your experience," Donahue recounted, "so we've really encouraged both guests and staff in the congregate setting to share those experiences if they're comfortable."

BHCHP and shelter leaders are launching a program for shelter guests to be trained as "vaccine peer ambassadors" to share information and dispel misinformation about the vaccines, Donahue said. She added that the program is meant to help improve equity in vaccine access between people of different racial and ethnic backgrounds.

The clinicians' goal is to get 70% or more of guests fully vaccinated. They hope the addition of the Johnson & Johnson single-dose regimen as an option soon will boost vaccination rates, Donahue said. And guests will still have the option of receiving the two-dose Moderna vaccine.

BHCHP continues conducting coronavirus testing in Boston's homeless community, with a focus on people with COVID-19 symptoms. The organization is also conducting some random sampling of people who haven't been vaccinated and are asymptomatic, according to De Las Nueces.

Data WBUR obtained from the Boston Public Health Commission show 0.9% of coronavirus tests performed among people experiencing homelessness last week were positive — the same positivity rate as a month earlier and significantly lower than the state's seven-day average of about 2%.