New York City has vaccinated several thousand of its homeless residents, making what advocates say is modest progress that they hope will be significantly accelerated by the Johnson & Johnson shot.
So far, 3,550 homeless New Yorkers have been fully inoculated—or about 10 percent of all adults counted in the city’s shelters. For the general population of NYC adults, the coverage is nearly twice as high, at 18 percent.
The doses are administered through the Department of Homeless Services’ vaccination hub in Manhattan and via city-run mobile clinics hosted at shelters. This currently small tally may be an undercount, because city officials said they don’t track unhoused adults who receive doses at sites open to the general public nor from a small number of non-profit shelter providers.
“This is just the beginning. Things are just starting,” said Giselle Routhier, policy director at the Coalition for the Homeless. “We'll have to see how it continues to go in terms of numbers and how many folks DHS is able to reach in the coming weeks and months.”
Progress has been partly shaped by New York State policy, which limits who among the 34,617 adults living in the city’s shelters can receive COVID-19 vaccines from DHS. Parents staying with their children haven’t been eligible because they reside in separate units with individual dining areas and bathrooms. Those quarters don’t qualify as congregate settings under state rules.
Vaccine doses offered through homeless services can only go to single adults —currently about 18,000—plus the staffers who work in these places. That includes congregate shelters for single adults, where eight to 12 people on average share a room, as well as the hotels, where city officials moved many homeless individuals during the pandemic to prevent the spread of the coronavirus.
Christine Quinn, a former City Council Speaker who runs Women in Need, the city's largest family shelter provider, said she’d like to see the DHS vaccination hub and mobile vaccination clinics be expanded to families as they become eligible.
“Anything that is targeted specifically at homeless people is better and more welcoming. And anything that is out there that includes singles, we want to have include families as well,” she said.
A spokesman at the Department of Homeless Services, Ian Martin, said they’d made strides, fully vaccinating 2,800 staff members alongside the 3,550 clients. More than 11,600 vaccine doses have been doled out overall.
“As the vaccine supply becomes more readily available, we are continuing to adapt our approach and do everything we can to ensure it is easy to access for some of our city’s most vulnerable residents and essential frontline workers,” Martin said in a statement.
Last week, Mayor de Blasio said vaccination “is going to be a big part of how we can start to move out of the hotels at the right time.” On Tuesday, eligibility in New York is also expanding to adults older than 30, ahead of becoming universally available to anyone over 16 on April 6th, which should aid the process of reaching homeless adults.
Advocates for the unhoused said the slow start to the city’s campaign is partially due to the DHS program initially only offering the Moderna vaccine, a two-dose shot that is harder to store and transport. But providers are starting to see improvements with the use of the Johnson & Johnson vaccine, which the U.S. Food and Drug Administration authorized in late February. It is a single shot that can be kept in normal refrigeration.
“The two doses was [sic] really not going to work for our clients. They're very suspicious of medical care,” said Cassie Dessalines, the program director at the Living Room, a drop-in center for homeless New Yorkers, and Safe Haven, a low-barrier shelter. Both share a location and are run by the non-profit group BronxWorks. By mid-March, only three people had received at least one dose across the two facilities—where the majority of clients are facing mental health and substance use issues. Compare that against a recent episode when 18 clients took Johnson & Johnson shots at the BronxWorks’ site in one day, Dessalines said.
Abigail Graham, 39, who’s been living at the Safe Haven in the Bronx since January, got one of those Johnson & Johnson doses. She said she was hesitant at first but reconsidered because she didn’t want to get her parents and other older members of her family sick.
“I want to see my dad. I want to see my mom,” she said. “I don't want to be the cause of anything happening to them.”
Public health experts caution, though, that it’s valuable to allow homeless New Yorkers to make their own choices. The Pfizer and Moderna vaccines outperformed Johnson & Johnson in clinical trials. The two-dose shots recorded higher efficacy rates—above 90%—relative to Johnson & Johnson’s 72% in areas without the variants.
“Being one-size-fits-all and choosing something that potentially has less efficacy for a group of people who are already so marginalized by society, I think, is really ethically dubious,” said Andrew Goldstein, an assistant professor at NYU and a primary care doctor. He currently treats around 60 homeless patients.
But he said he might counsel some patients to seek the Johnson & Johnson vaccine if they’re more likely to be at risk of missing their second dose of the mRNA options from Pfizer and Moderna.
“An individual patient who wants the Johnson & Johnson one because they want the simplicity of it, I think that's a great option and I still think it's a wonderful vaccine,” he said