The next big vaccine challenge: Homebound seniors

McHenry County residents who are not in a long-term care facility but are homebound or unable to drive seem to have “fallen through the cracks” of the county’s vaccination distribution, said Steve Rowley, whose 96-year-old mother had difficulty scheduling and getting to her appointment.

Rowley’s mother, who relies on a cane to get around, recently secured a vaccine appointment at the county’s McHenry vaccination site after months of trying and was able to have family members drive her there on short notice, but he said it would have been safer if she didn’t have to leave her home.

“She had to stand in line on the sidewalk out front first and then go inside, stand in line there and be subjected to everyone else,” Rowley said. “I’m from the perspective that someone should have come to her house with a needle considering her age and limitations.”

Another resident reported wait times of an hour and a half at the McHenry Kmart location, adding that it was a less-than-ideal experience for seniors who may not be able to stand for extended periods of time.

As McHenry County works to ramp up its vaccination of senior residents, those who cannot drive, and even more so those who are homebound for medical reasons, are among the most logistically challenging to reach, but remain a priority, County Board Chairman Mike Buehler said Tuesday.

“Rest assured that there will be some news forthcoming within the coming weeks when we do get the doses to address that population,” Buehler said in response to residents’ frustrations. “I wouldn’t say that their concerns are unfounded. We share the same frustrations at the county level.”

ExpandAutoplay

Image 1 of 15

People head inside a McHenry County Department of Health COVID-19 vaccination clinic at 1900 N. Richmond Road, the former site of a Kmart in McHenry, on Tuesday, March 2, 2021. Vaccinations are made by appointment only. (Matthew Apgar/Matthew Apgar)

Homebound people “need the help of another person or medical equipment such as crutches, a walker or a wheelchair to leave their home, or their medical provider believes that their health or illness could get worse if they leave their home,” according to an article by the Centers for Disease Control and Prevention that provides guidance for local health departments on vaccinating this population.

The health department currently is compiling data from local agencies such as the Senior Services Associates’ home care program to identify how many people fall into this categories, so they can develop a plan to reach them, said Buehler and Rita Boulden, office coordinator for the Senior Services Associates’ McHenry location.

“We are actively working on plans to address the homebound population in our County,” Public Health Nursing Director Susan Karras said in a written statement Thursday. “Specifically identifying the population and the logistical management of vaccine cold chain, multi-dose vials to prevent wastage, and post-vaccination observation and emergency response if needed.”

Karras did not respond to an emailed question on when vaccinations of homebound seniors will begin.

The main logistical challenge in vaccinating homebound seniors is that they live spread out across the county, so the health department will need to be strategic in how they schedule home visits to avoid wasting doses, Buehler said.

Both the Moderna and Pfizer vaccines must be kept in an ultra-low temperature freezer and, if thawed to room temperature, must be used within hours, according to the CDC.

The Moderna vaccine lasts for up to six hours at temperatures between 36 and 77 degrees, but for the Pfizer vaccine it is no more than two, according to the CDC. They also come come in vials of 10 doses each and, once a vial is thawed and punctured, it cannot be saved for later use.

“You don’t want to break the seal on a vial and only get to three people and waste seven doses,” Buehler said. “I mean the vaccine as it is right now is such a valuable commodity. We don’t want to waste a single dose.”

Some homebound seniors may also have medical conditions that put them at increased risk for anaphylaxis, or severe allergic reaction, with the COVID-19 vaccine, according to the CDC article. These people may need to be vaccinated somewhere where medical care is immediately available or vaccinators need to be trained to properly screen, monitor and, if necessary, treat them until help arrives.

Anyone with a history of allergic reaction to vaccines must be monitored for 30 minutes after injection, rather than the usual 15 minutes, further complicating the time-sensitive nature of home vaccinations.

In a document last updated Feb. 26, the Lake County Health Department advised that homebound seniors check with their home health care providers about at-home vaccinations as they are unable to offer home visits.

The Kane County Health Department said in a Jan. 29 news release that they are working on providing at-home vaccinations with the help of home health care providers.

For seniors who are not medically homebound but no longer drive, transportation is a significant barrier to being vaccinated, Senior Services Associates transportation coordinator Christy Strissel said Wednesday. This is especially true for those who are unable to rely on family or friends to drive them places.

Senior Services Associates offers a transportation program supported entirely by volunteers who drive seniors to “needs-based” locations like doctor’s appointments, meetings with lawyers and, now, vaccine clinics, Strissel said.

The program took 14 people to be vaccinated in February and three more this month as of Wednesday, and Strissel said she expects that number to increase quickly in the coming weeks.

Their capacity is limited though. Since most volunteers are seniors themselves, some decided not to serve in the program this year for fear of exposing themselves to the virus, Strissel said.

Also, each volunteer can only take one person, or two people from the same home, in their car at one time and typically only accept a few rides a week, she said.

One volunteer, Anna Gifford, has dedicated herself to taking on more rides with less notice in order to help bring seniors to clinics, Strissel said.

“We have simply got to get the seniors protected,” Gifford said Wednesday. “Seniors are less likely to have a computer, less likely to be knowledgable about technology, ... but then to have to find transportation on top of it is an additional burden.”

To prepare for an increase in ride requests, Senior Services Associates will be using funds available through AgeGuide, a regional nonprofit organization, to pay for MCRide bus passes for seniors and, as a last resort, for a taxi service.

MCRide Dial-A-Ride is a transportation service run by McHenry County that uses Pace buses to take seniors and other residents where they need to go, Transportation Planner Ryan Peterson said Wednesday. To make a reservation with MCRide, residents can call 1-800-451-4599.

Due to COVID-19, buses are only able to transport one person at a time, but the buses are wheelchair accessible whereas the Senior Services Associates program is only able to accommodate people with canes or walkers, Peterson and Strissel said.

The Senior Care Volunteer Network also runs a transportation program similar to that of Senior Services Associates, Peterson said.

Even with these agencies helping out, Gifford said that more should be done to ensure that seniors are able to access vaccine clinics.

Karras did not respond to questions about whether more transportation options for seniors should be made available or whether more support should be given to existing programs.