A covid caregiving challenge: vaccinating the homebound

“Then you also have to wait for a certain amount of time to see if there are any allergic reactions to the vaccine,” Chan adds. That leaves less time to travel to the next homebound person.

In contrast, vaccinating residents in nursing homes or other congregate living facilities is extremely efficient, allowing a median of 78 percent of nursing home residents to have received

at least the first dose by early February, according to the Centers for Disease Control and Prevention (CDC). “There’s a whole level of coordination that has to be taken into account,” says

Karen Anna Abrashkin, M.D., medical director of Northwell Health’s House Calls program, which is based in New Hyde Park, New York, and serves about 1,500 patients in the region. The program

plans to start home vaccinations soon, using “mapping software that clusters patients to allow for enough time from the vial puncture to when the last dose is drawn.” Another roadblock to

more efficient home vaccinations: strict eligibility rules. It would make sense for the people visiting homes to vaccinate both the older person and his or her caregiver, but that’s often

not possible under state rules. “We’re seeing that home health agencies are more reluctant to do the vaccine administration for homebound individuals, knowing that that one trip is only

going to result in one shot being administered,” says Chan, a member of California’s Community Vaccine Advisory Committee, which provides feedback on the state’s COVID-19 vaccine rollout.

THE GOOD NEWS The U.S. now has a vaccine in its arsenal that’s easier to store and administer. The Johnson & Johnson vaccine received emergency use authorization (EUA) for adults 18 and

older from the U.S. Food and Drug Administration (FDA) last weekend, and doses have begun shipping. It’s a one-shot vaccine, making it less complicated than the two currently used vaccines,

which require a second shot three or four weeks after the first.    The J&J vaccine also has less stringent storage requirements: It can be shipped and maintained at standard

refrigerator temperatures of 36 to 46 degrees Fahrenheit. And it’s just as good at preventing extreme outcomes from COVID-19: The data from phase 3 clinical trials show that all three of the

vaccines are 100 percent effective in preventing hospitalization and death from COVID-19. Adams is among the many health care experts and providers who say the J&J vaccine is likely to

be a game-changer for vaccinating the homebound, once its distribution becomes more widespread: “It will make all of these efforts easier,” she says. “It’s not that you can’t do it now, but

it will take away some of that complexity.” HOW TO GET A COVID-19 VACCINATION FOR SOMEONE WHO IS HOMEBOUND It’s not easy, but here’s where experts suggest you start: * Check with your or

your loved one’s primary care doctor. He or she may be able to refer you to a local program. * Connect with local community resources such as your Area Agency on Aging (AAA) (you can search

for one near you at n4a.org). Some managed long-term care or other practices providing in-home care might also have additional information, or be partnering with providers to administer

vaccines in homes. * Keep trying. “Even if you call and someone doesn’t know the answer at first, you shouldn’t give up,” says Chan. “The situation is evolving so quickly that persistence

may pay off.”    _Christina Ianzito is a Washington, D.C.-based journalist who joined AARP in 2010. She's the travel and books editor for aarp.org and _AARP The Magazine_, and also

edits and writes health, entertainment and other stories for aarp.org. She received a 2020 Lowell Thomas Award for travel writing._