A Wayne State University mask covered her mouth, but her eyes gave it away: Peggy Dixon was smiling. It was May 25, 2021, and the 87-year-old homebound, paralyzed senior had just received the first home-delivered COVID-19 vaccination through a partnership between the Detroit Area Agency on Aging (DAAA) and Health Centers Detroit (HCD).
Dixon’s daughter and caregiver shared her mom’s relief. “I’m so very happy and grateful because this really eases my mind,” she said. “I don’t do anything or go anywhere because I’m afraid to bring something back to her.”
Dixon’s shot was the first of over 1200 home-delivered shots provided to over 600 individuals through the partnership, which helped disabled seniors, their caregivers, and others who have limited access to transportation and healthcare in the Detroit area. These vaccinations are significantly more time-consuming than Detroit’s massive campaigns at Ford Field or the TCF Center earlier in the year, but they fill a key gap. The same people who face barriers to getting to a local pharmacy or clinic often face added risk to complications from COVID-19. And while it’s a significant success that 80% of Michigan older adults are fully vaccinated against the virus, the hundreds of thousands of older residents who have not yet received their shots continue to face increased risk of severe illness or death.
And so, for DAAA, HCD, and their partners, the work is well worth it. It starts, says DiAnna Solomon, director of fund development, communications, and advocacy for DAAA, with longstanding relationships in the community.
“One of our biggest drivers is trust—forged, built, and nurtured over 40 years,” she said. “You don’t form relationships overnight.”
The process started with phone calls to individuals that DAAA knew to be homebound. The vast majority of those people had already received their vaccine, and of those who hadn’t, about half weren’t interested in getting one. If the client did agree, they were connected to HCD, who trained local nurses to provide the vaccines. From state and federal certifications to maintaining vaccine temperatures and preparing medical equipment bags, the process took time. But taking time for vulnerable community members is nothing new to those involved.
One example among many
This partnership is one of 24 initiatives that received an award through the Health Fund’s $1 million in vaccine outreach funding in the spring. The Health Fund provided the initial funding to the Michigan Primary Care Association and the Michigan Association for Local Public Health, who in turn awarded grants ranging from $15,000 to $50,000 to federally qualified health centers and local health departments across Michigan to collaborate with community-based organizations (CBOs).
All the funded initiatives shared a common mission: to get vulnerable residents vaccinated. But the barriers to that goal, and thus the best approach to achieving it, varied across Michigan’s diverse communities.
“More than anything, these outreach initiatives have taught us that nothing is more valuable than conversations with trusted peers and community leaders,” said Health Fund Program Director Becky Cienki. “Those conversations, in tandem with a pop-up clinic, gas card, or something else to create the opportunity, can be really impactful on vaccination rates.”
Some initiatives, like the DAAA collaboration with HCD, have worked to provide home-delivered COVID-19 vaccines. In Berry, Eaton, Clinton, Gratiot, and Shiawassee counties, for example, health departments are working with CBOs to deliver vaccines via EMS or ambulance services.
Other projects are taking aim at vaccine hesitancy. In the Upper Peninsula, the Upper Great Lakes Family Health Center is partnering with Room at the Inn, a shelter in Marquette, to host listening sessions to better understand and respond to concerns within their communities. Pop-up and curbside vaccination clinics are also available to residents of area shelters.
In a different Detroit initiative, the CHASS Center is partnering with the United Neighborhood Initiative on a multi-pronged outreach effort: they’re training workers at nail and hair salons, restaurants, and more to be peer educators. They’re also promoting vaccine events and hosting virtual townhalls in English, Spanish, and Arabic. On top of that, they’re providing gas cards to residents, passing out informational materials, and purchasing advertising on Spanish language broadcast and print media.
The goal of these initiatives—increasing COVID-19 vaccination rates—may be new, but many of these Michigan organizations have been building trust, sharing knowledge, and creating opportunities for increased health access for decades. That experience makes them uniquely valuable in the battle against the virus.
A changing landscape
It’s been over six months since Dixon’s at-home vaccination, and over a year since the first COVID-19 shot was administered. Since then, eligibility has expanded from only the most vulnerable to everyone over five years old. In November, Michigan achieved its goal of vaccinating over 70% of residents 16 and older.
Despite those gains, COVID-19 has surged in the state at the end of 2021, overwhelming hospitals and causing unprecedentedly high case rates. On December 10, Michigan passed the grim landmark of 25,000 deaths related to COVID-19. Data from the Michigan Health & Hospital Association indicated that three out of four COVID patients are unvaccinated, and 88% of ventilator patients are unvaccinated—a harsh reminder of the potential consequences of leaving vulnerable residents behind.
With the omicron variant of the virus bringing its increased transmissibility to Michigan just as we enter the holiday season, community vaccine outreach efforts are as important as ever. DAAA continues to reach out to vulnerable residents, offering initial shots for the unvaccinated and booster shots for those further along. For these high-risk individuals that have not yet been reached or reassured, the extra effort could save lives.
Amid countless other pandemic-related conversations, from mask-wearing to school policies, organizations like DAAA and the advocates they work with remind us to continue to look out for the aging, disabled, and vulnerable in our communities. Over and over, this crisis has struck that population hardest, and, even now, those residents remain most at risk.
At that very first DAAA at-home vaccination, Dixon’s daughter put it this way:
“That’s why I’m so vocal as her advocate, because if she did not have an advocate, advocacy group, or family member, they can’t speak up for themselves. And that’s why so many people get sick in their home or die in their home and nobody knows. Someone’s got to speak up for this population.”