Key TakeawaysMost of the country’s 12 million homebound patients have not yet received COVID-19 vaccines.People in hospice care or who are at risk of a worsening condition if they leave home don’t currently benefit from new vaccination sites across the country.Health departments may see those who stay at home as being at low risk of contracting COVID-19.

Key Takeaways

Most of the country’s 12 million homebound patients have not yet received COVID-19 vaccines.People in hospice care or who are at risk of a worsening condition if they leave home don’t currently benefit from new vaccination sites across the country.Health departments may see those who stay at home as being at low risk of contracting COVID-19.

While states have prioritized COVID-19 vaccines for many of their most vulnerable residents, so far, most homebound patients—and, often, their family, volunteer and paid caregivers—have been left out of vaccine allocation and administration.

Vaccinations for the 12 million people estimated to be in hospice care or who are homebound because of health issues have been “localized, scattered, and limited,” Bill Dombi, president of the National Association for Home Care & Hospice, tells Verywell. “You’re not likely going to have them stand in line for hours at a convention center waiting for their vaccine,” he says.

What Is a Homebound Patient?According to the Centers for Disease Control and Prevention (CDC), homebound patients are defined as those who need the help of another person or medical equipment such as crutches, a walker, or a wheelchair to leave their home.Alternatively or additionally, their medical provider believes that their health or illness could get worse if they leave their home.

What Is a Homebound Patient?

According to the Centers for Disease Control and Prevention (CDC), homebound patients are defined as those who need the help of another person or medical equipment such as crutches, a walker, or a wheelchair to leave their home.Alternatively or additionally, their medical provider believes that their health or illness could get worse if they leave their home.

Dombi says that vaccinating homebound patients may have been overlooked until now because it is not an easy problem to solve. In addition, he says homebound patients may have been thought to have a lower risk of both contracting and spreading COVID-19. However, their caregivers generally spend time outside the home, and risk contracting the virus and transmitting it to homebound patients.

A Monumental Task

The CDC did issue guidance on vaccinating homebound patients on February 11 in response to requests from advocates, noting that the situation “presents unique challenges to ensure the appropriate vaccine storage temperatures, handling, and administration to ensure safe and effective vaccination.”

The CDC does a good job of outlining—but not solving—the complexity in its guidance, including:

Updated Guidance Needed

The CDC guidance “is really helpful [but] needs to be updated based on the Johnson & Johnson approval,” says a spokesperson forLeadingAge,which represents 5,000 nonprofit aging services providers. This includes the Visiting Nurse Association, which has some member agencies that have been administering COVID-19 vaccines for homebound patients.  The Johnson & Johnson vaccine, authorized for use on February 27 and several weeks after the CDC issued its guidance for homebound patients, needs only refrigerator storing. It does not need to be thawed and is given as a single shot, unlike the Pfizer and Moderna vaccines.

Medicare and Medicaid, which cover the health costs of many homebound patients, need to consider higher payment for vaccine administration outside a mass vaccination site. “The administration fees are great if you are cycling through people rapidly at a large site,” the spokesperson tells Verywell. “However, the current [payment] codes do not remotely cover the costs of sending out a staff person to a home, administering the vaccine, staying to be sure there is no adverse reaction, travel between sites, etc.”

Who Is Taking Initiative For Home-Based Vaccinations?

Stamford Hospital in Connecticut, Wake Forest Baptist Hospital in North Carolina, and the Boston Medical Center, for example, have all been vaccinating the homebound patients they currently take care of, as well as caregivers if there is sufficient vaccine supply.

Some People Are Getting the COVID-19 Vaccine Early. Here’s How

Georges Benjamin, MD, executive director of the American Public Health Association, tells Verywell that until there’s a coordinated system in communities, in order to get a homebound patient vaccinated, the starting point is talking to your primary care provider.

That’s what Nancy Hemenway of Fairfax County, Virginia, did in order to have her adult daughter, who is immunocompromised, get her shot. “[Our doctor] called our health department early in the process to alert them to the risk it would be for her to have to go someplace like the government’s center in Fairfax to get a vaccination,” Hemenway tells Verywell. “The Fairfax County health department arranged for EMTs to give her the vaccination…they also vaccinated me.”

In New York State, the health department launched a small pilot program this week in the city of Yonkers, just north of Manhattan, with Ro, a health technology firm, for the many complex tasks involved in vaccinating homebound patients.

How Organizations Are Working Toward Equitable COVID-19 Vaccine Distribution

Waiting for the White House

Access solutions announced so far include mobile clinics in neighborhoods and paid-for ride shares to vaccination sites, which don’t address the needs of people at risk if they leave their homes to get the vaccine.

While Dombi says he is “agnostic” about which vaccine should be used, other homebound care experts hope the one-dose Johnson & Johnson vaccine is prioritized. “It will make the process easier in part because, unlike the Pfizer and Moderna vaccines, it can be returned to the fridge if someone decides at the last minute that they don’t want it,” Wake Forest’s Yang tells Verywell.

But at least for now, the White House is holding firm that the Johnson & Johnson vaccine will not be allocated to special populations.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit ourcoronavirus news page.

1 SourceVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Vaccinating Homebound Persons With COVID-19 Vaccine. February 11, 2021.

1 Source

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Vaccinating Homebound Persons With COVID-19 Vaccine. February 11, 2021.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Centers for Disease Control and Prevention.Vaccinating Homebound Persons With COVID-19 Vaccine. February 11, 2021.

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