Coordinated effort helps vaccinate Spokane’s homeless

As public health officials struggle to convince the broader public to get vaccinated for COVID-19, they’ve found some success locally in homeless shelters.

In fact, vaccination rates inside Spokane homeless shelters have at times exceeded that of the county.

More than six months into the rollout of the COVID-19 vaccine, just 57% of eligible county residents 12 and older have initiated vaccination. But inside the House of Charity this month, 69% of beds have been occupied by people who were fully vaccinated.

Health officials and shelter operators have leaned on the data to help gauge the risk shelters face from COVID-19 outbreaks and focus their vaccination efforts.

They attribute the relatively high rates to the Spokane Regional Health District’s early and targeted efforts to offer vaccines in shelters, as well as an openness among shelter clients to get the shot.

“What is surprising to most folks is that just like any other segment of our culture, people at HOC take great pride in being part of an HOC family,” said Dena Carr, the shelter’s manager. “They really are persuaded to do what’s best for their family.”

The health district’s homeless outreach team has been eager to help, holding more than 100 clinics for people experiencing homelessness and administering 1,504 doses of the vaccine since they became available.

Tracking the data

How does the health district know the vaccination rate inside a shelter?

With a little help from the city of Spokane, according to Kylie Kingsbury, the health district’s homeless outreach coordinator.

The city manages a Community Management Information System, which allows organizations and service providers to share information and track data related to homelessness and housing.

The health district asked the system’s outgoing administrator, David Lewis, if the city could begin tracking vaccination status among shelter guests. Lewis and his team quickly built the tool into the system, Kingsbury said.

The health district has been able to track everyone it has vaccinated at its 144 clinics in shelters, as well as those who have been vaccinated by CHAS. It can also pull information from the Washington State Immunization Information System.

With that data, health district staff have tracked what percentage of a shelter’s guests have been vaccinated in any given month.

The data helps give health officials a “helpful tool in gauging where we are and protection levels in a shelter,” Kingsbury said, especially as the delta variant surges into the Spokane region.

Because shelter residency is inherently impermanent, the vaccination rate can fluctuate. For example, the vaccination rate at the Hope House women’s shelter was 63% in July, but has dropped to 48% in August. That’s useful information to health officials, who now know they have more work to do.

The data also allows health officials to focus their efforts on people they know are staying in a shelter every night. The team identified people who were regularly staying at House of Charity but had yet to be vaccinated.

Of the seven people they were able to have conversations with about the vaccine, Kingsbury said six agreed to get it. Some people simply needed the vaccine offered to them, while others had a list of questions.

“We can do incredibly targeted outreach,” Kingsbury said.

The system allows health officials to also view who has received only a single dose of the vaccine and requires a second, preventing them from slipping through the cracks.

House of vaccination

The House of Charity, a shelter operated by Catholic Charities, has been a consistent leader in the vaccination efforts.

The shelter has been offering guests small incentives for COVID-aware behavior throughout the pandemic. Trading in a used mask for a new one was rewarded with an ice pop last summer, for example.

The initial offer for vaccination was a simple cup of hot cocoa, said House of Charity’s Carr, the shelter’s manager.

That shelter guests were so willing to get the vaccine is likely due to a number of factors.

When COVID-19 outbreaks occurred during spikes in the pandemic, Carr noted that people had to watch as their friends and family tested positive and were forced into isolation – making the consequences of the disease very tangible.

Shelter guests also simply wanted to do what was best for those around them, Carr said. It also helped that shelter staff were vaccinated at the same clinics.

“It was kind of a good leveler – we’re all doing this together and making this decision together,” Carr said.

Carr also gave health district staff credit for their work with the homeless population.

“Watching them work is really an exercise in harm reduction and communicating to people where they’re at, in a way that really alleviates a lot of the concern or anxieties that people feel,” Carr said.

While COVID-19 has been resurgent in local shelters, House of Charity has so far avoided any major outbreaks that have forced it to stop accepting new people inside.

Several shelters have experienced COVID-19 outbreaks in recent weeks.

The delta variant is significantly more transmissible than previous iterations of the coronavirus, leading to spread among the unvaccinated and even breakthrough cases in people who are vaccinated.

As is the case across the broader community, symptoms in vaccinated people have tended to be less severe than in those who are unvaccinated, according to local health officials. Given that proven effectiveness, Kingsbury said, the health district is continuing to encourage vaccination.