Implementing a COVID-19 vaccination outreach service for people experiencing homelessness.

Publisher: Wiley Country of Publication: Australia NLM ID: 9710936 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1036-1073 (Print) Linking ISSN: 10361073 NLM ISO Abbreviation: Health Promot J Austr Subsets: MEDLINE

Publication: 2018- : Milton, Queensland : Wiley
Original Publication: West Perth, WA : Australian Association of Health Promotion Professionals,

COVID-19*/prevention & control ; COVID-19 Vaccines*/administration & dosage ; Ill-Housed Persons*; Adult ; Female ; Humans ; Male ; Middle Aged ; Australia ; Community-Institutional Relations ; Health Services Accessibility ; Immunization Programs/organization & administration ; Immunization Programs/methods ; Interviews as Topic ; Motivation ; Patient Acceptance of Health Care ; Vaccination Hesitancy/psychology ; Australian Aboriginal and Torres Strait Islander Peoples/psychology

Issue Addressed: In 2021, the Australian government implemented a population wide COVID-19 vaccination program. People experiencing homelessness faced challenges accessing vaccines and many were not being reached. By reorienting vaccination services to include assertive outreach strategies, a Brisbane-based non-profit health care team successfully administered 2065 COVID-19 vaccinations to homeless and precariously housed people. This study examines insights from stakeholders delivering the service and perspectives of clients who received a vaccine.
Methods: Semi-structured interviews with five stakeholders and a survey of 63 clients involved in the Micah Projects COVID-19 vaccination program are reported. Client survey questions covered demographic characteristics, and motivations and hesitancies around vaccination. Stakeholder interviews were inductively analysed and quantitative survey data were exported into SPSS (IBM V27) and analysed using descriptive statistics.
Results: The Micah Projects team initiated 220 pop-up vaccination clinics and worked closely with Aboriginal and Torres Strait Islander communities. Downsizing and mobilising the service engaged greater numbers of people sleeping rough and Aboriginal and Torres Strait Islander people. Clients' decisions to vaccinate were often spontaneous, driven by immediate availability and motivated by a desire to stay healthy and protect the community.
Conclusions: Tailoring vaccination programs to include assertive outreach strategies effectively reduces barriers for people experiencing homelessness. Community embeddedness, trust, flexibility and cultural safety are critical elements for success. SO WHAT?: People experiencing homelessness are motivated to vaccinate. Reorientating health services to remove structural barriers and build the supportive environments needed to work through vaccine hesitancies are critical elements to ensure equitable access and promote health.
(© 2024 The Author(s). Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Aust J Gen Pract. 2022 Apr 11;51:. (PMID: 35405735)
Health Promot J Austr. 2025 Jan;36(1):e885. (PMID: 38886135)
Aust J Gen Pract. 2022 Sep;51(9):725-730. (PMID: 36045631)
Int J Environ Res Public Health. 2022 Nov 25;19(23):. (PMID: 36497787)
Integr Healthc J. 2022 Jan 3;4(1):e000065. (PMID: 37440845)
Vaccine. 2022 Jan 3;40(1):122-132. (PMID: 34863618)
J Prim Care Community Health. 2021 Jan-Dec;12:21501327211041211. (PMID: 34427125)
Int J Environ Res Public Health. 2023 Jan 25;20(3):. (PMID: 36767539)
Am J Public Health. 2023 Feb;113(2):170-174. (PMID: 36455191)
Vaccine. 2022 May 20;40(23):3109-3126. (PMID: 35484042)

Keywords: COVID‐19; access to care; assertive outreach; homelessness; model of care; vaccination; vaccination hesitancy

0 (COVID-19 Vaccines)

Date Created: 20240617 Date Completed: 20250114 Latest Revision: 20250424

20250425

PMC11730347

10.1002/hpja.885

38886135