Vaccine uptake among homeless people reaches 80%

There are programmes for homeless people in hostels, homeless families, the Traveller community, women in domestic violence shelters, the Roma community, people in direct provision, and undocumented migrant workers among others.

Vaccine uptake among homeless people has hit 80%, according to the HSE doctor leading programmes for vulnerable groups.

Dr Margaret Fitzgerald, HSE public health lead for social inclusion and vulnerable groups, said providing access to vaccines is the biggest challenge, not vaccine hesitancy among homeless people. 

There are programmes for homeless people in hostels, homeless families, the Traveller community, women in domestic violence shelters, the Roma community, people in direct provision, and undocumented migrant workers among others.

She said people may not have a GP to get information, however. 

“So we have to look at access in terms of IT, basic literacy, basic English. These are all constraints, they are not quite hesitancy. It is a different issue.” 

Advice from the National Advisory Immunisation Committee (Niac) that the single-shot Johnson & Johnson vaccine be used in over-50s complicated this rollout, she said.

“So many of our people are much younger than 50; it is complicated to offer two different types of vaccines in the one clinic,” Dr Fitzgerald said.

That is why over the last week the decision was made: If you set up a special clinic for Travellers or homeless people you use Pfizer (for everyone).

Pop-up clinics in Limerick and Dublin have been very successful, she said.

Referring to vaccinations in partnership with the Cork Simon Community and St Vincent de Paul, she said: “Cork vaccinated their homeless very early with Pfizer because of supply and also an in-built service there with the GP leading it.” 

Public health staff also work with Traveller Health Units; a pop-up clinic was held recently in Tralee.

“Only 3% of Travellers are over 65, now is the peak time to reach out to Travellers; from now on. Over half of the Traveller population are under 25 so now is the time,” Dr Fitzgerald said.

“We now advise GPs they should vaccinate any Traveller or Roma person in their population, because they are seen as vulnerable medically.” 

She said for people traditionally excluded from society the reasoning for vaccines is not always clear.

“You are asking them to do something for society; you do it for collective responsibility and that works very well when your society is very cohesive," she said.

That kind of social cohesion may be missing a bit.

Many people in direct provision are also under-50 and coming into the rollout now, she said. 

She acknowledged “multiple outbreaks” in these congregated settings.

“They have not been targeted by Niac as in need of a rapid rollout, because even though they had a lot of outbreaks they haven’t been ill in the same way as older people.” 

The HSE found distrust of other governments can impact attitudes among migrant worker groups.

“I know with the Brazilian community there is great distrust of the government … it is quite recent,” she said.

The HSE is working with Brazilian community groups to share accurate information, especially for meat plant workers.

Dr Fitzgerald praised Translate Ireland — a Cork social enterprise that shares free information in 40 languages on Covid-19.

Across all groups, she said convincing young people they need the vaccine is challenging due to lower risks from Covid-19, as the HSE is also finding more generally.

“It is a rolling campaign with peaks of activity, it (these vaccinations) will continue for months,” she said.