Delivering Vaccines to Vulnerable Populations 

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Vulnerable populations—children, seniors and homeless—are at higher risk of contracting many preventable diseases. With immunity developing, declining, or at risk, these groups are more likely to suffer from illnesses that can be prevented with vaccines. Health providers and vaccine advocates can help protect vulnerable populations by promoting vaccines to all populations and delivering vaccines to those who need it most.

With immune systems still developing, children are particularly susceptible to vaccine-preventable diseases. For instance, children are more likely to experience flu-related complications, such as pneumonia and other respiratory infections as the Centers for Disease Control and Prevention (CDC) notes. While programs exist to increase vaccine availability among low-income children, unfortunately, not all parents have easy access to vaccinations for their children. 

One study revealed that among a low-income community in New York, 80% of parents believed that all children should receive a flu vaccination, but only 63% had immunized their own child. The same study also revealed that the reasons for vaccine hesitancy for nearly all of those who wanted a vaccination were due to lack of funds, insurance, access to doctors or time. 

New York’s low-income families are not the only ones experiencing these difficulties, and health organizations and agencies have taken proactive approaches to limit barriers to ensure that every child has access to vaccinations. As part of the Vaccines for Children (VFC) Program, health officials in Alameda County, CA have free immunization clinics around the city, specifically for low-income children. At their local public schools, YMCAs and health centers, families can receive not only flu vaccinations, but also other critical vaccinations that help keep them and others around them healthy. 

Due to declining immunity as one ages, seniors are another group vulnerable to vaccine-preventable diseases. The CDC recommends that adults aged 60 years and older be vaccinated against flu, shingles and pneumonia, among others. Yet, a CDC report revealed that nearly 40% of seniors had not been vaccinated against pneumonia, a disease that affects close to one million seniors each year.  

In addition to weakening immune systems, tight quarters in nursing homes and restricted mobility to access vaccines can also make seniors particularly vulnerable to poor health. During the 2009 H1N1 pandemic season, Oregon found that many people, mostly elderly, who had not been immunized against flu, were also not able to access the recommended immunizations due to being homebound or disabled. In a proactive effort, the local emergency medical services, public health officials, and community organizations collaborated to deliver vaccines to seniors that could not leave their homes. In many cases, paramedics were able to vaccinate whole households that may not have otherwise been vaccinated.  

For those who are homeless, constant migration obstructs the ability to have a healthy lifestyle or regular healthcare provider. Additionally, substance abuse and mental health issues can be barriers to care, according to research published in the American Journal of Managed Care (AJMC). Additionally, close-quartered shelters can facilitate the spread of disease when it does arise. 

After one homeless individual in a Boston shelter died from meningococcemia, a blood-borne disease targeted by the meningococcal vaccine, Boston Health Care for the Homeless (BHCH) sent out a team to administer vaccines to hundreds of homeless people around the city, and the group continues to deliver vaccines to people living on Boston’s streets as an established practice for their Street Team.  

With many obstacles to care determined by their social situations, vulnerable groups are not always able to seek care on their own. The efforts of Alameda County, Oregon EMS, and BHCH demonstrate that proactive care for vulnerable populations can help keep them healthy. By advocating for vaccines and connecting vulnerable populations with the appropriate resources, providers can help raise vaccination rates and the overall health of our population.