29: Vaccinating Neighborhoods

Haley Burrous, an analyst on ASTHO’s preparedness team, explains a positive side effect of Mississippi’s in-home vaccination program; Adrienne Williams, a disability specialist working with the Mississippi State Department of Health, talks about...

Haley Burrous, an analyst on ASTHO’s preparedness team, explains a positive side effect of Mississippi’s in-home vaccination program; Adrienne Williams, Esq., a disability specialist working with the Mississippi State Department of Health, talks about the opportunity to expand vaccination efforts in neighborhoods; Dr. Deb Stone, a behavioral scientist and the team lead for the CDC’s suicide prevention efforts, discusses tools for ASTHO members who want to improve local suicide prevention programs; and ASTHO releases a blog article explaining how some states are adopting crisis standards of care.

ASTHO Brief: Strategies for vaccinating people who are homebased

CDC Resource: Preventing suicide - A technical package of policy, programs, and practices

ASTHO Blog Article: Scarce medical resources caused by COVID-19 lead to difficult allocation decisions

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This is Public Health Review Morning Edition for Monday, September 20th, 2021. I'm Robert Johnson. Here's today's news from the Association of State and Territorial Health Officials. 
The COVID-19 pandemic has brought us a lot of bad news the last year and a half, but we start this week with a good news story from Mississippi reported by teams who make house calls vaccinating home-based people. 
Haley Burrous is an analyst on ASTHO'S preparedness team. 

Well, one thing that we have heard on the ground from our disability and preparedness specialists is that when folks are going out to provide in home vaccination in the community, 
they're actually able to capture a lot of individuals surrounding that person as well. So it seems like there's this really unique phenomenon happening where caregivers, 
family members, friends, neighbors of the person who's home based see the vaccine teams coming into the community. They see maybe this process isn't as scary or as difficult as they once thought it was. 
And they decide that they want to get the shot too.


What began as a mission to vaccinate people who can't leave their homes for medical or other reasons now has become an opportunity to protect many others during those same visits. 
Adrienne Williams is a disability specialist working with the Mississippi department of health. 
She says many hesitant people have decided to get their COVID shots while vaccination teams are working in their neighborhoods. 
It's today's morning conversation. 

Let's talk about the other individuals. This caught you off guard originally. 


Yes, it did. You know, at first it was a lot of pushback about the program, but we heavily advocated for those who were unable to go to those local sites, whether they were drive through or walkup or whatever. 
And so once we got out there, they were really concerned with the numbers. You know, we're putting together these teams, our state is already stretched as it comes to resources. 
Does it make sense? But once we started going into the homes, we found that this was an opportunity not only to get that shot in that one arm, but to advocate, to educate, and to get more shots in other people's arms. 

So what you will find is caregivers, who were very hesitant. Once you come in and talk to them and they see the process would say, oh, you know, this is not bad. 
Well, do you have enough for me? And in the beginning it was a, well, no, but you can schedule an appointment. 
And then we were putting barriers again in place for those individuals to more likely not get it. So we said, hey, let's cut all the barriers down. 
If we're already in the home, if we're already in the community, let's get it done. So we don't turn any individual away. We usually take more than enough. 

And we're out there encouraging people up and down the street, they see us, they see the nurses get out so they know what's going on. 
And they usually come. With Mississippi, there are a lot of stigma associated with getting the vaccination and a lot that comes with people being out in public doing it. 
So we found that the in-home bound vaccination program also helps those individuals who might not want to be ridiculed by, you know, their peers to do something in the privacy of 
their own home and not have to discuss it if they choose not to. 

So it's kind of opened up an avenue for us again, to not only reach those who are home bound because of disabilities, 
but also reach those who have hesitation because of fear of what others might say about them being vaccinated or not. 

I've heard you talk about this and some of the people you're vaccinating aren't related to, or connected to the person that you're originally there to vaccinate. 
These are people who are attracted by what's happening in the driveway and they come from other parts of the neighborhood to see what's going on. The end result is they get a shot. 

Exactly, and that is the excitement that comes along with even putting this together is that initially we had a small number of those who were home bound and we were thinking, 
you know, well, we'll get to those individuals, but now we've opened it up and we're able to reach, you know, communities sometimes, you know, three or four people on the street. So it's been awesome. 

You've got to be excited about the side effect, right? I mean, getting people to do this who you may never have seen otherwise. 

Absolutely. That's the goal is to get the shot in the arm by any means necessary. 

Does this help make the case for making house calls? 

Absolutely. I think that we often forget that there are those who have fears that are beyond, you know, what's in the vaccine. A lot of things come from social media. 
A lot of things come from social influence and again, giving people the option to have this done in their home with the privacy that they feel like they need to feel adequate 
about getting it is something that we totally didn't think of, but we're glad that we have now, we're very discreet about it. 
You know, we've had people call and say, well, I don't want people to know, you know, who's coming. 

And so in those situations we do, you know, go in and you know, we're very discreet, but usually when we come out and we're getting in those cars and 
leaving, people are asking and wondering and inquiring because it's small communities and they know who you are. So it's really working out for the good. 

Also today, the CDC reminds ASHTO members that resources are available to help improve local suicide prevention programs. 
Dr. Deb Stone is a behavioral scientist and the team lead for the CDC suicide prevention efforts. She outlines the agency's comprehensive approach to suicide prevention that debuted last year.

This Approach relies on the use of data to identify populations at increased risk of suicide and to understand the contributors to suicide in those populations. 
And then with all that information in hand states can select programs with the best available evidence. And examples of these programs are found in one resource that CDC put out in the last few years called 
Preventing suicide, A technical package of policies, programs, and practices, and one of the most important components to the comprehensive approach that I'll mention 
that states can really do is think about their partnerships. 

Partnerships are key because no one agency or entity can carry out a comprehensive approach alone. So bringing together partners across the public and private sectors, 
such as Public Health, business, housing, health care, and mental health, you name it. These sectors can all come together and start a conversation about suicide prevention and how they all can contribute. 

Finally, this morning, many states have been forced to adopt crisis standards of care for hospitals, struggling to treat a wave of COVID-19 patients. 
There's a new ASTO blog article on the topic. Find out how states are navigating the strain on their healthcare networks. Addressing key considerations, such as equity, politics, and staffing. 
There's a link to the article along with links to other resources mentioned today in the show notes. Also remember to follow us on apple podcasts or Spotify, or listen on Alexa or Google assistant. 

And if you have a minute, please take time to leave us a rating and a review. Join us tomorrow morning for more ASTO news and information. I'm Robert Johnson. You're listening to Public Health Review Morning Edition. 

Haley Burrous MPH

Senior Analyst, Preparedness and Disability Data, ASTHO

Adrienne Williams JD

Disability Specialist, Mississippi State Department of Health

Deborah Stone ScD

Lead Behavioral Scientist, Division of Injury Prevention, CDC Suicide Prevention Team