Advocates see homeless as priority for H1N1 vaccine

Advocates see homeless as priority for H1N1 vaccine

NEW BEDFORD — Advocates for the homeless are worried about the potential spread of H1N1 flu in that population, but state health officials say they are not a priority.

"No one has spoken to the issue of, 'Should they have priority,'" said Arlene McNamee, executive director of Catholic Social Services. "Given their compromised health, they probably should."

But as things stand, the limited amount of swine flu vaccine available is going to high-risk groups already identified by the state.

"It doesn't matter where you reside. It's still children, pregnant women, then people with underlying conditions," said Jennifer Manley, spokeswoman for the Massachusetts Department of Public Health.

McNamee and others who work with the homeless say that as an unsheltered population living on the streets or in tents in the woods, they tend to have compromised health because of their living conditions and lack of regular medical care.

If a homeless person were to seek medical attention, it might be health care workers' only chance to vaccinate him or her.

"You might not see them again because of severe mental health issues," McNamee said.

"If they show up, should we give (the vaccine) to them? I would think so."

But that's not the way it works.

According to Manley, vaccine administrators agree to follow the state's priority group guidelines when they receive a shipment of vaccine. More than 600,000 doses of the vaccine will have arrived in Massachusetts by today, but that is still only a fraction of the 3.5 million doses ordered by the state.

A change in the guidelines is not in the state's plans, Manley said.

"The priority right now is just the high-target groups" that have been identified, she said.

McNamee said it is hard to argue against making pregnant women and children a priority. She just questions whether homeless people should be on that list, as well.

"I think it's certainly something that should be up for discussion," she said, but added that health officials are "facing so many things" that no one has addressed the issue yet.

Margaret Khouri, case manager for First Step Inn emergency shelter program in Fall River, agreed homeless people should be given a second look.

"A lot of them have underlying conditions and they might not be taking their medications," she said. "Would I put it as a priority? Absolutely."

At last January's "point in time" count of New Bedford's homeless population, there were 496 homeless people living either in an emergency shelter, transitional housing or on the street, according to Christina Connelly, community development coordinator for the city's Office of Housing and Community Development. Of these, 102 made up the "unsheltered" population mentioned by McNamee.

Even if there were plenty of H1N1 vaccine to go around, it could be hard to find these people and convince them to get the shot, as they are often reluctant to cooperate with officials, Connelly said.

"We haven't discussed yet any attempts there might be to reach out" to them, she said.

Also among the homeless population in January's count were 43 children, considered by the state to be a high-risk group for complications from swine flu. The number of pregnant women is harder to pinpoint, Connelly said, but they probably make up only a small portion of the overall homeless population.

Homeless or not, the people in these groups are being given priority for receiving the vaccine. But finding the vaccine could be a problem.

"We really haven't gotten any information on where mass vaccinations are going to happen imminently" said Pamela MacLeod-Lima, executive director of the Greater New Bedford Women's Center. Organizers do not plan to run clinics at the shelters the center oversees, but they will arrange transportation for the women and children they serve to get to a public clinic when the vaccine is available.

"We're making everything available to them that's available to the general public," MacLeod-Lima said.

While the wait for the vaccine goes on, public health nurses are visiting the shelters to talk to residents about other flu prevention techniques, and hand sanitizers have been placed throughout the agency's buildings.

MacLeod-Lima pointed out that the psychological and physical tolls of being homeless can make a person more susceptible to any illness.

"Flu is something that can be easily caught if your resistance is down and you haven't been eating properly" or not getting enough rest, typical with many homeless people, she said.

"Exposure to any health issue is greater for someone without access to health care," she said.