Top 5 Takeaways

1. Low Vaccination Coverage: Full COVID-19 vaccination coverage among persons experiencing homelessness ranged from 18.6% to 44.5%, significantly lower than the general population in the same jurisdictions.
2. Data Collection Challenges: Estimating vaccination coverage for persons experiencing homelessness is difficult due to the lack of routine housing status collection in vaccination records and the temporary nature of homelessness.
3. Integrated Data Systems: Some health departments have successfully linked deidentified records across housing, health care, and public health systems to estimate vaccination coverage.
4. Limitations of the Study: The study’s findings are not generalizable to all persons experiencing homelessness in the U.S. due to nonrandom selection and the inclusion of only six jurisdictions.
5. Strategies for Improvement: Enhancing vaccine access through pop-up clinics, mobile clinics, and street outreach, along with strengthening partnerships, can improve vaccination coverage among persons experiencing homelessness.

Original Article Author and Citation

Corresponding Author

Martha P. Montgomery, lwx6@cdc.gov

Suggested Citation

Montgomery MP, Meehan AA, Cooper A, et al. Notes from the Field: COVID-19 Vaccination Coverage Among Persons Experiencing Homelessness — Six U.S. Jurisdictions, December 2020–August 2021. MMWR Morb Mortal Wkly Rep 2021;70:1676–1678. DOI: http://dx.doi.org/10.15585/mmwr.mm7048a4

Summary

This report highlights the COVID-19 vaccination coverage among persons experiencing homelessness in six U.S. jurisdictions from December 2020 to August 2021. The study found that vaccination rates in this population were significantly lower compared to the general population. Data linkage between immunization information systems and homeless services data systems was used to estimate vaccination coverage. The report underscores the challenges in estimating vaccination rates due to the transient nature of homelessness and the lack of routine housing status data in vaccination records.

Methods

Data on COVID-19 vaccinations administered to persons experiencing homelessness were collected from six urban public health jurisdictions. Full vaccination status and coverage with at least one dose were determined through data linkage between immunization information systems and homeless services data systems or during vaccination events at homeless service sites. The total population of persons experiencing homelessness was estimated using either the number of persons accessing homeless services during the study period or an annual census. Vaccination coverage and general population size were obtained from CDC’s COVID Data Tracker or local health departments.

Discussion

The study found that full vaccination coverage among persons experiencing homelessness was substantially lower than that of the general population in each jurisdiction. The report discusses the challenges in estimating vaccination coverage due to the lack of routine housing status data and the transient nature of homelessness. It also highlights the potential of integrated data systems to link deidentified records across housing, health care, and public health systems as a solution.

Conclusion

Given the low COVID-19 vaccination coverage and increased risk of infection in congregate settings, it is crucial for state and local health departments to follow CDC guidance to plan and respond to COVID-19 among persons experiencing homelessness. Enhancing vaccine access through multiple strategies and strengthening partnerships across health departments, health care clinics, and homeless service providers are essential steps to improve vaccination coverage.

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