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Johnson & Johnson Vaccine Setback Creates Challenges For Clinics Targeting Vulnerable Populations

Mohammad Shahhosseini
Federal officials recommended a pause in the use of the single-dose Johnson & Johnson vaccine while it investigates severe blood clots in six people who received it. But this has affected vaccine clinics in Iowa targeting vulnerable residents who may struggle to get to a follow-up appointment.

The Johnson & Johnson COVID-19 vaccine has huge advantages for people who may struggle getting to a follow-up dose appointment, but in the past month this vaccine has experienced multiple setbacks.

This includes a recommended pause in its use by health officials while they investigate six cases of severe blood clots in people who received it. That’s made it more difficult to vaccinate vulnerable groups, like those who are experiencing homelessness.

This week, Primary Health Care, or PHC, was planning to get some of Des Moines’ most vulnerable residents vaccinated for COVID-19 — those living right on the streets.

The community health care center’s “unsheltered clinic” was set to take place on several strategic street corners in the city. It’s the kind of clinic that takes careful planning.

"We're working with the city to hopefully not move any camps during this time, just so that we can make sure we know where people are at," said Shelby Ridley, PHS's homeless support services director.

She said the clinic had also secured doses of the Johnson & Johnson vaccine from the Polk County Health Department.

Ridley said the one-dose vaccine is the most practical for a population whose most concerned about where their next meal is coming from or where they’re going to sleep that night.

"A doctor's appointment for a follow up vaccine isn't going to be in the Top 10 on their list of things to do," she said. "So for us, a one single dose vaccine is going to be more effective."

But last week, the unsheltered clinic was abruptly postponed, following health officials’ request to temporarily halt the use of the Johnson & Johnson vaccine.

The news was a setback for groups like PHC working to vaccinate the 2,315 Iowans estimated to be without a home.

It has also disrupted other scheduled clinics planning to use the vaccine, like the state’s three public regents universities, which were forced to cancel and scale back mass clinics.

At a press conference on Wednesday, Gov. Kim Reynolds said state health officials worked quickly to get the schools additional doses of the Pfizer and Moderna vaccines.

"Within just a day or two college clinics were reopened and students are again taking advantage of the opportunity to get vaccinated," Reynolds said.

This pause wasn’t the first hiccup in the Johnson & Johnson vaccine rollout. A Baltimore manufacturing plant ruined millions of doses last month. This caused a sharp drop in the state’s allocation even before the pause.

Some feel people who greatly need this one-dose vaccine have been overlooked.

Linn County health officials sent the state a letter earlier this month criticizing them for allocating the limited number of Johnson & Johnson vaccines to places like college campuses and businesses over more vulnerable populations like those experiencing homelessness.

Elizabeth Bowen, a professor of social work at the University of Buffalo, said this pandemic has been difficult overall for people currently without a home.

"From the earliest days of the pandemic when we were being told to stay home and to socially distance, and to wash our hands, I mean, all of those things that are hard, if not impossible, if people are homeless," she said.

Bowen said when it comes to getting them vaccinated, many homeless people also face significant logistical challenges just getting to clinics, making the Johnson and Johnson vaccine the best choice by far.

"We need to try to make it as convenient and as easy and hassle free as possible for this vulnerable population to get the vaccines," she said.

But these recent issues with the Johnson & Johnson vaccine have led some clinics to switch to the two-dose Pfizer or Moderna vaccine rather than postpone.

Will Bird, the housing services director for the Friends of the Family, a Waterloo-based non-profit that provides housing assistance, said switching vaccines could help clinics vaccine people experiencing homelessness faster.

"It depends on each individual's, you know, specific scenario, and a clinic could very well be looking at a more heavily populated area," he said. "It could be within walking distance of where they're residing, or where they're kind of laying their head at night."

But Bird said, with Iowa being primarily a rural state, getting back for a second appointment could just end up being too challenging for most homeless people.

Natalie Krebs is IPR's Health Reporter