If anyone has experience overcoming obstacles, it’s John Chappell. The 77-year-old Hanover resident, who is a paraplegic, is a former deputy commissioner of a state agency designed to help disabled people.
Yet Chappell, who is now president of an advocacy group called the Disability Policy Consortium, is struggling to get a COVID-19 vaccine because he is bedbound and can’t find a way to get the shot at home.
“The way the state’s priorities are set, if you’re in an institution you are OK, but if you’re at home with a disability, there is no way to go,” Chappell said.
It’s hard enough getting a wheelchair through the snow, disability advocates say. Or navigating the state’s vaccine locator website, which has not meshed well with software that reads computer screens for the blind. But older and disabled residents who can’t easily travel to one of the state’s mass vaccination sites, let alone to a local pharmacy, say state vaccination plans have forgotten about them.
“We have been told that the state is planning to work with home health agencies to administer vaccinations to people who are stuck in their homes,” said Colin Killick, executive director of the consortium. “What we’ve heard [from the state] is short on details, and it’s alarming at this point.”
Perhaps tens of thousands of people are stuck in the same limbo as Chappell, eligible for a COVID vaccine, but physically unable to get one. No one knows the exact number of homebound adults who are eligible for shots, but among the state’s 430,000 people 75 and older, the number is probably substantial.
The problem will only grow in the near future, when shots become available to at least 540,000 residents aged 65 to 74, in addition to those with certain medical conditions, many of them unable to get to vaccination sites on their own.
Dr. Asif Merchant, a geriatrician who serves on the Baker administration’s Vaccine Advisory Group, said he first raised concerns about vaccinating homebound residents to state health officials in November. He said he was told everyone was preoccupied planning the initial rollout to vaccinate health workers and those in nursing homes, which began in December, and to come back later. Merchant said he raised the issue again in December, to a similar response.
“They have no mechanism set up, and they are finally talking about it now, and they should have been talking about it in November,” Merchant said.
Older and disabled people who rarely go out of their homes need a vaccine because they often rely on younger family members, home health aides, or care attendants who may not yet have been vaccinated. And even if someone has been vaccinated, it’s still unclear how likely it is for them to transmit the infection to others.
A Baker administration spokeswoman said getting vaccines to residents across Massachusetts is not a “one size fits all” endeavor, so the state is working with communities, health insurance companies, and other groups to set up transportation to sites for those who can get out, as well as home delivery systems for those who can’t.
“The administration is working to provide a clear option for individuals who are unable to leave their home and are not being actively outreached by a health plan or other organization,” said spokeswoman Kate Reilly in a statement.
Disability advocates in many states have raised concerns that homebound elders and disabled people are being left out of vaccination plans, but, recently, that has begun to change. Earlier this month, Governor Ron DeSantis of Florida announced the launch of a program to vaccinate homebound seniors, using state workers and local fire-rescue and paramedic teams to go to their homes. Various county health departments in other states have also announced initiatives to vaccinate those shut in.
In the absence of a plan for Massachusetts homebound people, a constellation of private and public groups have recently stepped into the breach, doing their best to fill considerable gaps.
Mascon Medical, a Woburn manufacturing and supply-chain company, joined forces with the Professional Fire Fighters of Massachusetts and Brewster Ambulance Service to deliver and administer vaccines to roughly 450 older and disabled residents in affordable-housing developments in Chelsea and Quincy.
“Mass vaccination sites are great; you have to have them, but you need other options because there are a lot of people who can’t get to Fenway or Gillette” stadium, said John Chen, Mascon’s president.
Chen said his company paid to staff the mobile sites, and is now seeking state funding to significantly expand the initiative, called the Last Mile Vaccine Delivery. He said a trial run earlier this month demonstrated that bringing shots to people’s homes on a large scale is possible and sorely needed. But he said he is still waiting for an answer from the Baker administration about state funding for expanding the program.
Roughly 15,000 Massachusetts residents are receiving vaccines in their federally funded senior housing developments under the same federal-pharmacy partnership that sent vaccination teams to the state’s nursing homes. They became eligible weeks before thousands more in state-funded senior developments, who won’t get their turn until later this month or early March.
Elissa Sherman, president of LeadingAge, which represents nonprofit nursing homes and other senior living centers, said advocates worked with the Baker administration to ensure the state signed up for the early access for seniors in federally funded housing.
“I know the Baker administration is trying to create opportunities for onsite clinics so people don’t have to leave the community they are living in, so I have been pleased to see that,” Sherman said.
Among those who will receive an early dose is Dennis Heaphy, 59, a quadriplegic who lives in Symphony Towers, a federally funded senior housing development in Boston. Heaphy is scheduled to get his shot Feb. 20. He is relieved, but frustrated because he said other homebound seniors and disabled residents who don’t live in senior housing are being overlooked — especially those in communities of color. Heaphy is a health justice policy analyst for the Disability Policy Consortium.
“A lot of people with complex medical conditions don’t get out in the winter,” he said.
Tony Santoro, a North Shore resident, has been calling everyone he can think of for the past two weeks, including a primary care doctor and local elder services agencies, trying to find a way to get a shot for his 88-year-old homebound mother. She lives in her own home, with the help of visiting nurses.
Finally, on Thursday, Santoro said he got a callback alerting him that his local health department was creating a list of homebound seniors. He is awaiting further details.
“I was thrilled,” he said, “that someone is thinking ahead.”