Having the COVID-19 vaccine: what are the barriers and solutions for people experiencing homelessness?

Advice from Groundswell’s Tasia and Dena via Direct Relief

A new podcast by Direct Relief provides helpful solutions to vaccine hesitancy for those supporting people experiencing homelessness.

During the podcast, Groundswell’s Tasia and Dena – who both work directly with people experiencing homelessness and have their own experience – reported what they’ve found to be the key barriers and solutions. Here, we summarise their recommendations and the discussion that took place.

Barriers:

  • Incorrect information readily available on the internet and social media
  • Health can be a low priority when you are homeless
  • Managing anxiety and other mental health issues
  • Feeling reluctant to attend a health setting when you’ve been let down in the past
  • Finding it hard to trust and accept offers of help
  • Doubt that it’s been tested properly so quickly

Solutions:

  • Building trust is key
  • Provide reassurance that people’s vaccine fears are understood
  • Emphasise that a lot of research strongly tells us that the vaccine is safe
  • Encourage people to speak to medical staff about how the vaccine works and its safety
  • Share that you’ve safely had the vaccine, if you have
  • Encourage people to think about their safety, as well as that of friends, peers and families

With thanks to funding from Direct Relief, we have produced a number of vaccine information resources for services and people experiencing homelessness, including a video, leaflets and posters. They are available here.

 

Podcast transcript highlights, hosted by Amarica Rafanelli

People who are homeless urgently need the Covid-19 vaccine, but getting it to them is hard.

TASIA: So at the moment, we are doing loads of COVID vaccinations outreach, which has been a very prime thing right now where the government wants to make sure that everyone is getting at least their first vaccination.

Tasia Thompson is a project worker at Groundswell—a UK-based organisation that connects those experiencing homelessness with health care services.

TASIA: So we’re going to lots of hostels, temporary accommodation, also going to people on the streets to ask them if they want to be vaccinated. So we’re very, very busy at the moment. Lots going on.

Tasia got involved with the organisation after years of homelessness.

Tasia: About five, six years ago, I had myself a nice mental breakdown due to stresses of work, stresses of life. Never, ever thought that I would ever be in that situation. I was one of them people who was always like that will never be me, that won’t happen. I have enough support. It can’t happen. You could have the greatest support and still have a moment where things don’t connect correctly for you. So, I became homeless.

What would you say is the biggest barrier to vaccination?

TASIA: The biggest barrier is, I believe, is the fear from social media. We have lots of different sites that are telling people all different news.

So our main barrier is the fact that we have lots of social media, lots of internet sites, giving information, which may not be correct. So people have read all different horror stories. People have been told that they’re going to have a chip put in them or that they’re doing this because it’s a big scheme to do something.

And that’s the hardest thing is trying to get across to people that yes, we may be coming from the health side and worked with the doctors, but we understand their fears and we’ve all been there and we’ve done our research and here is what we’ve got to show you to be able to say don’t panic so much. Cause that’s the hardest thing. Social media has caused a massive stir with this jab.

Dena Pursell is also no fan of vaccines, but even she has made an exception for COVID-19.

DENA: I mean, I’m an anti-vaccinator. And I had the vaccine.

Dena is a homeless healthcare navigator at Groundswell. Like Thompson, she was homeless for years before getting involved at the organisation.

DENA: I thought how can I go and encourage people if I haven’t had it myself? Because I was very anxious. It’s a new vaccine. We don’t know much about it. But then I talked to a local doctor who we call GP service over here and listening to him it actually made me want to have the vaccination, because he explained to me what the vaccination does. He explained to me what the virus does, you know, and the implications if you don’t have it are quite severe. So that encouraged me and now I’ve took it. It’s making me much more confident in trying to encourage others.

In addition to misinformation, she says general fear and anxiety are an obstacle to vaccine uptake.

DENA: I mean, a lot of them have got good intentions. They do want to have the vaccine, but a lot of them are unable to get to that point. Being homeless in itself is such a big obstacle. Not only have they got homeless and to be quite honest, a lot of people who are homeless, their health is their last concern. Their health doesn’t come first to be quite honest. And it’s their health that suffers a lot when they are homeless, mental health, physical health.

So a lot of people who’ve got fear and anxiety, so they’ve got addictions, a lot of people self-medicate, you know, I don’t want to think about that, you know, and. Obviously now, you know, people have to think a bit, they’ve not only got themselves to think about, and we’re trying to encourage people, you know, we’ll all be all the people, your friends and your peers and your families, and, you know, you need to keep everybody safe, you know, not just yourself.

Throughout the pandemic this line of reasoning has been used to encourage adherence with public health measures. Wear a mask to protect not only yourself, but those around you. Get vaccinated to slow the spread in your community.

TASIA: I feel a lot with people that are homeless, they feel a little bit like no one probably really cared before so why would you now need me to come along and do something? It feels like there’s a bit of a hidden agenda behind it.

Especially for some people they don’t have a doctor because they don’t want to be attached to the system. And so it feels a little bit like, to some people, that they’re being made to be part of this system and that there’s very much a big scam behind all of it.

So they feel like they’re being asked by the system, which they feel hasn’t given them anything or hasn’t helped them. They’re being asked by the system to return some favour. That’s never been given to them?

TASIA: Yeah, It’s like, ‘Oh, here you go. We haven’t done anything for you, but now we’re going to just give you this vaccine and we want all your details please.’ And it’s like, ‘You didn’t help me last week when I needed to go and see someone because I had an abscess on my arm or my mental health, you left me then.’

But because now this is global, we have to look as if we’re doing the correct thing. And it is, people do feel very much like that. They’re just like, ‘No, not having it. I’m not, I’m not going to do that.’

Dena became homeless when she was 16 and from there was either living on the streets or in prison. She began using drugs to cope.

DENA: I felt alienated by everybody, but then that was partly, probably be my fault, you know? They did try and support me, but it’s very difficult to explain when you’re homeless, you’ve lost all hope, you’re at the end of the road, you probably self-medicate because you don’t want to think about all the crap that’s going on, all the rubbish that’s going on around you. The only thing you’re thinking about is to get away from that horrible place, that horrible space.

So if you’re self-medicating, you know, you don’t want anyone to come and try and help you, you really don’t. So that was probably one of my downfalls not accepting all the support that I probably could have had, and lack of trust as well.

It’s hard to trust people, especially when you’re homeless and maybe you’ve been let down by one person in your life or in services, it’s very hard to build that trusting relationship again. It’s really difficult.

Now, Dena has been in stable housing and drug-free for 19 years. She’s been volunteering at homeless charities for over 20.

 

Listen to the full podcast

Available here.

Or through the following platforms: Apple Podcasts | Stitcher | Google Podcasts | Spotify

With thanks to Direct Relief for permission to draw on their article and full podcast transcript, available here.

In 2020, Direct Relief generously supported Groundswell’s vaccine work with a donation of $125,000, for which we are incredibly grateful.