Homebound Older People in NYC Are Among Last To Receive Vaccine : Shots - Health News Despite being hit hard early in the pandemic, New York City lags behind in vaccinating people 65 and older, and its efforts to reach the homebound and disabled have been disorganized.

New York City Has Been Slow To Vaccinate Homebound Elderly, Causing More Sickness

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NOEL KING, HOST:

Across the country, doctors report that the people now ending up in the hospital for COVID-19 are, for the most part, people who have not been vaccinated. It's not just people who don't want the shot. Some are older folks who are homebound or disabled and just can't get it on their own. This has been a particular problem in New York City. Here's Fred Mogul.

FRED MOGUL, BYLINE: Robert Janz is an artist of impermanence. He paints with water on public surfaces outdoors and pokes carved wooden sticks geometrically into cracks in rock walls.

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ROBERT JANZ: My view of art is that it is soul medicine, and it should explore in every possible way.

MOGUL: That's Janz in a documentary from a few years ago when he was in better shape, wandering the streets and parks of Manhattan. These days, the 88-year-old native New Yorker is bedridden and homebound. His wife, Jennifer Kotter, has struggled to get him a much more literal kind of soul medicine, a COVID vaccination shot. She started asking a home health aide for help back in March.

JENNIFER KOTTER: And it took a while. He finally gave me a number, and I called that number, and they gave me another number, and I got on a waiting list.

MOGUL: New York City began sending vaccination teams to the homebound in March while the state began similar efforts for the rest of New York. Advocates at the time noted that Florida, Texas and Massachusetts were further along than New York at meeting people where they live with syringes and vials of vaccine.

LEORA HORWITZ: It's great. The city is organizing to get vaccines in the home. It just seems that it is organized, though, in an inefficient way.

MOGUL: Dr. Leora Horwitz is an internist and researcher at NYU Langone Medical Center. Almost all of her hospitalized patients are unvaccinated, many of them because they're elderly, homebound, cognitively impaired and, unlike Robert Janz, lacking advocates.

HORWITZ: These are not patients who are able or organized enough to go out and seek vaccines on their own.

MOGUL: They're not completely off the grid, though. When Horwitz discharges her patients, she notices almost all of them get home care from various agencies, both public and private. She began asking why those agencies aren't bringing the vaccine to their own clients.

HORWITZ: It seems like that should be a strategy we should be using.

MOGUL: The city is using its own employees and short-term contracts with specific home care agencies for each of the five boroughs. They've identified 23,000 people they say are fully homebound, and so far they've reached around half of them. But advocates say that number is a fraction of the residents out there who are impaired and need home vaccinations. Manhattan borough president, Gale Brewer, says she hasn't been able to get a straight answer from city health officials about how they decide who gets targeted for home visits.

GALE BREWER: There's been a lot of confusion. Like, am I homebound or not if I go down to get my mail, but I don't go out? So the real issue is the lack of transparency.

MOGUL: Despite experiencing the brutal first wave of pandemic deaths, New York City is lagging when it comes to vaccinating the elderly. Nationally, 87% of people 65 and older have received at least one shot, but in the city, it's only 73%. A spokeswoman for Mayor Bill de Blasio says resources are limited, and the city can only reach people in the most dire condition. Susan Dooha from the Center for Independence of the Disabled, New York, says the city won't catch up unless it defines homebound more broadly.

SUSAN DOOHA: Under the Americans with Disabilities Act, if you need a home visit, you don't have to be absolutely homebound by a disability. You deserve an accommodation.

MOGUL: For homebound artist Robert Janz, it took three months to get a Johnson & Johnson vaccine. His wife, Jennifer Kotter, says she had to be persistent and remain calm.

KOTTER: When you're caring for a patient, you have to be patient.

MOGUL: Despite these problems reaching vulnerable New Yorkers, the city continues to open up. Full-capacity restaurants and eventually Broadway theaters won't affect the homebound directly, but even people largely isolated at home interact with the outside world and need to be protected against it.

For NPR News, I'm Fred Mogul in New York.

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