Advancing the health of homeless populations through vaccinations.

Washington-Brown, Linda; Cirilo, Rose Wimbish

BACKGROUND Homeless individuals and families are at an increased risk for contracting and transmitting communicable infections and diseases. Due to poor living conditions and limited access to health care resources, homeless people of all ages are vulnerable to acquiring communicable infections, such as pneumococcal pneumonia. LOCAL PROBLEM Less than 40% of sheltered and unsheltered homeless people in South Florida, who were interviewed for this project, knew their immunization status and/or were up-to-date with their recommended vaccine histories. METHODS The immunization project implemented a five-step process to provide pneumococcus (pneumococcal polysaccharide vaccine 23) and Prevnar 13 vaccinations to a convenience sample of adult homeless men and women (N = 209) participants, who completed the financial eligibility form (J11) during their intake process to admission, for sheltered services from two local clinics. INTERVENTIONS To promote herd immunity, the five-step process was followed. As per the Centers for Disease Control and Prevention guidelines, initial training was provided to homeless shelter health care providers on vaccine storage, handling, and vaccination. A subsequent 1-week follow-up was completed with participants to determine if any delayed vaccination adverse reactions occurred. RESULTS Descriptive statistics was used to examine data from the initial project implementation. Findings indicated that more African Americans (n = 117) participated in the project than Whites (n = 50), Hispanics (n = 35), or Haitians (n = 7). CONCLUSIONS Homeless individuals experience illnesses that are preventable through involvement with a structured immunization program. Collectively, nurse practitioners can reduce barriers to immunization by increasing vaccine coverage and introducing incremental policy changes that enhance the health status among homeless populations.