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As people get vaccinated for Coronavirus and Orange County reopens, homeless advocates warn those who are out on the streets may be getting left behind — potentially leading to more problems. 

County health officials, in a response to Voice of OC questions last week, say they held vaccination clinics at 34 homeless shelter locations throughout the county between March and April of this year, and that 841 homeless people got their shot over the course of them.

At the time of the shelter vaccination efforts, there were a total of 1,650 homeless people at those 34 sites combined, said Jason Austin, director for the Office of Care Coordination at the county Health Care Agency, in a written response to questions last Thursday. 

That leaves about 809 people who were present at those shelters during the county’s vaccine clinics yet never got or refused the vaccine, per the county’s numbers. 

But Austin argues that scenario constitutes a 51% acceptance rate, “which is around the general community rate as well.” 

It’s estimated that between 7,000 and 10,000 homeless people reside in Orange County.

“I think this is really the quiet before the storm,” said Paul Leon at the nonprofit Illumination Foundation, which provides medical services and operates homeless shelters.

In a Thursday interview last week, Leon said a marginal slice of homeless people his team recently serviced throughout the county — less than 20% of them, he ventured to guess — have gotten the shot.

Leon also points to the looming threat of the Coronavirus Delta Variant, a version of the coronavirus that’s been found in more than 80 countries since it was first detected in India.

“We’re really concerned,” he said. 

COVID vaccine doses are prepped during a community clinic in Santa Ana. May 21, 2021. Credit: JULIE LEOPO, Voice of OC

At the City of Placentia’s regional homeless shelter, 40 people out of 92 staying there were vaccinated as of Tuesday, according to Manvir Kaur, director of programs for the shelter’s nonprofit operator, PATH OC.

“People don’t want to get vaccinated for various reasons,” Kaur said, adding one of the biggest drivers of hesitancy “is not being educated. There’s been a lot of misinformation about side effects, so breaking that stigma is important.”

Asked what happens when people at the shelters refuse vaccinations, Kaur said “We ask for the reason, ‘What is holding you back?’ For some people it’s religious, for others it’s what they read. Pregnancy rumors. Stuff like that.” 

Kaur said a lot of education goes into their efforts to vaccinate shelter residents, but if they continue to refuse vaccines, she said that’s when a nurse comes in to try and persuade them. But, after all, vaccinations can’t be forced.

“When they still refuse it — at the end of the day, we do (tell) them it’s a communal living shelter and it’s for other people’s safety and they do understand, we make sure they understand,” Kaur said. “We emphasize it in all our house meetings and community meetings with folks … Sometimes it’s a process.”

Kaur said testing happens weekly for shelter residents and staff there. 

At the nonprofit’s other Yale St. shelter it operates in Santa Ana, Kaur said nearly 150 people have been vaccinated with the help of the OC Fire Authority and a local health clinic.

Community health clinic Families Together has vaccinated roughly 1,700 homeless people in the county, according to estimates by clinic spokesperson Cassie Rossel on Tuesday.

Jeanine Robbins, a homeless advocate and Anaheim resident, does routine meal distribution runs to feed homeless people in her city.

In an interview last Thursday, she said she talked to around 40 people “at least” and “none of them were vaccinated.”

Every Wednesday, Robbins said she and others “prepare between 80 and 100 meals in our driveway” and a group of them makes the rounds at bus stops and parks throughout Anaheim.

She said groups of homeless people — all close together — at these public spaces are becoming more common again: “They’re all grouped up together again … it could be tragic if the variant strikes. Just takes one person.” 

“I was visiting with one homeless woman, passing out food to her, and she was asking me about vaccinations — and this was the same lady at the same location, the same park, every day — she had no idea she could just go to CVS and also had no idea she didn’t have to have her insurance card or anything,” Robbins said. 

Robbins said very little information is getting out to the people she’s met: “They (can get) the vaccine but don’t realize it.”

The corner of Ross and Civic Center in Santa Ana, where a homeless encampment used to be located by. March 5, 2021. Credit: GARRETT TROUTMAN, Voice of OC

Austin, on the other hand, said “Public Health Nurses continue to engage individuals at congregate sites and at unsheltered street locations to educate about vaccinations and facilitate getting vaccinated as individuals decide they are ready.” 

“In addition, (Federally Qualified Health Centers) also provide vaccinations for any unsheltered individuals wanting vaccination access at their community locations,” Austin said.

He added that the county isn’t “able to track the unsheltered individuals getting the vaccine at FQHCs.”

He also pointed out that the Health Care Agency worked with CalOptima — the county’s health care provider for the poor — in providing incentive “food cards” for homeless people who get their shots. 

“To date, over 1,200 incentive cards have been distributed to individuals experiencing homelessness who follow through with vaccination shots confirmed by Public Health Services,” Austin said. 

The way Robbins sees it, county elected officials can and should be doing more: “They want to ignore them. If they don’t deal with them, then they don’t exist.”

Critics, for instance, have torn into the County of Orange’s own Commission to End Homelessness as ineffective — at one point dubbed “Orange County Commission to Ignore Homelessness” by homeless advocate and volunteer David Duran, in a community Op-Ed.

The idea and purpose of the commission is to work with the Health Care Agency’s Director of Care Coordination “to focus on regional policy and implementation strategies, affordable housing development, data and gaps analysis, best practice research, social policy, and systemic change,” according to the commission’s page on the county website.

By mid-June, the commission — which is advisory in nature — had cancelled seven of their last 12 meetings.

Asked what the risks are in having unvaccinated homeless people out on the streets, Austin said “as with any unvaccinated population, the risk is that they are more prone to infection and have more severe consequences if they have co-morbidities and risk factors.” 

“We continue to make vaccines available to our homeless communities.”  

Kaur said the county has been integral to PATH OC’s vaccination efforts, adding public health workers “have been doing a great job … CalOptima was amazing for us, connecting us with Families Together of OC to get the rest of residents vaccinated.”

“OC Public Health has conducted educational sessions and outreach for both sites,” Kaur said.

Around 1.7 million people have been fully vaccinated in the county, according to the latest official data available as of June 23.

The virus has killed more than 5,100 people in Orange County.

Brandon Pho is a Voice of OC reporter and corps member at Report for America, a GroundTruth initiative. Contact him at bpho@voiceofoc.org or on Twitter @photherecord.

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