HUD supports the Centers for Disease Control and Prevention (CDC) efforts to meet the demand for vaccinations nationwide and will continue providing shared guidance for planning purposes to Continuum of Care (CoC) recipients, Emergency Solutions Grants (ESG) recipients and subrecipients, Youth Homelessness Demonstration Program (YHDP), and Housing Opportunities for Persons with AIDS (HOPWA) providers. Local public health authorities lead the COVID-19 response, and their guidance should be followed at all times. Communities must provide feedback to ensure this guidance is rooted in equity and informed by those with the lived experience of homelessness. For more details regarding racial equity as it relates to rehousing activation and COVID-19, please visit the HUD Exchange Rehousing Activation and Racial Equity page.
HUD plans to issue a weekly listserv message to provide COVID-19 vaccination updates in collaboration with partners. The purpose of the messages will be to highlight and summarize information provided by the CDC and other partners and its relevance to homeless service providers. Emerging science and evidence will continue to guide response efforts.
CDC Vaccination Implementation Guidance
As early supplies of the COVID-19 vaccine are limited, states are required to establish a phased vaccination approach. States may have prioritized people experiencing homelessness and/or homeless service provider staff in early phases of vaccination. According to the CDC Interim Considerations for Phased Implementation of COVID-19 Vaccination page, increased rates of transmission have been observed in congregate living settings, like homeless shelters, and jurisdictions may consider vaccinating staff and residents concurrently.
HUD concurs with the following CDC Interim Considerations for Phased Implementation of COVID-19 Vaccination guidance and COVID-19 Vaccination Frequently Asked Questions:
- Per the March 28, 2020 U.S. Department of Homeland Security Memorandum, homeless service staff and outreach teams are considered essential workers and should be prioritized for Phase 1.
- Homeless shelters meet the definition of congregate settings and should be prioritized for the vaccine, consistent with other congregate settings determined by CDC to be high risk.
- State and local vaccine distribution strategies should include bringing the vaccine to people experiencing homelessness, including unsheltered locations. These strategies will look different in rural, suburban, and urban communities.
- People experiencing homelessness often have a history of trauma and many have negative experiences with medical services. Furthermore, systemic discrimination in healthcare, stigmatization of homelessness, and social inequities experienced by racial and ethnic minority groups have led to diminished trust in healthcare systems. To improve vaccine confidence and build trust between healthcare providers and people experiencing homelessness, communities must provide easily understandable and consistent vaccine information to staff, community organizers, and people experiencing homelessness.
HUD Recommendations for CoCs Preparing for Vaccine Rollout
Keeping this guidance in mind, HUD recommends that CoCs implement the steps below to prepare for vaccine rollout:
- Review Your State’s Vaccination Plan
Each state has a vaccination plan which prioritizes groups based on health risks. Review the plan and document any concerns or critical issues that should be discussed with the public health partners responsible for vaccine distribution.
- Engage Public Health Partners to Plan for Vaccine Rollout
Contact state or local public health authorities to determine who is responsible for vaccine planning and coordination. Ongoing dialogue with public health partners will be critical given the fluid nature of vaccine rollout. Review this list of questions to assist in planning with health partners.
- Assure Priority Vaccine Access for Essential Staff and People Experiencing Homelessness
If people experiencing homelessness are not prioritized, refer to HUD and CDC’s guidance to educate public health partners and local decision makers about prioritizing sheltered and unsheltered people experiencing homelessness in Phase 1. This aligns with federal prioritization principles and the federal government’s December 2020 memo which designate staff and management of outreach programs, homeless shelters, and other programs sustaining human life as essential.
- Engage People Experiencing Homelessness and Identify Vaccine Ambassadors
CoCs should talk to people experiencing homelessness to learn about concerns and other vaccination barriers. Enlist trusted individuals in the people experiencing homelessness community, including encampment members, case managers, and faith leaders, and support them in encouraging people to get vaccinated.
Steps 1-3 were shared in the December 24, 2020 How CoCs Can Start Vaccine Distribution Planning listserv and we are repeating them here for your reference. Step 4 is new.
HUD is posting new resources to the Vaccine Planning and Distribution page. Check this page frequently for updates. Current resources include:
Visit the Disease Risks and Homelessness page on the HUD Exchange for a full list of resources related to COVID-19 infectious disease prevention and response for homeless providers.