Characteristics Associated With Homebound Vaccination Against COVID-19

• Published in: Journal of the American Medical Directors Association Vol. 25; no. 9; p. 105147
• Main Authors: Ren, Jennifer, Kumar, Anish, Zhao, Duzhi, Ornstein, Katherine A., Gliatto, Peter M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2024
• Subjects: Covid-19; dementia; health equity; home-based care; homebound; vaccines; dementia; health equity; home-based care; Covid-19; vaccines; homebound
• ISSN: 1525-8610; 1538-9375; 1538-9375
• DOI: 10.1016/j.jamda.2024.105147

Homebound patients are older and suffer from multiple comorbidities, and many experienced difficulties getting vaccinated because of their inability to routinely leave the home due to health and function. Home-based primary care (HBPC) programs offer vaccination at home to reach this high-risk population. We evaluated an urban HBPC program's COVID-19 vaccination campaign to explore whether home-based vaccination can reduce inequity in vaccine administration or improve vaccine efforts.
We conducted a cross-sectional study to examine characteristics of homebound patients who were vaccinated through an HBPC program or were vaccinated elsewhere.
We analyzed 795 patients enrolled in the HBPC program who were eligible for vaccination at home in 2021.
We collected vaccination data from patients, demographic data from the electronic medical record, and neighborhood-level characteristics for each patient based on census tract.
Homebound patients vaccinated by HBPC were significantly more likely than homebound patients vaccinated outside of the program to have a history of dementia (P = .003), live in public housing (P < .001), have Medicaid (P = .005), be enrolled in HBPC for longer (P = .03), and live in neighborhoods with higher proportions of immigrants (P = .022), lower English proficiency (P = .007), lower computer usage (P = .001), and greater poverty (P < .001).
Home-based vaccination campaigns may help lower-resourced patients get vaccinated by mitigating logistic barriers and using the influence of trusted patient-provider relationships established through HBPCs.