While vaccine access, such as the mRNA vaccine has been expanding rapidly across the country and region, there are some vulnerable groups who are at risk of being left behind.
For patients with disorders like schizophrenia and Tourette’s, going to a public vaccination site can be a challenging task. Barriers like access to transportation or to a computer or smart phone prevent patients from signing up for appointments in the area and traveling to their destination. It can also be a struggle to leave the house for patients with anxiety, depression, or delusions. “Some patients can’t tolerate standing and waiting in long lines, and there’s often a history of scheduling and cancelling appointments more than once,” said nurse Donna Cartwright, BSN. “They need that extra support to follow through with their appointments.”
As part of her role for Pennsylvania Hospital’s Hall-Mercer Community Mental Health Center, Cartwright typically travels through Philadelphia to offer medical and mental health support to behavioral health patients. To tackle these barriers to the vaccine, Cartwright also administered the COVID-19 vaccine at patients’ homes, allowing her clients to comfortably receive their shot.
When Penn Medicine opened vaccine outreach to patients, Cartwright’s team, consisting of Maryann Bourbeau, MS, manager of Hall-Mercer’s Targeted Case Management Program, Patty Inacker, DSW, MBA, administrator of the Behavioral Health Service Line, and Hall Mercer’s case managers, began to have conversations on how to better reach their behavioral health clients in the city.
Prior to launching the home-visit vaccine outreach, Cartwright encouraged Hall Mercer’s case managers to identify any of their clients who were interested in getting the vaccine, including contacting patients’ caregivers and other members of their household. The team would call to schedule and confirm appointments, even speaking with individuals who were hesitant. “Some clients were on the fence, so I would call and provide resources about the vaccine,” Cartwright said. “We wanted to make sure they had the right information to make a decision that’s best for them.”
The team was ready to hit the road in April but had to briefly pause their plans when distribution of the single-dose Johnson & Johnson vaccine was temporarily paused for additional safety evaluation. Once the review was completed and deemed safe, Cartwright was equipped with stacks of vaccination cards and a cooler to store the vials in a cold temperature, ready to vaccinate her first patient on May 5th.
Donna Cartwright, BSN
In just one month, Cartwright administered 52 vaccines, one by one in vulnerable patients’ homes. Once a vial was opened for the day, Cartwright only had six hours to reach her next clients, who lived all over the Philadelphia community. Racing against the clock, Cartwright would drive to and from patients’ houses, administer the vaccine for each willing individual in the home, and monitor her clients for 15 to 30 minutes for any potential side effects.
For patients who received the vaccine, Cartwright’s outreach has provided opportunities to safely reconnect with loved ones free from the fear of COVID-19, and it brought relief to those uncomfortable leaving their homes. Cartwright recalled meeting a young woman who was grateful to have the vaccine because afterward she could have face-to-face visits with her daughter again. Another patient, a man struggling with hoarding, felt at ease to not have to go to a public place for his vaccination.
“My two sons and I were vaccinated, and it was a quick and easy process,” said Patricia, one of Cartwright’s clients. “We were worried about the side effects from the vaccine, but they went away quickly. We feel good that we got it.”
“Everything went as smooth as can be,” said Johnnie, another patient who received the vaccine with her friend. “Scheduling was easy and Donna waited with us to make sure we didn’t have any side effects. We were very happy and grateful to have this offered.”
Reflecting on the outreach, Cartwright appreciates her team’s collaboration for driving this initiative and helping patients receive their shots safely and in the comfort of their homes. “Our goal was to vaccinate as many interested people as we could, and with my team’s efforts, we were able to accomplish that goal.”