Serving the most vulnerable, weary community health centers worry about COVID vaccine booster shot demand
As health centers across the country prepare to receive COVID-19 booster shots, many community health clinics serving vulnerable people are preparing for a slew of patients amid limited resources.
Nationwide, community health centers serve about 30 million patients. Most are uninsured or on Medicaid, and about two-thirds live at or below poverty. About half are people of color, who disproportionately suffered throughout the pandemic.
The centers provide health care to underserved communities across the country and have been essential in vaccinating hard-hit populations, experts say, and will continue to be key in ensuring the populations receive booster shots.
In a joint statement from the Department of Health and Human Services, the Centers for Disease Control and Prevention and several other federal agencies, officials said the administration is prepared to expand booster shot eligibility for Americans beginning the week of Sept. 20.
The expansion is still subject to approval by the Food and Drug Administration and the CDC’s Advisory Committee on Immunization Practices, who will independently asses the effectiveness of Pfizer-BioNTech and Moderna mRNA third doses.
But community health clinicians are worried about having enough resources to provide the booster shots amid short and overburdened staff, continued vaccine education and efforts to ramp up and resume missed primary and preventative care appointments.
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“There’s a lot of angst out there,” said pediatrician Dr. Lowell Gordon, medical director at Families Together of Orange County, part of the Coalition of Orange County Community Health Centers in California.
Gordon and other experts expect fewer mass vaccination sites, leading to increased demand at clinics, primary care practices and hospitals already strained amid surging cases in unvaccinated communities.
“It really is going to fall to the clinics like ours,” Gordon said. "Where’s the support to make this happen?”
Last spring, his center shut down a main building to use for immunizations. But this time, that won’t work.
"People depend on the center. We can't shut it down," he said. "At the same time, we’re trying to be this wide open resource for a county – and you can imagine the logistical struggles that would encompass."
Practitioners are running between appointments to sign off on shot requests for immunocompromised patients, and the clinic has also ramped up COVID-19 testing.
“It’s draining. It’s very draining. You have to rob that time from somewhere,” Gordon said, adding patient visits have been shortened. His center serves a large segment of undocumented immigrants, many of whom are uninsured hospitality workers who still have questions about the vaccine, he said.
Isabel Becerra, CEO of the coalition, fears her clinics, including Families Together, will be heavy-hit with the same volume of vaccine recipients as last spring, when the clinic had to hire 20 additional staffers to equip pop-up vaccination events.
“There’s going to be some mass confusion going on,” Becerra said. “The scrambling before was because there was limited supply of vaccine and we were trying to tier it in a way where we focused the resources on those most at risk. Now, the scrambling is going to be everyone is going to want it at once.”
Michael Curry, president and CEO of the Massachusetts League of Community Health Centers, said the league's clinics are trying to meet increased demand across the board, as the state doesn't plan to reopen mass vaccination sites.
“We are still in the throes of getting vaccines in arms,” Curry said.
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At the same time, staff members have been working on a campaign to help bring back patients for regular appointments after sheltering in place and avoiding preventative care. He said the balance will require "tremendous resources."
“Our primary goal is to get people back into primary care ... that’s a draw on our workforce,” he said. “In addition, we’re now ramping back up to do boosters, and having to redeploy staff."
Curry said his staff are trying to integrate booster shots into primary care appointments to "normalize" the COVID-19 vaccine and make it part of a patient's regular, ongoing care.
"We want to look at boosters as a succession of immunizations like we do all the time," he said. "We want to do it within the context of a doctor's visit, so that we're not always looking at it as an episodic shot."
The league is in talks with the state and other partner agencies to develop a plan for the complex booster rollout.
It will be "a tremendous feat to have the processes and the systems in place to do that work," he said. "We are ramping up as we speak to redeploy our health care workers.”
Reach Nada Hassanein at nhassanein@usatoday.com or on Twitter @nhassanein_.