National | Homeless

Who is vaccinating the homeless?

They are some of Aotearoa's most vulnerable whānau and, if the vaccination numbers of Auckland's homeless community are anything to go by, the most vulnerable may also be the most susceptible.

The Borgen Project reported last September that 1% or 50,000 people in New Zealand are homeless. Auckland is a central point for the most vulnerable communities and the epicentre of the latest outbreak

So far, there are  764 cases connected to the Auckland outbreak; 747 in Auckland and 17 in Wellington.

So what's being done to protect this community against the highly infectious Delta strain?

Asked for comment, Prime Minister Jacinda Ardern confirmed some numbers on August 27 saying:  "The three Auckland Metro DHBs have been working on that programme. Keeping in mind these are numbers for the chronically homeless, they have been offering vaccinations via a GP clinic at the Auckland City Mission. And so far they have vaccinated 89 homeless - homeless, including 33 Māori. They also have mobile outreach teams that are working with homeless providers to visit temporary housing sites and vaccinate there. They have vaccinated 63 people in that way. Providers are also offering transport to those in temporary housing to take them to vaccination centres. Where they have done that, I don't have the exact figures for how many they have transported to existing vaccination centres."

Promises, promises

However, this came after over a week of Te Ao Mārama asking the government for answers on the vaccine rollout and whether there was a focus on the homeless.

On one occasion at the daily health briefing, the Prime Minister passed the response to Health director-general Dr Ashley Bloomfield but not before saying that the government was making sure the vaccine rollout was "equitable". She said: "My recollection is that there was good outreach going on with our social services into those groups."

No real detail came from the health director-general, who simply said, "I would have to come back to you with the detail. A number of the DHBs had specific initiatives to reach to homeless people."

We asked the Prime Minister again the following day on August 20 about the number of homeless vaccinated and the response was much the same. "Unfortunately, the information I got before I came down was about housing rather than vaccinations, so I will make sure I provide that to you directly this afternoon."

No response was provided directly to Te Ao Mārama.

Talking to each other

Te Ao Mārama asked Bloomfield on August 22 about the data of homeless vaccination. He said: "We will see if we can get that from the DHBP and it may take a few days because of the other priorities at the moment but we will work."

Te Ao Mārama emailed the Ministry of Health for numbers and clarification and on August 22 received a response saying that there is a possibility that the homeless were vaccinated in group 2. The group specifications include "at-risk people living in settings with a high risk of transmission or exposure to Covid-19".

Nothing on the numbers themselves was revealed in this response from Vince Barry, lead-delivery at scale, Covid-19 vaccination and immunisation programme. He wrote:

"The Ministries of Health and Housing and Urban Development have been working together on vaccinating people in transitional housing and motels housing the cohort of rough sleepers from the original Covid-19 lockdown and initial vaccinations have started.

"District Health Boards (DHBs) are working closely with providers of transitional housing, and are relying on existing relationships where residents have some trust and confidence in those providers to boost the chances of homeless and rough-sleepers accessing vaccinations.

"The Ministry of Health has been talking to DHBs to learn what plans they have to provide vaccinations to this group of people."

No single dataset

"DHBs in Auckland and Wellington have already begun this work. The three Auckland Metro DHBs are vaccinating homeless people via three main mechanisms:

Offering vaccinations at the Calder Centre (a GP Clinic) at the Auckland City Mission. This initiative involves significant support from outreach workers engaging with those who attend the City Mission.

Mobile outreach teams are working with homeless providers to visit temporary housing sites and vaccinate people living there.

Providers are also offering transport to those in temporary housing to take them to vaccination centres as another alternative.

The first outreach clinic for Wellington’s homeless and transient population was held on July 21. The programme worked alongside Tū Ora PHO, Te Aro Medical, and non-government organisations Downtown Community Ministry, City Mission and Wellington Soup Kitchen, and delivered vaccinations across a series of clinics. Providers like Kahungunu Whānau Services have also begun running vaccination programmes for the homeless in and around Wellington.

It is unlikely vaccination rates for homeless and rough sleepers will be able to be monitored through data at the national level because no single dataset is held for the homeless and it can’t be easily developed.

234 vaccinated

Te Ao Mārama wasn't the only one asking about the homeless community - in Parliament National's spokesperson for Māori development, Harete Hipango asked the Māori Development Minister Willie Jackson what was being done to house the homeless.  She said 50 people were homeless in Whanganui, where she lives, the majority being Māori and 12 being children.

Jackson said he and Te Puni Kōkiri were putting pressure on mainstream agencies because it was "not acceptable."

On Tuesday the Northern Region Health Coordination Centre told Te Ao Mārama work began on initiatives in early August such as an on-site GP at the Auckland City Mission, outreach services and providers offering transport. By the end of the month, it said 234 homeless had been vaccinated and efforts would continue with providers.

The Ministry of Health says the Auckland and Wellington DHBs have started vaccinating the homeless. Last week Canterbury DHB teamed up with the Christchurch City Mission, and the Tairāwhiti and Taranaki DHBs claimed to have vaccinated most of their homeless community. When the ministry was asked whether that had been completed, it had no answer.

The Prime Minister said: "What we don't have is a national dataset that categorises people as homeless. That is because no such dataset in that way exists, people move in and out of housing but they will be known by the housing providers. That is why we work with them who know the community and know who they need to target."

The cabinet makes a decision on Monday about alert levels.

So far, we know 234 homeless people have been vaccinated out of a potential 50,000. The Delta outbreak may not be over.