Abstract
ObjectivesHomebound 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. DesignWe conducted a cross-sectional study to examine characteristics of homebound patients who were vaccinated through an HBPC program or were vaccinated elsewhere. Setting and ParticipantsWe analyzed 795 patients enrolled in the HBPC program who were eligible for vaccination at home in 2021. MethodsWe collected vaccination data from patients, demographic data from the electronic medical record, and neighborhood-level characteristics for each patient based on census tract. ResultsHomebound 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). Conclusion and ImplicationsHome-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.
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