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In Homeless Communities, Gaining Trust is Key for Vaccination Efforts

Activists are using their own experience with homelessness to help others overcome hesitancy.

At Groundswell, a UK-based homelessness outreach organization, activists are helping individuals register to get the vaccine, accompanying them to their appointments, and delivering information. (iStock)
At Groundswell, a UK-based homelessness outreach organization, activists are helping individuals register to get the vaccine, accompanying them to their appointments, and delivering information. (iStock)

While those experiencing homelessness are some of the most vulnerable to Covid-19, the population faces substantial barriers to accessing vaccines.

Many lack transportation to get to and from a vaccination site. Others live nomadically, making it difficult to commit to a second vaccine appointment.

But according to homelessness activist Tasia Thompson, misinformation is the primary issue: “Our main barrier is the fact that we have lots of social media, lots of internet sites, giving information, which may not be correct.”

Thompson works for Groundswell, a UK-based grassroots organization that connects those experiencing homelessness with health care services. Like many of their employees, she was homeless for years before getting involved. “That’s the hardest thing is trying to get across to people that yes, we may be coming from the health side and worked with the doctors, but we understand their fears and we’ve all been there,” said Thompson.

On this episode of the podcast, we speak with Thompson and others about their own experiences with homelessness and the obstacles preventing those who are homeless from accessing the Covid-19 vaccine.

Direct Relief has supported Groundswell with a $125,000 grant to support their vaccination efforts in homeless communities across the UK. The group helps individuals register to receive the vaccine, accompanies them to their appointments, and delivers information. In addition, the organization is training an outreach team to administer the Covid-19 vaccine to individuals living in homeless shelters and encampments. All staff members involved in Groundswell outreach efforts have had previous experience with homelessness.

Tasia Thompson, left, is a project worker at Groundswell where she is helping individuals who are homeless get vaccinated against Covid-19. (Photo courtesy of Groundswell)

Transcript:

People who are homeless urgently need the Covid-19 vaccine, but getting it to them is hard.

THOMPSON: So at the moment, we are doing loads of COVID vaccinations outreach, which has been a very prime thing right now where the government wants to make sure that everyone is getting at least their first vaccination.

Tasia Thompson is a project worker at Groundswell—a UK based organization that connects those experiencing homelessness with health care services.

THOMPSON: So we’re going to lots of hostels, temporary accommodation, also going to people on the streets to ask them if they want to be vaccinated. So we’re very, very busy at the moment. Lots going on.

Thompson got involved with the organization after years of homelessness.

THOMPSON: About five, six years ago, I had myself a nice mental breakdown due to stresses of work, stresses of life. Never, ever thought that I would ever be in that situation. I was one of them people who was always like that will never be me, that won’t happen. I have enough support. It can’t happen. You could have the greatest support and still have a moment where things don’t connect correctly for you. So, I became homeless.

RAFANELLI: What would you say is the biggest barrier to vaccination?

THOMPSON: The biggest barrier is, I believe, is the fear from social media. We have lots of different sites that are telling people all different news. I’m sorry, you want me to stop? Cause that lovely police car. You can tell we’re in London. OK, I’ll start again.

Essentially, misinformation. Thompson says its rampant.

THOMPSON: So our main barrier is the fact that we have lots of social media, lots of internet sites, giving information, which may not be correct. So people have read all different horror stories. People have been told that they’re going to have a chip put in them or that they’re doing this because it’s a big scheme to do something. And that’s the hardest thing is trying to get across to people that yes, we may be coming from the health side and worked with the doctors, but we understand their fears and we’ve all been there and we’ve done our research and here is what we’ve got to show you to be able to say don’t panic so much. Cause that’s the hardest thing. Social media has caused a massive stir with this jab.

Dena Pursell is also no fan of vaccines, but even she has made an exception for Covid-19.

PURSELL: I mean, I’m an anti-vaccinator. And I had the vaccine.

Pursell is a homeless healthcare navigator at Groundswell. Like Thompson, she was homeless for years before getting involved at the organization.

PURSELL: I thought how can I go and encourage people if I haven’t had it myself? Because I was very anxious. It’s a new vaccine. We don’t know much about it. But then I talked to a local doctor who we call GP service over here and listening to him it actually made me want to have the vaccination, because he explained to me what the vaccination does. He explained to me what the virus does, you know, and the implications if you don’t have it are quite severe. So that encouraged me and now I’ve took it. It’s making me much more confident in trying to encourage others.

In addition to misinformation, she says general fear and anxiety are an obstacle to vaccine uptake.

PURSELL: I mean, a lot of them have got good intentions. They do want to have the vaccine, but a lot of them are unable to get to that point. Being homeless in itself is such a big obstacle. Not only have they got homeless and to be quite honest, a lot of people who are homeless, their health is their last concern. Their health doesn’t come first to be quite honest. And it’s their health that suffers a lot when they are homeless, mental health, physical health. So a lot of people who’ve got fear and anxiety, so they’ve got addictions, a lot of people self-medicate, you know, I don’t want to think about that, you know, and. Obviously now, you know, people have to think a bit, they’ve not only got themselves to think about, and we’re trying to encourage people, you know, we’ll all be all the people, your friends and your peers and your families, and, you know, you need to keep everybody safe, you know, not just yourself.

Throughout the pandemic this line of reasoning has been used to encourage adherence with public health measures. Wear a mask to protect not only yourself, but those around you. Get vaccinated to slow the spread in your community.

Public health officials have called upon individuals to put the interests of society before their own. But for those experiencing homelessness–many of whom feel alienated by society–this may not be the most effective approach.

TASIA: I feel a lot with people that are homeless, they feel a little bit like no one probably really cared before so why would you now need me to come along and do something? It feels like there’s a bit of a hidden agenda behind it. Especially for some people they don’t have a doctor because they don’t want to be attached to the system. And so it feels a little bit like, to some people, that they’re being made to be part of this system and that there’s very much a big scam behind all of it, so they feel like they’re being asked by the system, which they feel hasn’t given them anything or hasn’t helped them.They’re being asked by the system to re return some favor. That’s never been. You know, given to them?

THOMPSON: Yeah, It’s like, ‘Oh, here you go. We haven’t done anything for you, but now we’re going to just give you this vaccine and we want all your details please.’ And it’s like, ‘You didn’t help me last week when I needed to go and see someone because I had an abcess on my arm or my mental health, you left me then.’ But because now this is global, we have to look as if we’re doing the correct thing. And it is, people do feel very much like that. They’re just like, ‘No, not having it. I’m not, I’m not going to do that.’

To better understand the roots of this skepticism, I spoke with homelessness expert Dr. Elizabeth Bowen

BOWEN: I am Elizabeth Bowen and I’m an associate professor at the University of Buffalo School of Social Work.

She says many individuals’ past experiences give them reason to distrust authority.

BOWEN: So it’s really a given that trauma goes along with homelessness, many people that are homeless have experienced various types of trauma prior to becoming homeless, as well as trauma while being homeless. And that can be in the form of violence that occurs to people physically mentally, emotionally and psychologically, sexually while being homeless and while living on the street or in other unstable housing situations. And sometimes that trauma is from other people. Sometimes that trauma may come specifically from authority figures, from police and from other people that are in various positions of authority. So, because this is such a new issue of vaccinations and COVID vaccinations it is not that well researched at this point, but I would think that these issues of trauma and specifically with people in authority are going to come up often as a barrier, that people that are homeless may not trust people who are saying they get a vaccine and they have good reasons not to trust people in authority.

That was the case for Pursell. She became homeless when she was 16 and from there was either living on the streets or in prison. She began using drugs to cope.

PURSELL: I felt alienated by everybody, but then that was partly, probably be my fault, you know? They did try and support me, but it’s very difficult to explain when you’re homeless, you’ve lost all hope, you’re at the end of the road, you probably self-medicate because you don’t want to think about all the crap that’s going on, all the rubbish that’s going on around you. The only thing you’re thinking about is to get away from that horrible place, that horrible space. So if you’re self-medicating, you know, you don’t want anyone to come and try and help you, you really don’t. So that was probably one of my downfalls not accepting all the support that I probably could have had, and lack of trust as well.

It’s hard to trust people, especially when you’re homeless and maybe you’ve been let down by one person in your life or in services, it’s very hard to build that trusting relationship again. It’s really difficult.

Now, Pursell has been drug-free for 19 years. She’s been volunteering at homeless charities for over 20.

This transcript has been edited for clarity.

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