Delivering COVID-19 vaccinations to vulnerable communities

Mid-pandemic, NSW Health, the Department of Communities and Justice (DCJ) and local support services reached out to rough sleepers, social housing tenants and other vulnerable members of the Illawarra and Shoalhaven communities to offer them COVID-19 vaccinations. The response they received was one of the best in the state, and demonstrates the power of mobile clinics, targeted communication, and genuine collaboration to save lives.

In September and October of 2021, the Delta variant of COVID-19 was rife. Australian vaccination rates were still comparatively low and rising COVID-19 cases and hospitalisations were causing serious concern. Worryingly, those most at risk were not getting the vaccines, with COVID-19 spreading fast in social housing and other vulnerable communities despite availability of mass vaccination centres and other immunisation clinics. 

The DCJ had contact details for social housing tenants, and NSW Health had data on people’s vaccination status. Bringing this information together proved to be a powerful tool. 

The DCJ used public housing location data statistics to target SMS notifications, conduct door knocks, and distribute flyers and information to social housing tenants. The Illawarra and Shoalhaven local Public Health Unit was then able to use DCJ information to set up clinics in these locations in places that were easy to access for those who might otherwise find it difficult to get vaccinated. Those locations included public housing blocks, community centres, parks, car parks, homeless hubs, specialist homeless services and crisis/transitional homeless accommodation services.

The DCJ and Health teams ensured communication strategies and promotional material used were simple to read, tailored and accommodated different levels of health literacy.  No bookings were needed. Support workers staffed sites, and interpreters were called in when required. The vaccination team also linked with existing services such as Kind Heart Illawarra meal service, Aboriginal and Torres Strait Islander services and cultural centres, mosques and churches. 

The program significantly increased the COVID-19 vaccination coverage for vulnerable people, as well as the wider community in the region, achieving one of the highest rates of vaccination in social housing tenants in the state.

"Our team of immunisers were incredibly passionate about reaching people who otherwise couldn’t, or wouldn’t, access a COVID-19 vaccine. Going out into the community, it became about so much more than just providing a vaccine. We were meeting people in their own environment, where they felt safe, which meant it was really important that we respected their trust in allowing us into that space." – Program coordinator

In total, 7,493 vaccination doses were delivered over three months, including to Aboriginal and Torres Strait Islander communities and those impacted by mental health and drug and alcohol issues. Of the vaccines administered, 2,771 were given to social housing tenants, the homeless and those in specialist homeless services. 

Significantly, the DCJ social housing vaccination rates in the local district significantly improved from 58% having dose 1 (in September 2021) to 84% (November 2021), and from 31% to 81% for dose 2 over the same period.

The program has been replicated to include other important immunisations, such as for influenza. Its success highlights the potential effectiveness of going out into vulnerable communities to deliver public health initiatives rather than expecting clients – who may lead itinerant lifestyles or be fearful of authority – to present for vaccinations in established clinics with complex booking systems.