COVID-19 Vaccine

Inclusion criteria (based on CMS definition)^1,2

1. The individual needs the help of another person or medical equipment such as a wheelchair to leave their home OR their doctor believes that their health or illness could get worse if they leave their home; AND
2. It is difficult for the individual to leave their home for the purposes of getting vaccinated against COVID-19.

Priority groups & special considerations

1. Individuals who need any of the following durable medical equipment on a daily basis:
   • Hospital bed
   • Oxygen tank
   • Ventilator
2. Individuals who are unable to care for self, functionally dependent on others for activities of daily living (feeding, bathing, dressing/grooming, toileting, transferring), and otherwise require equivalent of institutional or nursing home level of care.
3. Individuals who are confined to a bed or chair more than 50% of waking hours due to a medical, cognitive, and/or psychiatric condition (e.g., dementia).
4. Individuals residing senior housing facilities* AND have not yet been able to access existing vaccination sites in the community.
   *Including but not limited to the following facilities that do not have an established relationship with a long-term care pharmacy that can provide timely access to vaccination: assisted living facilities, adult residential facilities, residential care facilities for the elderly, independent senior living, board and cares, affordable/low income housing.

Exclusion criteria

1. Individuals who are able to get to a community vaccination site if provided transportation (please call the DPH Vaccine Call Center at 833-540-0473 (8:00am - 8:30pm, 7 days a week for more information).
2. Individuals who might be at increased risk for anaphylaxis following vaccination (i.e., people with a precaution to vaccination or those with a history of anaphylaxis due to any case) should consider whether they could be vaccinated in a setting where medical care is immediately available should they experience serious adverse reactions following vaccination.³
   • On a case by case basis, exceptions can be made for individuals for whom in-home vaccination is the only option and, after a risk assessment, it is determined that the benefits of vaccination outweigh the potential risk for anaphylaxis. In this case, homebound vaccination providers should ensure they are able to manage anaphylaxis including appropriate screening; post-vaccination observation; medications and supplies; staff qualifications for recognition and treatment of anaphylaxis; ability to call for EMS; and location in an area where EMS is available.

References

1. CDC Vaccinating Homebound Persons With COVID-19 Vaccine: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/homebound-persons.html
2. Medicare homebound requirement: https://www.medicareinteractive.org/get-answers/medicare-covered-services/home-health-services/the-homebound-requirement
3. Interim Considerations: Preparing for the Potential Management of Anaphylaxis after COVID-19 Vaccination: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/managing-anaphylaxis.html#management