VA Bedford Healthcare System
Seniors in VA home-based care get COVID vaccine
BEDFORD, Mass.—For the past year, Veteran Dorothy* refused to let the nurses of VA Bedford Healthcare System’s Home Based Primary Care (HBPC) Program into her home for fear of being infected with the COVID-19 coronavirus. Instead, she opted for telehealth visits and left her prescription bottles on her front doorstep for refills, wiping them down before bringing them inside.
A few weeks ago, Dorothy’s life changed as Bedford’s HBPC providers called to offer her the Pfizer BioNTech COVID-19 vaccine, to be administered in her home. She met them at the door, insisting she be vaccinated before allowing them inside.
Dorothy is just one of 180 Veterans in Bedford’s HBPC program, a unique model of home health care that targets persons with complex chronic diseases that worsen over time. HBPC provides cost effective primary care services in the home and includes palliative care, rehabilitation, disease management, caregiver assistance and support, and coordination of care.
Most of Bedford’s HBPC patients are over 70, placing them squarely in the Centers for Disease Control and Prevention category of persons who should get the vaccine first because they are at high risk of hospitalization, illness, and death from COVID-19.
When VA Bedford received its first shipment of the Pfizer vaccine in December 2020, schedulers began calling Veteran patients in the high risk categories to offer it to them. Veterans in the HBPC program, like Dorothy, were no exception. However, VA Bedford could only administer the vaccine at its main hospital.
The Pfizer vaccine has cold storage and transportation issues. It is fragile after being thawed and requires careful handling, and once opened, the shot must be administered within six hours, according to instructions from Pfizer.
“VA Bedford was one of the initial 37 VA hospitals to receive the vaccine,” Jackie Honors, HBPC Nurse Manager, said. “We had a plan in place for our HPBC patients, ready to implement, provided we could get regional approval to leave behind the critical care resources of the hospital.”
“Most of our patients said they didn’t want to wait for us to come to them,” Honnors said. “Home-based primary care doesn’t mean they are home-bound, but it can be difficult or even dangerous for some of them to leave the house.”
Indeed, more than 100 HPBC-participating Veterans arranged for family, neighbors, friends, or home health aids to transport them to the VA hospital to receive the vaccine.
After careful consideration, regional approval was received and VA Bedford’s HBPC providers began in-home vaccinations Feb. 10, 2021, with second doses starting March 3. Fifty-three more Veterans were vaccinated in their homes, including Dorothy, and five more Veterans have scheduled their shots.
“We’ve offered the COVID vaccine to all Veterans in our HBPC program,” Mary Anderson, Associate Director for Patient/Nursing Services, said. “Our vaccination rate is over 90 percent and we offer it to all our new participants as well. We also tell our Veterans they can change their minds at any time.”
“We’ve even reached out to VA Bedford patients living in non-VA nursing homes and assisted living facilities to offer them the vaccine,” Honnors said. “No Veteran should be left behind.”
*Names have been changed for patient privacy