Read on Twitter
A geriatrician’s logistics for delivering covid vaccines to homebound older adults. A thread 1/ #MedTwitter #ThisIsGeriatrics @anandiyermd @m_dattalo @mattanster @MLRobertsonMD @jesscolburn @jesscolburn @AAHCMedicine
Prep: identify first those who are bedbound or extreme difficulty leaving their homes, send out covid vaccine letter with FAQs, address common concerns re: altered DNA, safety, SE, etc. then proactively call each pt and ask direct caregivers if interested/eligible 2/
Prep cont: work with hospital or health dept vaccine task force to procure vaccines, talk about staffing with pharmacists/residents. We are going out in pairs: provider+pharm resident. Map out 6-11 pts/caregivers in each geographic cluster 3/
Staffing: block or move patients around so vaccines could be administered Wed-Mon as state releases # of doses on prev Thurs at 6:30pm 4/
Roles/supplies: pharmacy resident preps vaccines in centralized location (6hr clock starts), provide cooler for transport, anaphylaxis kit, and needles, document in EMR and VCMS; provider inject and monitor for 15min, bring WiFi hotspot, laptop, alcohol wipes, bandaids, gloves 5/
System can be modified by scaling up patient/caregiver clusters and providers pairs in teams depending on # of vials of Covid vaccines allotted for the following week. Once # vials confirmed, contact patients of date and approx time of arrival. 6/
Equity: 42% of our patients who will get covid vaccines at home are Black. 33% caregivers are Black. Very few Hispanic patients, one is currently hospitalized with covid. 
