A new program dedicated to helping older adults who cannot leave their homes get access to the COVID-19 vaccine was halted this week after the sudden pause of the Johnson & Johnson vaccine.

A week ago, a new partnership between KC Shepherd’s Center, the Kansas City, Missouri, Fire Department Community Medical Response Team, and the National Guard started delivering vaccinations to older adults in their homes.

The program was possible specifically because of the Johnson & Johnson vaccine.

“We really weren’t able to do (this program) until Johnson & Johnson, because of the transportability of the other vaccines,” said Janet Carlson Baker, executive director of KC Shepherd’s Center. “That was really the saving grace, that was really the answer to all of our prayers. And here we are.”

Unlike the Moderna and Pfizer vaccines, which require two doses, the Johnson & Johnson is just one shot. It also can be transported in a standard refrigerator. 

After the Centers for Disease Control and Prevention and the Food and Drug Administration recommended the pause on April 13, the program had to cancel appointments with 25 people.

“It’s very disappointing, but there’s nothing that the Fire Department or we can do about it for the moment,” Baker said. “We are all on hold to see what happens with the FDA, the CDC and the state of the Missouri to allow us to do the in-home vaccines.”

Challenges to older adults at home in Kansas City getting vaccine

Older adults are one of the first groups of people who had the COVID-19 vaccine available to them. In Kansas and Missouri, adults age 65 and older were able to be vaccinated starting mid- to late January.

But older adults who are homebound — unable to leave the house due to medical conditions — have been left behind, susceptible to COVID-19. 

KC Shepherd’s Center, which provides services to the city’s older adults, struggled with figuring out how to get vaccines to residents who are homebound.

Some people suggested providing transportation to vaccine sites. 

“But there are a number of older adults in Kansas City who are just physically unable,” Baker said. “They are in wheelchairs, they have oxygen tanks. There are some people who live on hospital beds in their living rooms.”

Baker started searching for a way to get COVID-19 vaccines to them in February. But there were a number of challenges.

“The main problem was the transportability of the vaccine,” she said. “When it was just the Pfizer and Moderna vaccines, the refrigeration requirements made it impossible to be in a vehicle for hours going from house to house.”

The Pfizer and Moderna vaccines both have particular refrigeration requirements. After the Pfizer vaccine is mixed, or after the first dose is taken from a Moderna vial, the vaccines can only be left at room temperature for six hours. 

Baker said it was difficult to find refrigerated vehicles that operated at the correct temperature.

However, the Johnson & Johnson vaccine can be stored in a normal refrigerator until it is about to be used.

Kansas City Fire Department Community Medical Response Team administers vaccine

Even with the Johnson & Johnson vaccine, there was another problem. It was hard to find clinical partners that could administer the vaccine. Baker reached out to different health systems, but they were unable to help.

“There weren’t people licensed to give injections outside their facility,” Baker said.

Then, Baker heard about the new Kansas City Fire Department Community Medical Response Team from a neighbor who is a retired firefighter.

The KCFD Community Medical Response Team formed in the beginning of April. It aims to use paramedics to help people in the community without using ambulances.

“For years and years, we really stressed people to call 911 for an emergency. And that’s worked out really well, except now, some people utilize 911 as their primary care physician,” said Jimmy Walker, assistant chief of the emergency services department for the KCFD Community Medical Response Team.

Demand for emergency care in the U.S. has been increasing and leads to issues such as emergency department crowding and longer wait times for patients. People who use emergency services frequently include those who don’t have access to primary care or have transportation issues. The KCFD Community Medical Response Team will help people get medical care without burdening emergency rooms, hospitals or the 911 system, Walker said.

The response team’s trained paramedics will reach out to people who are overusing ambulances. It plans to work off of referrals and feedback from KCFD field emergency crews.

The response team, in partnership with the Missouri National Guard, is now working with KC Shepherd’s Center to help provide COVID-19 vaccines to the people they serve at home.

“We can reach their clients with our resources, and together we can help a lot of Kansas Citians who otherwise can’t get vaccinations,” Walker said.

The vaccine program is increasing KC Shepherd’s Center’s client base and the number of people it can help with services in the future, Baker said. And the partnership with the KCFD Community Medical Response Team will help.

“We are going to be working with the Fire Department to provide other services to our older adults, especially those who are most vulnerable,” Baker said. “It’s going to be exciting, because once everyone has their COVID vaccine, this partnership will be able to evolve into other types of in-home services.”

Johnson & Johnson vaccine pause

Missouri and Kansas paused administration of the Johnson & Johnson vaccine on April 13, after federal guidelines were released by the CDC and FDA.

Six cases of a rare and severe blood clot reported by people after receiving the Johnson & Johnson vaccine, which has been administered to more than 6.8 million people, are being reviewed by the CDC and the FDA.

In news releases, Kansas Gov. Laura Kelly and Missouri Department of Health and Senior Services Director Randall Williams both said the Johnson & Johnson vaccine is being paused out of “an abundance of caution.”

The blood clot cases happened in women between the ages of 18 and 48, which is younger than the patients being vaccinated by the KC Shepherd’s Center, National Guard and KCFD Community Medical Response Team program.

While the review is underway, KC Shepherd’s Center and the KCFD response team are optimistic about resuming the vaccine program.

“We’re going to remain watchful and hopeful,” Baker said. 

“As soon as the word comes down that we are able to resume our in-home vaccinations, we will be doing so within days.”