GOTHAMIST: NYC Mobile Clinics, Pop-Ups, And Homebound Programs Pivot To Moderna After Johnson & John

The Bronx Rising Initiative got shots into the arms of seven homebound residents on April 12th, a feat for the organization and the start of a campaign to address vaccine inequities for people without internet or adequate transportation.

But one day later, when federal health authorities recommended a pause on the Johnson & Johnson shot due to rare and atypical blood clots, the nonprofit had to cancel its program.

“That really just was devastating for everybody, for our program, for the participants,” Tomas Ramos, the initiative’s founder, said. They and the city are now looking to regroup by securing dosages of Moderna. Mayor Bill de Blasio announced the switch on Tuesday for the city’s in-home campaign, while the Bronx Rising Initiative partnered with a clinic, VIP Community Services.

The pause is now having ripple effects in how some get the shot. City officials have long touted the Johnson & Johnson vaccine as the key to mobile vaccination because the single-shot jab relies solely on normal refrigeration, unlike its two-dose competitors. Some volunteers are worried the pause will make it more difficult to reach everyone at risk.

But while the Pfizer vaccine depends upon ultra-cold storage for the majority of its lifecycle, Moderna actually offers more flexibility for covering what public health experts call “the last mile.”

City health officials contend they’ve found a way to use mobile coolers of Moderna without the deep freeze required for long term storage. If a vial of vaccine is used within six hours, it doesn’t require the same “intense frozen storage,” said Dr. Mitchell Katz, the head of the city’s Health + Hospitals. Unpunctured vials of Moderna can be stored at refrigeration temperatures for 30 days.

“The main challenge has been that we designed our homebound program according to the J&J requirements, because of course it is much more flexible overall,” Varma said. “It did take us a little while to adjust our procedures to manage how we’re going to administer the Moderna vaccine but we are able to do that now.”

The city’s mobile vaccine bus—also reliant on the Johnson & Johnson shot—restarts in Chinatown and Astoria this week, de Blasio said. In the week they were running, the vaccine buses administered 500 doses in Williamsburg and Sunset Park. The mayor hopes the use of Johnson & Johnson can restart after the federal review on Friday. This week, health regulators in Europe determined the benefits of the vaccine outrule its risks.

Ramos said if his group’s efforts to secure Moderna works in the Bronx, it will still be double the labor for health personnel, who would need to visit a recipient’s home twice.

He also worries about how the Johnson & Johnson pause will influence perceptions of COVID-19 vaccines overall. Days after the company’s vaccine went under further evaluations, only 80 out of 300 people showed up at a pop-up vaccine site the initiative organized at the Bronx River Houses public housing complex. Ramos attributed the low turnout to newfound vaccine reluctance.

Brooklynites volunteering to help residents get the vaccine are worried about logistics and the prospects of appointments for those who would prefer the one-shot option. Clinton Hill/Fort Greene Mutual Aid had organized pop-up sites in collaboration with local pharmacies, sometimes using Johnson & Johnson. Planning efforts were put on hold due to the pause, according to mutual aid group member Chelsea Frosini, but no bookings had been canceled there yet since pharmacies get week-by-week allocations.

“It’s impacting it quite a bit,” said Frosini, who lives in Clinton Hill. “A lot of the local pharmacists that we were working with were getting Johnson & Johnson doses and that was working the best for them to organize pop-ups.”

Contrary to what Ramos observed at the Bronx housing complex, an Axios/Ipsos

Coronavirus Index poll found nearly 9 in 10 Americans who knew about the Johnson & Johnson news thought it was a responsible choice. And Frosini said in her conversations

with neighbors, cab drivers, restaurant workers and seniors or people with mobility issues often prefer the one-shot option over Moderna or Pfizer, which require two doses.

“I have some concerns around the coordination of that now with second-dose scheduling,” Frosini added.

The shelving of Johnson & Johnson doses also impacted state-run pop-ups, including the April 14th opening of one at Emmanuel Baptist Church in Clinton Hill. A representative for the church did not immediately respond to an email for comment.

State health spokesperson Jonah Bruno said in a statement, “Some pop-up sites were able to adjust operations in order to proceed as planned while others are rescheduling for later dates.” ​

Park Slope resident Elena Tate, who helped seniors get inoculated at the mutual aid pop-up, said many homebound seniors she’s in touch with hadn’t even been scheduled through the city’s sign-up sheet.

“To be honest, no one that I’ve spoken to has even had an appointment scheduled with the homebound [program],” said Tate, a vaccine volunteer with community newsletter, Epicenter-NYC. “I have people that signed up in March and they’re still waiting—they never heard anything.”

Yet some patients have adjusted their vaccination plans during the Johnson & Johnson pause. Astoria resident Jean-Pierre Renault was advised by his doctor weeks ago to get the Johnson & Johnson due to an allergy issue and because it requires one-dose. She also advised a two-hour waiting period rather than the standard 15-minute window in a hospital setting because of his allergies, Renault said.

But he was unable to find a vaccine site that allowed for a two-hour observation period at a hospital with the Johnson & Johnson option before the vaccine was placed on hold. Now, he plans to get the Pfizer dose with special precautions so he can be protected from coronavirus and eventually visit his 90-year-old mother in France, who he hasn’t seen since late 2019.

“I don’t want to wait another six months,” Renault said. “I don’t want to take the plane with 200 people having no vaccine.”