On an overcast day in Louisville, two men dressed in scrubs get in a truck and leave the Jefferson County Health Department. A few minutes later, they arrive at an apartment complex.
“We’re going to be in and out today,” Capt. Michael Hart with the Kentucky National Guard said as he stood in the apartment’s kitchen.
It’s the home of Tony Leslie, who answered Hart’s questions about COVID-19 and the vaccine. Leslie is one of the first patients on a list of about 10 people the Kentucky National Guardsmen will vaccinate today.
Leslie’s 15 year-old dog Chico barks at the small crowd gathered in the kitchen. Leslie asks to get his second shot in his left arm.
“Now this is going to finish off your series,” Hart said. “Two weeks it takes though for your body to build up those antibodies. So two weeks from now is when you’ll really be considered fully vaccinated.”
Leslie has trouble getting out, and he said taking the bus can take anywhere from 15 minutes to two or three hours, so getting the shot in his home was his best option.
“So it makes a heck of a difference so this was more convenient for me,” he said.
As record numbers of new cases are reported in Kentucky, it's urgent that medically vulnerable people get the COVID-19 vaccination.
The Kentucky National Guard has been working with the Jefferson County Health Department and other public health departments to vaccinate people who are unable to leave their homes regardless of the reason. Rural health departments in the Ohio Valley have also relied on the military to administer shots. During the pandemic, National Guard vaccination missions have bolstered public health infrastructure that often lacks money and staff and has been overwhelmed by the pandemic.
Hart is the officer in charge of the mobile vaccination mission. He coordinates with health departments to see what support is needed from the Kentucky National Guard.
“It really helps to have the additional manpower from the Guard to have more people who can put shots in arms. So that’s where the Guard comes in and helps,” Hart said.
On another stop, the guardsmen arrive at Jocqueline Turner’s home. Turner, a lifelong Louisville resident, was due for her second vaccine. Turner has used a hospital bed since 2008. She wanted the vaccine to protect herself from health care workers who treat her at home.
After getting the shot, Turner said she felt relieved.
“Because it worried me that somebody might come in here and give it to me, not that I was going to go out and get it.”
Turner said she wished more people would get the vaccine, likening it to the polio vaccine.
“Nobody ever refused to get the polio vaccine. Of course I know these young people don’t understand how devastating that was to be in an iron lung and to be crippled for the rest of your life if you survived,” Turner said. “I just don’t understand this. With all the people that have died, why wouldn’t someone get the vaccination?”
On the drive to the next home vaccination appointment, it began raining. The two-man team arrived at another apartment complex. Hart greeted the new patient.
“Mr. Wheat, I’m Michael from the health department,” he said.
Wheat uses a wheelchair and said he felt “OK” about getting the second dose. Wheat said he doesn’t get out much so getting the shot at home was nice.
“It was nice rather than having to go somewhere,” he said. When asked what he thought about the National Guard giving him the shot, Wheat said, “Taxpayer money at work.”
At the end of the day, Hart said vaccinating people at home is rewarding.
“There’s that level of appreciation for these folks who really cannot get out of their home, or to get out of their home is a really big event, and they are so grateful for it,” he said. “There’s just an extra level of fulfillment being able to help those people out.”
Maj. Sarah Woodson is a registered nurse in the Ohio National Guard and has been vaccinating people in their homes. Whether people can’t get out because they are on oxygen or are medically vulnerable, Woodson said people she’s spoken to are thankful.
“We've been in our homes and away from people,” Woodson said. “So just kind of talking with them and being that source to listen to their stories and kind of hearing what they've been going through — it's just been a really good experience.”
Health Department Vaccination Challenges
In eastern Kentucky, geography isolates people, creating a challenge for administering home vaccinations. Scott Lockard is the Public Health Director for the Kentucky River District Health Department, which serves Leslie, Letcher, Knott, Lee, Owsley, Perry and Wolfe counties.
“Here in the mountains, we have some very medically fragile individuals that it takes great effort to transport them,” Lockard said. “So the willingness of the Guard to get out and go up the hollers across the creeks, wherever people live, in the public housing complexes, in a mobile home up a holler. They've just been so helpful to get out and help us with these vaccination efforts.”
For the last few years, Lockard said budget cuts in Kentucky have forced public health departments to downsize. The Kentucky River District Health Department once had 350 employees and now has 120.
“Responding to the pandemic has strained our resources to the max,” Lockard said. “Without the assistance that we have received from the National Guard, and other staffing from funding that's been directed to us, we would have been totally overwhelmed by this pandemic.”
Lockard said preventative services — like promoting healthy behaviors and preventing the spread of disease — are some of the first services axed because of budget cuts.
“This pandemic has highlighted situations where and why we need public health departments, because they’re segments of our population, without the special work that we do, they would never get served,” Lockard said.
Lockard said the health department serves people with substance abuse disorders, populations that are isolated both socially and geographically.
“These are not the individuals that are going to come into a normal health care provider and get vaccinated.”
National Guard Medical Services
In Kentucky, Ohio and West Virginia, the The National Guard has also set up and administered shots at vaccination clinics.
The Kentucky National Guard has given shots to people in detention centers, has set up vaccination clinics at high schools and most recently assisted the Madison County Health Department at a vaccination clinic on the Eastern Kentucky University campus.
Cooper Campbell is a freshman at EKU and had planned on getting his first dose when he arrived on campus. After getting his shot at the clinic, Campbell said more students should get the vaccine.
“That’s what college is all about coming here, enjoying the experience, meeting new people,” Campbell said. “If people aren’t getting the vaccines, people may have to stay in their dorms, we may get sent home, we don’t know.”
Kentucky, Ohio and West Virginia suffer from some of the nation's poorest health outcomes. With higher than normal rates of diabetes, heart disease and chronic respiratory illness. The need for medical care goes beyond COVID-19 vaccinations.
Every year, The Ohio National Guard provides free medical services in the state.
“We go out to different counties, where there's like that vulnerable population and that community and we will do immunizations with the health department for kids and adults, and then also do medical checkups, dental exams, things like that,” Woodson said.
In June, Lockard said he worked with Remote Area Medical, RAM, when the nonprofit provided free medical services in Perry County — where rates of chronic respiratory and cardiovascular disease and diabetes are higher than 75% of all counties in the U.S.
“We had individuals coming from bordering states who did not have coverage for dental services or vision care and they were coming to get those services,” Lockard. So I think that the need for these type of clinics and the free care, it really spotlights the lack of the gaps in our health insurance or Medicaid or Medicare coverage.”