For months, Victoria McAllister searched online to make a vaccination appointment. Unlike other people who can hop into a car, though, she has ruptured discs that could slice her spinal cord if she hits a pothole or her wheelchair bumps floor molding.
So McAllister, 64, was over the moon when her local county health department in Hayward, California, called offering to inoculate her against COVID-19 at home. Two paramedics with Hayward Fire came last month, jabbed her arm with the one-dose Johnson & Johnson vaccine and stuck around to make sure she was alright.
"Absolutely blessed," she said of how she felt after receiving her vaccination. As soon as they left, she called her doctors and passed along the county phone number with this message: "Call this number and get all your homebound patients to call this number."
As interest in mass coronavirus vaccination sites dwindles nationwide, providers are ramping up efforts to find and reach millions of people in the U.S. who cannot leave their homes or who need help with transportation. The process is slow and requires careful planning, but advocates say getting vaccinated is critical for people who are constantly exposed to visiting aides — and that they should have been a focus sooner.
While the effort is happening in many states, experts say California has one of the most robust programs. Last week, state officials announced residents could go online or call a number to request a ride or an at-home vaccination. So far, there have been more than 5,000 requests for help, said state public health spokeswoman Sami Gallegos.
Meanwhile, Pennsylvania is stepping up efforts, Gov. Tom Wolf said in April. Health care workers at Boston Medical Center started racing to inoculate patients in February. And New Jersey, under pressure from advocacy groups, recently posted a phone number and online form for people needing in-home vaccinations.
Elsewhere, the Visiting Nurse Association of Texas, which delivers hot meals to thousands of people in Dallas County, is partnering with the fire department to deliver about 60 in-home vaccinations a week.
Jennifer Atwood, managing director of development and communications for the Texas nonprofit, said a woman who survived brain cancer only to fear COVID-19 "was almost in tears" about getting the vaccine. Another client in her late 80s was persuaded to accept a vaccination after speaking with Atwood and others.
It's hard to say just how many people are in the group. Harvard Medical School professor Dr. Christine Ritchie has said there are an estimated 2 million homebound adults in the U.S. and another 5 million who have trouble leaving their homes or require help to do so.
Inoculation efforts are scattered, and much depends on local officials and medical providers.
"California is one of the few states I've heard that's doing anything in regards to that, like actually going out and vaccinating people in their homes," said Kelly Buckland, executive director of the National Council on Independent Living, an advocacy group in Washington.
He and others are frustrated that providers and government are just now starting to focus on that population.
"This was a problem we knew we were going to have," said Caitlin Donovan, spokeswoman for the National Patient Advocate Foundation. "How are there not plans in place?"
In Los Angeles County, Torrance Memorial Medical Center started inoculating people at home in March, identifying people through a city hotline, county health department, senior centers and doctors offices, said Mei Tsai, a pharmacist who coordinates the program.
Socorro Franco-Martinez, 50, and her sister, Barbara Franco, 47, were vaccinated Wednesday. The sisters both have weakened lungs from muscular dystrophy and have stayed home for more than a year, tended to by Socorro's husband, Martin Martinez.
The socially active sisters can't wait to return to the beach, mall and Sunday Mass, as well as catch up on medical and dental visits.
"I don't want to be here in the house forever," said Barbara Franco. "After my COVID-19 shot, I can have a little freedom."
Under federal guidelines, seniors in nursing homes and health care workers were prioritized when California began vaccinations in December. Homebound people were not in the spotlight.
"This is a group of people who, since the pandemic began last year, have been afraid for their lives and who were worried they would be left behind," said Dr. Kathleen Clanon, medical director Alameda County's Health Care Services Agency in the San Francisco Bay Area.
Last week, nurses Patricia Calloway and Devette Laflore wheeled carriers of vaccine and paperwork to several homes, including the Hayward condo of Patti Amaral, 73. She has severe sciatica and hasn't left the upstairs for at least a year and a half.
The nurses stayed after the shots to monitor Amaral and her husband, John McFarland, who called their visit a treat.
"You're both angels," he told the nurses.