Mobile vaccine sites — as in vans — have long been part of New Jersey’s plan to dispense COVID-19 vaccines. For at least six months, public health officials have been considering how these vans could expand vaccine access in underserved communities around the state.
But the state’s rollout of the program seems stuck in low gear.
The state Department of Health placed an order in November for three customized vans, according to department officials; the vehicles, which were delivered in mid-March, are now being registered with the state’s Motor Vehicle Commission. Gov. Phil Murphy has said it could be several weeks before they hit New Jersey’s streets.
“We’ve got the vans. We ordered them. It took a while to get them; we have them,” Murphy said at a pandemic media briefing in late March. He said vaccine supply — which has been limited since the state’s immunization program began in December — is “hopefully going up from the (federal government) and using things like the mobile vans at our disposal hopefully sooner than later that can go deep into urban communities, especially, that have been harder to reach.”
Why it has taken six months to roll out the mobile units is not clear; additional details were not available Friday, a state holiday. The health department already had potentially appropriate vehicles, according to several people familiar with its operation, and more are licensed to the State Police and its Office of Emergency Management, which have served as close partners in New Jersey’s COVID-19 response. The DOH could also partner with a nonprofit health care provider, like some of the state’s large hospital systems, to access a vehicle for this purpose, some people with knowledge of the state’s response suggested.
Possible reasons for delay
Others familiar with the state immunization plan said the timeline for mobile units was driven largely by the availability of the vaccine — which is allocated by the federal government on a weekly basis — and that the DOH would have been unable to initiate a mobile program much sooner. The vans themselves are unique and required customization, according to the DOH. In addition, the public procurement process — designed to protect taxpayers — can cost additional time, some said, and obtaining equipment during the pandemic has proved challenging.
“We call them the triplets,” DOH commissioner Judy Persichilli said of the three vans delivered to the DOH in March. “We are working on getting them licensed because the vans have to be licensed under a health care facility to be able to give the vaccinations.”
The vans will be staffed by licensed clinicians who can administer the shots, or the state will partner with health care providers or other community-based groups with staff who can do so, according to the DOH.
One of the vans is expected to provide COVID-19 testing, at least at first, with the other two focusing on vaccination. Vaccine supply will determine how many people can be immunized at these mobile sites, officials said, and additional details are still being finalized.
DOH spokesperson Nancy Kearney said the mobile program is designed to reach deep into communities where residents have struggled to get vaccinated. “The goal is for the units to provide coverage in the northern, central and southern parts of the state and to go into underserved communities, including prioritizing congregate settings, such as public housing. The health department will consider input from local public health departments and community stakeholders in order to meet the vaccination needs of the community,” she said.
Vans as part of overall plan
Vaccine vans are just one element in the state’s comprehensive COVID-19 immunization plan, a draft of which was submitted to federal regulators in October. The plan envisions hundreds of vaccination sites — more than 700 of which are now established — at hospitals, community health clinics, public health offices, drugstores and other locations. It also calls for adding more community-based sites, through partnerships with churches or nonprofit organizations, and mobile clinics, as vaccine supply increases.
Murphy’s goal is to inoculate 70% of the eligible adult population — or 4.7 million New Jerseyans — against the coronavirus by early summer. Federal vaccine shipments have started to increase slowly and nearly 4.5 million doses have been administered statewide, with nearly 1.7 million people fully vaccinated, according to state figures. Since the virus first emerged here in March 2020, more than 900,000 people have been diagnosed with COVID-19 in New Jersey, including at least 24,500 who have died as a result.
Both Murphy and Persichilli have stressed that vaccine equity is an essential element of New Jersey’s immunization effort, but this has proven difficult to achieve. Minority communities — particularly hard-hit by the virus — so far have been vaccinated at lower rates, state data show. Hispanic individuals, who make up 19% of the state’s population, have received less than 8% of the shots administered and Black individuals, who comprise 14% of state residents, have gotten just 5.2% of the doses.
The DOH has had some past success in targeting specific underserved populations for COVID-19 vaccination. In March, operators at its vaccine hotline — who traditionally answer questions and assist with appointment scheduling — placed outbound calls and sent text messages to more than 100,000 seniors, starting with those over age 75. While many were already vaccinated or scheduled for a shot, officials said the operators made more than 60,000 appointments for elderly residents, a group that is most at risk for hospitalization or death from the virus.
The state has also partnered with religious organizations and community groups to create immunization pop-up sites in a growing number of urban areas, as part of its effort to reach more Black and brown individuals. While the state’s six immunization mega-sites were located near mass transit, public health experts have found that these and other large, government-run operations — which generally require online registration — can be out of reach for vulnerable residents who don’t have easy access to computers and cars.
Where vans are already being used
“Our goal overall in the state is that everyone will be within a 15-minute walk or a 20- to 30-minute drive to a vaccine site. There should be no reason why someone cannot get access to a registered vaccine site,” Persichilli said in late March, noting the Federal Emergency Management Agency is assisting the state with some of these pop-up sites. “That is the best way to get deep into communities who otherwise have a digital divide, cannot register, [or] have some disabilities that cannot bring them to a larger site,” she said.
Some provider groups — like the Visiting Nurse Association of Central Jersey’s Community Health Center, a federally funded organization focused on low-income residents in Monmouth County — already are using mobile units to help them vaccinate individuals in senior housing facilities or group homes. The group also sends nurses to vaccinate homebound residents, another population the DOH said it is finalizing plans to immunize.
Health center CEO Christopher Rinn said its teams have become adept at stocking vans with folding tables, chairs, a tent, laptops, protective gear and a cooler packed with 100 or more vaccines. They can then set up an immunization operation in the parking lot of a senior center or in the lobby of a residential building and provide shots on site, he said.
“Under the pandemic we have to think differently about how we deliver care to those in our most vulnerable communities,” said Rinn, a former assistant commissioner at DOH. “That means taking the operation on the road, which is exactly what we’re doing. We’re taking the show to them.”