March 8, 2021

A week after launching a mobile program to vaccinate residents and staff at adult care homes who were unable to receive their shots elsewhere, Multnomah County has now vaccinated more than 900 people —  reaching those adult care homes licensed by the Department of County Human Services that were unable to access large vaccine clinics, and expanding the mobile project’s scope to include certain homebound adults.

Medical Reserve Corps volunteer Dr. Aviva Zigman administers the COVID-19 vaccine to Carol Hansen, center, and Vivian Wescott, left.

The door-to-door vaccine project launched Feb. 27 by Multnomah County’s Emergency Operations Center — the County’s COVID-19 response team. The project is a partnership with the Public Health Division and the County Human Services, which helps provide care for seniors and people with disabilities, among other vulnerable groups. The project pairs Medical Reserve Corps volunteers — licensed medical practitioners— with additional volunteers to assist with administering the vaccines. 

"Being part of this collaborative effort was both inspiring and humbling,'' said Dr. Sharon Meieran, who is also an emergency room physician. "Getting to meet people 'where they are at' and administering a life-saving vaccine is an incredibly powerful experience. It truly brought people hope. The coordination it takes to make this kind of outreach happen is no small feat — but it's precisely the kind of work we need to do in order to respond quickly to inequities and gaps in vaccine distribution, especially for those who are most vulnerable." Dr. Meieran has long pitched using volunteer health professionals to reach people in small, scattered households that have difficulty accessing large community vaccine sites and is a Medical Reserve Corps member, which provided the trained volunteers she envisioned.

Dr. Sharon Meieran vaccinates Vivian Wescott, as Carol Hansen looks on.

County Human Services staff say the mobile vaccine clinics will help reach as many as 5,000 home-bound people who live alone and receive some level of services through the Department’s Aging and Disability Services Division.

Officials say they will also begin working to reach additional homebound residents who aren’t yet connected to County services. But a process to reach those individuals will take more time to ramp up, they cautioned. For now, anyone who may need a vaccination at home should dial 2-1-1 or to call the Aging and Disability Resource Connection hotline at 503-988-3646 to talk about their options.

The door-to-door work to reach homebound people connected to County services, and eventually include people who aren’t connected, reflects months of planning and cross-department coordination that started last fall. Vaccines hadn’t been approved for use yet, but County staff knew they needed to be ready to distribute them urgently once they were.

“It was a long process to get here, and now the days are just a blur,” Annie Neal, program supervisor with the Adult Care Home Program said Friday, between calls to adult care homes.

She dialed number after number — her staff have made well more than a 1,000 calls in the past two weeks — from a foldable desk in the back of a briefing room at the Portland Fire Training Center in Northeast Portland. It was the County’s fourth day of mobile vaccine clinics, and only a handful of care homes remained. 

Emergency management Director Chris Voss prepares COVID-19 vaccine cards for the residents at Camelia Milea's adult care home—With a little help from Milea's dog..
“We have been working on this for months, and once it started, it was just fast and furious,” she said. “And we have also known that we would be facing the same challenge to reach our homebound adults that aren’t in care homes. So we began mapping those residences as well, so we could reach as many people as possible in the same geographic areas.”

The pace is dizzying, even for a team used to intense immediate responses to emergencies, and even for a team that has now been responding to COVID-19 for more than a year. 

“It’s organized chaos,” Aaron Monnig, a unified commander with the County’s COVID-19 response, said Friday morning without taking his eyes from the spreadsheet lists of residences and adult care homes he sought to schedule that day. “I think we’ve done good work.”

He and Alice Busch, a fellow unified commander, begin their days at Health Department headquarters at 5 or 6 a.m., gathering the supplies their teams will need that day. They brief their teams at 8, and send them out by 9 or 9:30 to make the first rounds of residences. Their day ends after everyone else has gone home, after they’ve cleaned up and put all the supplies away again. It’s not uncommon for their working hours to stretch late into the night.

“We’re going to get into a normal cadence that makes this doable,” Monnig said. “There is a lot that goes into making sure those teams can go out.”

On Friday, with help from about 20 volunteers and County staff—including emergency management Director Chris Voss and Commissioner Meieran —the teams planned to administer about 180 vaccine doses.

After a briefing at the Portland Fire Training Center, Voss and Meieran headed to the Southeast Portland home of Camelia Milea, where Milea cares for six older adults.

The sight of the mobile vaccine team was a welcome one for the staff at the care home, where residents have remained largely isolated for the last year. Standing in her kitchen, Milea watched her residents fill out their health screening forms and spoke to Voss and Meieran.

“As we age we lose so much already. We lose our freedom, our home, our family. You have to adjust,” Milea said. “And with COVID-19, that loss is compounded by fear and further isolation.”

It’s been harder for the four caregivers, too, who have redoubled their efforts to keep spirits high. Milea was a kindergarten teacher before she took in aging adults, and she leans on many of the activities she taught her students. 

“We paint. We read. For people with dementia, music and dancing helps a lot, so we do that,” she said. “So it’s good, we’re happy.” 

Carol Hansen, 83, can attest to that. Hansen said she used to visit a local senior center, but had to abandon that social outlet last year. She doesn’t miss it, she said. She’s happy sitting in the family’s living room, playing cards, figuring out word search puzzles, and watching “Alaskan Bush People” on TV. 

Commissioner Sharon Meieran, who is also a doctor, administers the COVID-19 vaccine to adult care home manager Camelia Milea.

Hansen sits with fellow resident and friend Vivian Wescott, 71. They each have a favorite chair. Ever upbeat, Wescott nonetheless admits the past year has been a little hard for her.

“It’s been up and down. I got sick a few times, and every time I got sick, I didn’t know if I had it or not,” she said. “I’m not about to really get out. I miss doing that. I miss going to the Kingdom Hall.”

When it came time for Wescott to get her vaccine, she said she felt nervous. 

“Are there many side effects?” she asked. “Is it safe?”

She rubbed her knees and thought back over other momentous medical moments in her life—harkening back a ways, she said, to recall a shot as important as this one. She said it felt a little like when she was 10 and, after tripping and skinning her knee, she got her first shot of penicillin. But within minutes, the COVID-19 shot was over, and Wescott was back in her favorite chair joking with Hansen. 

Her post-vaccine aspirations are singular and entirely all-encompassing.

“I’m hoping to get out more,” she said.