Checking the Research to Inform Best Practices: Vaccinating those Experiencing Homelessness


The following is not intended to present official guidance of COVID vaccinations. For your local health information in BC, refer to your local health authority. For other regions, please refer to the federal info page on COVID-19.


COVID-19 represents a public health crisis on a scale not seen in most lifetimes. This ongoing challenge had its own unique medical and logistical contexts that have challenged policy makers and program planners every step of the way. As we quickly ramp up our vaccination efforts, we will inevitably face similar challenges.

These discussions are ongoing, both in terms of general guidance (see, e.g., the recent Globe and Mail contribution) as well as on-the-ground discussions within communities.

To help inform planning and the potential path forward, our team looked back at the lessons of the past. Researchers at the Kelowna Homelessness Research Collaborative scanned through ten peer-reviewed articles related to homelessness, vaccines, and pandemics (or other highly contagious illnesses like tuberculosis, influenza, etc.), as well as the Canadian Observatory on Homelessness’ report on lessons learned during the H1N1 pandemic.

We identified several key observations and recommendations within existing works, including – but not limited to:

Ultimately, “hard-to-reach” populations are better understood as “easy-to-miss” (Vlahov et al, 2007). Accordingly, successful implementation requires additional forethought, consultation, planning, and investment.


For a complete summary of articles and associated recommendations, see our full Annotated Bibliography and Summary of Prior Research on our Resources page.

This work is part of KHRC’s ongoing efforts to synthesize information relevant to the intersection of homelessness and pandemics. For additional KHRC content on this and other topics, refer to both our Resources page as well as our Publications & Presentations. Likewise, stay tuned for our upcoming publication which discusses this intersection in greater detail:

  • Babando J, Quesnel D A, Woodmass K, Lomness A, Graham J R. (Accepted – Forthcoming, 2021). Responding to Pandemics and Other Disease Outbreaks in Homeless Populations: A Review of the Literature and Content Analysis. Health and Social Care in the Community.


Referenced Works

Beers, L., Filter, M., & McFarland, M. (2019). Increasing influenza vaccination acceptance in the homeless: A quality improvement project. The Nurse Practitioner Journal, 44(11), 48-54.

Buccieri, K., & Gaetz, S. (2013). Ethical vaccine distribution planning for pandemic influenza: Prioritizing homeless and hard-to-reach populations. Public Health Ethics, 6(2), 185-196.

Buccieri, K., & Schiff, R. (Eds.). (2016). Pandemic Preparedness & Homelessness: Lessons from H1N1 in Canada. Canadian Observatory on Homelessness.

Coady, M. H., Galea, S., Blaney, S., Ompad, D. C., Sisco, S., & Vlahov, D. (2008). Project VIVA: a multilevel community-based intervention to increase influenza vaccination rates among hard-to-reach populations in New York City. American Journal of Public Health, 98(7), 1314-1321.

Castillo, E. M., Chan, T. C., Tolia, V. M., Trumm, N. A., Powell, R. A., Brennan, J. J., & Kreshak, A. A. (2018). Effect of a computerized alert on emergency department hepatitis A vaccination in homeless patients during a large regional outbreak. The Journal of Emergency Medicine, 55(6), 764-768.

Doroshenko, A., Hatchette, J., Halperin, S. A., MacDonald, N. E., & Graham, J. E. (2012). Challenges to immunization: the experiences of homeless youth. BMC Public Health, 12(1), 1-10.

Duncan, L. (2018). A community clinic’s response to a hepatitis A outbreak. American Journal of Infection Control, 46(9), 1057-1059.

Ghosh, M., Turnbull, J., Macdonald, N., Bond, A., & Orkin A. (March 16 2021). “How to innovate for vulnerable populations: COVID immunization for people experiencing homelessness”. Globe & Mail. 

Kong, K. L., Chu, S., & Giles, M. L. (2020). Factors influencing the uptake of influenza vaccine vary among different groups in the hard‐to‐reach population. Australian and New Zealand Journal of Public Health, 44(2), 163-168.

Metcalfe, S. E., & Sexton, E. H. (2014). An Academic‐Community partnership to address the flu vaccination rates of the homeless. Public Health Nursing, 31(2), 175-182.

Weatherill, S. A., Buxton, J. A., & Daly, P. C. (2004). Immunization programs in non-traditional settings. Canadian Journal of Public Health, 95(2), 133-137.

Vlahov, D., Coady, M. H., Ompad, D. C., & Galea, S. (2007). Strategies for improving influenza immunization rates among hard-to-reach populations. Journal of Urban Health, 84(4), 615-631.