In Puerto Rico, reaching people missed by COVID-19 vaccination rollout

MSF joins with health organizations to help vaccinate vulnerable and hard-to-reach communities

Estados Unidos 2021

April 13 Update: Following the recommendation of federal health authorities, we paused vaccinations using the Johnson & Johnson COVID-19 vaccine. As of April 15, we are continuing COVID-19 vaccinations in Puerto Rico using the Moderna vaccine, which is not affected by the pause.

SAN JUAN, Puerto Rico/NEW YORK, March 29, 2021—Doctors Without Borders/Médecins Sans Frontières (MSF) is working with the local health organization Puerto Rico Salud, the Puerto Rico Department of Health, and the Colegio de Profesionales de Enfermería de Puerto Rico to vaccinate vulnerable and hard-to-reach communities on the island, the international medical humanitarian organization announced Monday.

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The participating organizations plan to vaccinate 6,000 people according to certain risk factors, including people experiencing homelessness, living in long-term care facilities or with disabilities, in Arecibo, Humacao, Aguadilla, Mayagüez, Ponce, Loíza and La Perla, San Juan. This effort aims to help protect these communities and demonstrate the feasibility of vaccinating people at risk of being missed by local vaccination efforts due to geographic isolation or living conditions.

"We have seen that many people face barriers in accessing COVID-19 vaccinations because they lack transportation, live in remote areas, or have conditions that make it difficult to reach a vaccination site," said Carla Sofía González, a nurse with Puerto Rico Salud. "Now that vaccines are available, we are showing that it is possible to go into communities and ensure that people are not left out because of their circumstances."

In 2020, MSF began working in Puerto Rico to provide home-based care and COVID-19 monitoring for people isolated at home in multiple communities. Staff from this effort went on to form Puerto Rico Salud, which will carry out the two-month vaccination effort with MSF's support. The Department of Health is providing the Johnson & Johnson COVID-19 vaccine,  which requires only one dose, and the Colegio de Profesionales de Enfermería de Puerto Rico is aiding in the safe storage of the vaccines.

In the coming days, health workers from Puerto Rico Salud will begin visiting communities to vaccinate people whom community leaders have identified as lacking access to existing vaccination programs. These vaccinations may take place in local health centers or community buildings, or, when necessary, in people’s homes.

"Based on our experience in Puerto Rico, we understand the logistical challenges of bringing health care to geographically isolated areas, to people who are homeless, or to those who are home-bound due to chronic health issues," said Sophie Delaunay, coordinator for MSF in Puerto Rico. "While all too often, health care providers lack the means to ensure that hard-to-reach people are vaccinated, we are showing a way to overcome these challenges."

As the COVID-19 vaccination rollout ramps up throughout the U.S., Puerto Rico continues to have one of the lowest vaccination rates among U.S. states and territories, highlighting disparities in access to medical services and a lag in administering doses or recording them. According to the CDC's COVID Data Tracker, as of March 25, Puerto Rico has received 1,310,000 vaccine doses, of which 867,570 have been administered.

“Thanks to the commitment of our nursing professionals in Puerto Rico we will have the opportunity to join with Doctors Without Borders and support this vaccination effort against COVID-19,” said Dr. Ana García, president of the Colegio de Profesionales de Enfermería de Puerto Rico. “Our goal is to reach places that are difficult to access in order to ensure that we can impact as many people as possible."  

Puerto Rico's vaccination efforts have targeted primarily health professionals, frontline workers, people 65 years old and above, people above 60 years old with chronic conditions, prisoners and people with disabilities. As of mid-March, Puerto Rico has reported more than 100,000 cases of COVID-19 and more than 2,000 deaths.

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