As Montreal's vaccination campaign for homeless people ramps up, questions remain about 2nd dose

Mark Paquet made his way down to Montreal's Old Port Tuesday, had lunch, watched TV, and got vaccinated against COVID-19.

The 62-year-old has been homeless for about a year. By his estimation, he is outside for about 85 per cent of any given day.

He received his vaccine at a drop-in centre run by Accueil Bonneau. He said he worries about getting the virus, "especially because I'm homeless and the fact that other people may have it and not even know about it."

Tanya Martin, 30, got her vaccination at a space near Chez Doris, the day centre where she spends her days before taking a shuttle to a hotel where she spends the night.

Martin had open-heart surgery a year and a half ago, and while everything went well, she knows her heart condition puts her at risk. She got her shot Monday.

"It's good because we are 35 women cramped into one house, so we are all [in] close proximity."

About 930 doses of the COVID-19 vaccine have been set aside for the first and second waves of the city's campaign to vaccinate homeless people, which started last week. Those doses will be given to people from Indigenous communities, the people who work with them, and those who are using emergency shelters, among others.

In December, the number of cases among the homeless population started to rise, prompting local organizations to press the government to make vaccinating homeless people and staff at organizations who work closely with them a priority.

On Tuesday, Premier François Legault said he won't give homeless people an exemption from the province's overnight curfew, despite calls to do so from advocates and Montreal Mayor Valérie Plante, days after a homeless Innu man was found dead.

Sam Watts, CEO of the Welcome Hall Mission, said people who are homeless should be prioritized for vaccines because they're mobile, there's nowhere for them to self-isolate and they have other health conditions, which makes them more susceptible to the adverse effects of COVID-19.

"People experiencing homelessness are remarkably well-informed, and so they generally understand this is a good idea."

Challenges with the second dose

One of the big challenges associated with vaccinating people living in shelters is the dilemma of the second dose.

While the government is pledging to deliver boosters within a maximum of 90 days, it is unclear when, exactly, they will be available. And when trying to administer vaccines to a population that can be mobile, that could pose a problem.

Watts says while he isn't sure they'll be able to get everyone to return, he believes they have reasonably complete data on who is coming in to be vaccinated. Many who showed up at the site in the Old Port are people staying at Hotel Place Dupuis.

David Chapman, project co-ordinator at Resilience Montreal, told CBC Montreal's Daybreak a lot of people who use the shelter come on a semi-regular basis, so staff will be able to keep them up to date.

But, he said, "it would obviously be reassuring to people if you could tell them" exactly when they'll get their second dose.

In Toronto, about 80 residents and staff at a shelter in Scarborough received vaccinations under a similar pilot project.

Dr. Stephen Hwang, a physician at St. Michael's Hospital and the director of the MAP Centre for Urban Health Solutions, a research centre, says the risk of complications is high in part because of the number of seniors in the shelter system and the underlying health conditions homeless people experience.

But he also mentioned the challenge of persuading people who may not trust the health-care system to get the vaccine.

"Certainly, we're going to need to depend on people who have an established relationship with people experiencing homelessness at each of these sites, so that they have someone they trust conveying to them the safety and efficacy of the vaccine."

On Tuesday, Chapman was the first of about 63 people to be vaccinated at Resilience Montreal.

"I made a point of going first, getting my photo taken, and showing people as they entered that I had just taken the same vaccine," he said.

"There's definitely a question of trust there."

Fiona Crossling, the executive director of Accueil Bonneau, said the 565 doses set aside in this first wave of vaccinations will make a small dent but the aim must be to keep up the efforts as more doses are delivered.

She said she believes people who are homeless are, like everybody else, getting tired of dealing with the pandemic, and anxiety levels are increasing.

"It's just another layer of stress on … people who live stressful situations every day."