St. Louis Veterans Call VA System For COVID-19 Vaccinations A Public Health Model
When Army veteran Kenny Holloway decided to get the COVID-19 vaccine a couple of months ago, he pre-registered with hospital systems and clinics across the St. Louis region.
The 57-year-old Desert Storm veteran from south St. Louis didn’t hear back immediately. But when he called the St. Louis Veterans Affairs Health Care System where he is enrolled, he soon got a response.
“I called the hospital. And they say, ‘Would you like to come?’ I say, ‘When do you have an appointment?'" Holloway recalled. “And he was like, 'Can you come next two days?' Boom. I was there. I got the shot.”
The Veterans Health Administration is the nation’s largest health care system. Since the arrival of the first COVID-19 vaccine doses in late December, the VA has fully vaccinated more than 2 million veterans and staff members. In the St. Louis system, about 24,000 of the 45,000 enrolled veterans who use the system have received two doses of the Pfizer or Moderna vaccines.
That’s better than the region is doing as a whole. For example, about 24% of people in St. Louis County and 18% of residents in St. Louis have been fully vaccinated. Veterans and advocates for veterans say the VA’s vaccination efforts could serve as a model for other public health institutions.
By summer, St. Louis VA officials hope to vaccinate up to 80% of enrolled veterans.
Holloway wasn’t surprised that the VA has made so much progress distributing the vaccine.
“The VA system, it's come a long way,” he said. “I have a doctor at the VA. And also you can go outside as well for different services, you know, and if you don't call them they call you. ‘Mr. Holloway. How you doing? You know, it's time for you to come in for your annual exam.’”
VA officials said the system’s doctors have long established significant trust with their patients — and that helps when they need to advise them to get the vaccine.
“Once we knew we're getting vaccines, we really did a lot of communication from our staff to our veterans,” said Patty Hendrickson, St. Louis VA associate director of patient care services. “We did a lot more touches with our veterans, because we just didn't want them to be out there on their own, you know, so I think we built stronger relationships with them.”
Hendrickson said fewer than 1% of vaccine appointments end up as no-shows. She said once a veteran has a positive experience getting vaccinated at the VA, they’re more likely to share their experience with other veterans. The VA also uses a messaging system to contact veterans to book vaccine appointments.
“Our primary care providers reach out and actually have asked and encouraged them to get vaccinated,” Hendrickson said. “They put in a return to clinic visits so that when they come in, they can get vaccinated that same day, or they can schedule something, whatever is at their convenience.”
Veterans can sign up through email and by calling the VA hotline. The St. Louis VA has been able to vaccinate up to 800 veterans a day in recent weeks at clinics across the region. The VA expanded its outreach efforts by renting the Grand Hall on Chouteau Avenue for a vaccination clinic. It also used its clinics in St. Charles County, north St. Louis County, Jefferson Barracks, Franklin County and St. Clair County to help vaccinate veterans.
The VA also is vaccinating spouses of veterans and veterans who aren’t enrolled in the system. President Joe Biden signed the SAVE LIVES Act in March, which expands VA vaccination eligibility to 33 million people across the U.S.
The VA’s vaccination system and doctor-patient relationships could set a blueprint for public health systems in the future, said Suzanne Gordon, senior policy analyst for the Veterans Healthcare Policy Institute in California.
“It's a lesson America needs to learn,” Gordon said. “You need a national system, not just a national payer, like Medicare. You need systems of care and protocols and processes. You need to know who your patients are, and you need to be able to contact them.”
A 2018 study from the RAND Corporation found that VA health systems generally deliver the same if not higher-quality care to its patients than non-VA hospitals. The study did note a high level of variability between hospital systems.
Daniel Heckstetter, 73, said as an Army veteran he knows he can count on the VA to give him the care he needs. He has two primary care doctors, one with the VA and one outside the system. Heckstetter said the care he’s received from the institutions is comparable.
He got his vaccine from the Jefferson Barracks hospital, where he also has a primary care doctor.
Heckstetter said as an Army veteran he knows he can trust the care he receives.
“In Vietnam, they would always tell us, ‘you know, if you get shot or injured, your medical care would be better in Vietnam because we can put you on a helicopter and get you back to a bigger hospital or to a hospital ship faster than they could get you off a highway if you had a highway accident in the United States,” Heckstetter recalled “That's what we were always told, and I kind of believe that.”
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