Background Ensuring effective access to vaccinations for people experiencing homelessness is crucial to protecting the health of a vulnerable, yet often overlooked population. Reaching this goal with COVID-19 vaccines takes more than a one size fits all approach. This study evaluates how a dedicated health team in Cork City collaborated with multiple agencies to register and deliver the COVID-19 vaccine to one of the most difficult to reach populations.

Methods This mixed methods study includes the collection and analysis of quantitative and qualitative data and was co-designed with the Adult Homeless Integrated Health Team. Quantitative data on age, gender, nationality, language and accommodation status collected by the health team at the point of vaccine registration will be available for service users who participated in the vaccination programme. Semi-structured interviews will be conducted with staff and service users to explore their experiences with the pandemic and the delivery (staff) or receipt (service users) of the COVID-19 vaccine. The eleven agencies involved will be invited to participate in the interviews. A manager in each of the homeless agencies will ask service users within their agencies if they would like to participate in the study.

Results The health team in partnership with all the agencies administered 728 vaccine doses to people experiencing homelessness in Cork City since 10th May 2021, 401 first doses were administered with a 95.2% uptake for the second dose. Study participants are mainly male (77%), middle aged (mean aged 41 years) and predominantly Irish (87%). Ten staff members who were involved in the vaccine rollout have agreed to participate in an interview and these interviews are ongoing. Initially, four interviews with staff have identified barriers for accessing mainstream vaccination services including addiction, mental health disorders and external stresses. Facilitators included organised transport, the help of key workers and trusting relationships between staff and clients. Face to face interviews with service users will commence in March.

Conclusion This mixed method evaluation of an innovative approach to the delivery of vaccinations to very vulnerable and high-risk groups will provide insights into the design of services for the homeless population and will help inform future interventions for practitioners and policy makers, therefore improving health services for the homeless population.