CINCINNATI — Nancy Elcho of Mount Lookout has been eligible to receive the COVID-19 vaccine since Jan. 19, but as of Thursday, she still had not.

That's because, like some other seniors across Ohio, the 94-year-old cannot leave her house to go get the vaccine, her son and caretaker, John, told WCPO.

John Elcho emailed WCPO looking for guidance after calling the Ohio Department of Health, the Hamilton County Health Department, the Cincinnati Health Department, the Southwest Ohio Council on Aging and talking with his mother's home health care nurses.

He wasn't looking to have his mother vaccinated immediately, he said: "I just wanted to know the plan" for getting his mother and other homebound seniors like her to receive the vaccine.

Elcho said his mother has stayed isolated at home for nearly a year now, too frail to leave home.

Health officials in both Ohio and Kentucky told WCPO Thursday afternoon that they are working on a plan to address the needs of homebound seniors in need of the vaccine, but the nature of the treatment imposes specific and rigid transportation and storage requirements.

"We are unable to transport a vaccine once it's opened," said Hamilton County Health Commissioner Greg Kesterman. "Once a vial is opened, even if you fill a syringe, you can't take that syringe off site... The two manufacturers that have vaccine available say that it's not permissible."

The Northern Kentucky Health Department's director of population health, Stephanie Vogel, echoed Kesterman's take.

"When considering vaccinations at an off-site location, some of the important requirements that must be considered and maintained include maintaining appropriate temperature of the vaccine, environmental control measures inside personal residence, how long a vial may remain punctured before all doses must be given, the length of time that a vial remains frozen, refrigerated and at room temperature, and many others," Vogel said in an email.

During his routine COVID-19 briefing Thursday, Ohio Gov. Mike DeWine deferred to his Department of Aging director, Ursel McElroy, who said: "We have identified home health providers that have the ability to manage the proper way to store and deliver the vaccine."

Meanwhile, Cincinnati and Hamilton County are partnering with home health agencies -- including the Council on Aging -- to develop a solution.

"We know that home health care workers are going into these homes, so ideally, at some point, the state would allow us to give vaccine to them, to bring vaccine to these homebound individuals," Kesterman said.

Without a firm date in place for when providers might be able to begin vaccinating homebound individuals, though, people like Nancy Elcho and her son will have to keep waiting.

The recommendation for those waiting is to continue to follow pre-vaccine guidelines and make sure home health care providers wear masks, wash hands often and don't come to work sick.

Dozens of vaccination sites across the Tri-State now offer COVID-19 shots to eligible people. With many sites located in hospitals, pharmacies, supermarkets, convention centers and arenas, could that system leave out the homebound?

WCPO viewer Patricia Keller asked how her mother, who is 95 and homebound, and other seniors could still receive their shots.

Dr. Steve Feagins, chief clinical officer at Mercy Health and medical director of Hamilton County Public Health, said leaders are working to get vaccines to those stuck inside.

“We know there are about 26,000 (Ohio) residents who have home health,” he said.

Ohio could model other states that have paramedicine, he said, where EMTs give doses and are legally able to go to people's homes. Feagins said some local fire chiefs have supported the idea.

Meanwhile, Ohio’s Council On Aging and United Way 211 offer transportation to seniors who can’t drive themselves to vaccine clinics.

While the main focus right now is to take people to the vaccine, he also said leaders are working on a plan with home health agencies to bring vaccines to those homebound.

“But we are definitely working to get a process to get vaccine to people's homes,” Feagins said.

This month, WCPO 9 is taking your questions about COVID-19 vaccines and posing them to local health care experts. Email newsdesk@wcpo.com or message @KristynHartmanWCPO on Facebook with your name, neighborhood and question, and you could see an expert answer it on air.

OCEANSIDE, Calif. — As thousands of vaccine appointments go unfilled in the United States, some of the most vulnerable are getting left behind.

Homebound seniors remain isolated and caregivers like Donna Linthicum have waited months for help. She contacted 211 back in March in hopes of getting her mother vaccinated.

"Her mind just failed her, she got Alzheimer's," said Linthicum. “She might be on hospice, she might be 91 years old, but I don’t want COVID to be what does her in.”

Her mother's condition worsened during the pandemic and left her unable to walk. While homebound seniors are not exposed to the virus in public, loved ones and caregivers could put them at risk when coming into the home. Once her mother is protected, Linthicum says she'll feel safe flying to see her granddaughter.

"She lives in Virginia. If I have missed anything, I think that's what I've missed. Is I've missed people and connection."

This month, she finally got the long-awaited call.

"He said, well, we have this mobile unit. And if your mom still needs the vaccine, we’d like to send the mobile unit to your house. And I said, wow, I’ve been trying since February!" said Linthicum.

In collaboration with San Diego County, Tri-City Medical Center mobilized experienced teams to vaccinate seniors at home.

“The one thing we've seen with this vaccine, it's unlike any other vaccine we've ever worked with," said Dr. Gene Ma, Chief Medical Officer at Tri-City Medical Center. "It's not just a shot – it’s what it represents. It represents a path forward, it represents getting back to all the things that really matter to them. It represents hope.”

In a report released last month, the Assistant Secretary for Planning and Evaluation (ASPE) said approximately 1.6 million adults 65 years of age and over living in the U.S. may have trouble accessing the COVID-19 vaccine because they are homebound.

Despite being highly prioritized for the vaccine, it can be a challenge reaching homebound seniors. They may have limited transportation options, lack access to the internet, or distrust the health care system.

And mobile vaccine teams must follow strict health and safety guidelines.

"There are significant logistical challenges to this vaccine," said Dr. Ma.

Each vaccine has cold storage requirements, and once opened, must be distributed within a certain amount of hours. After administering the vaccine, clinical providers must monitor patients in case of any adverse reactions.

“A lot of these families and patients, the entire group, they've been isolated for a long period of time. And the idea of getting out and getting vaccinated is really overwhelming to them," said Dr. Ma.

To get on the wait-list, San Diego can call 211.

The 211 network covers all 50. Specialists provide information to help with basic needs like housing, food, transportation, and health care.

Had it not been for the house call vaccination effort, Linthicum says it would have been impossible to get her mother vaccinated.

"The mobile unit was the answer.”