After nearly 30 years of marriage and decades of volunteer work, Nancy and Paul Kern could have spent their free time kicking back on the couch in recent years.
Instead, the couple has devoted countless hours to the homeless, passing out essential goods and acting as a secret weapon against hepatitis A during a time when the liver disease was a growing concern in the Louisville area.
Dr. Sarah Moyer, director of the Louisville Metro Department of Public Health and Wellness, said the couple “almost single-handedly vaccinated almost all of the homeless that weren’t in shelters.” This was a “vital” service to the community, from late 2017 through summer 2018.
On Sundays, and sometimes during the week, the Kerns would go out and visit homeless camps and other sites, bearing signature beverages and a heaping of kindness along with vaccine.
“I’m the hot chocolate lady, or in the summertime, I’m the lemonade lady,” Nancy Kern said. So, “usually it was like, ‘Here, I’ve got some hot chocolate, and have you gotten your hep A shot ‘cause I can do it right now?’ We would approach it that way.”
All told, more than 600 people received shots from the couple, who felt they were not only helping to protect the homeless but the city as a whole from an illness that has infected thousands around the state and country.
At times, “we’ve literally pulled over on a sidewalk and said, ‘Hey, would you like your hepatitis A shot?’ ” Nancy Kern said.
Nancy Kern, an advanced practice registered nurse, is among nearly a dozen people who will receive a Commitment to Compassion Award Wednesday morning from Insider Louisville. The awards for people who exemplify compassion in health care will be presented at the Muhammad Ali Center.
She was nominated through Spalding University, where she is interim chair of the School of Nursing and also an associate professor. But she’s quick to note that the vaccine work that led to the award was a team effort with her husband.
“We’re kind of outward focused in everything that we’ve ever done together,” said Nancy Kern, a longtime volunteer for the American Red Cross, where her husband used to work.
“This is not about me,” she said. “It’s not even about Paul and I. It’s about what … we’re able to do for the community.”
Paul Kern is interim public health preparedness administer for Public Health and Wellness, where he was in charge of coordinating outreach to the homeless camps and homeless shelters.
He and his wife’s vaccination efforts, which they said were more of a personal calling, began in late 2017 as an outgrowth of work they were already doing. Louisville-area homeless know them for distributing items like socks and batteries. Kern approached Moyer and told her that he and his wife would be glad to give out the vaccine, using their connections with various groups around town, such as My Dog Eats First and Hip Hop Cares, that serve the homeless.
At the time, Kentucky was experiencing a hepatitis A outbreak, which continues, and Louisville was trying to get a handle on its cases, which would reach 4.1 per day by April. Moyer says the city has now returned to pre-outbreak levels, following a huge vaccination effort by the health department and others, such as the University of Louisville and the Kerns.
Hepatitis A, an inflammation of the liver, can result in serious illness or even death. As of late last month, there had been 647 cases and seven deaths in Louisville.
Statewide, there have been more than 4,100 cases and at least 43 deaths. Several other states, including California, Michigan, Indiana and Ohio, also have been hit by hepatitis A outbreaks, which primarily have affected the homeless and people who use illicit drugs.
Homeless people often live in unsanitary conditions, which makes them susceptible to hepatitis A because the disease is spread through what the medical community refers to as the fecal-oral route — people ingesting small amounts of stool left on their hands or that has contaminated an object they’ve come in contact with.
When you’re homeless, “proper hand hygiene is difficult,” because there’s limited access to running water and soap, and hand sanitizer isn’t effective against hepatitis A, Moyer said.
Poor hand hygiene also can be a problem for drug users, she said. And both groups can be hard to find for vaccination purposes since they’re often reclusive and distrustful of authorities, such as police and health care workers.
“People that live out on the street” in camps, tents, and other places, “they’re out there a lot of times because they really don’t want people to know where they are,” Paul Kern said.
But various groups that serve the homeless have areas in Louisville that they cover, or concentrate their time in, to help the homeless acquire food and other items, he said. So the Kerns often would work in conjunction with them to get into areas in various parts of town, such as Portland, Shively and the portion of Bardstown Road by a former Economy Inn.
“We don’t take a medical vehicle. We don’t identify ourselves as with the Health Department unless people ask. We’re not hiding it. But there are a lot of people that shy away from Metro Government cars,” Paul Kern said.
Wearing casual clothes and working out of the back of their car, the Kerns were so incognito that they were sometimes mistaken for being homeless themselves.
“We chuckled about that several times when people would walk up to us and go, ‘Would you like to have something to eat?’” Paul Kern said. The couple would respond, “We’re doing OK.”
Getting people to accept a shot took education and persistence. Often, the first thing out of their mouths was “Oh, I’m clean,” or “I’ve been tested,” Nancy Kern said.
So the couple would have to explain that hepatitis A isn’t a blood-borne illness, but rather spread person to person and that it’s not something that people are routinely tested for, she said. (It also can be spread through contaminated food and water, which is why there was a push last year to vaccinate food-industry workers in Louisville.)
Sometimes, “it took us two or three or four times talking to somebody and they finally said, ‘Oh, well. OK. I’ll get the vaccination,” Paul Kern said.
Some of that was because “we were there constantly and they were familiar with us,” and then as the numbers of cases went up, “more and more people probably knew somebody that had been sick or got sick. … Until somebody really feels they’re at risk and really feels like they may get sick, they shy away.”
They were sometimes assisted by students from Spalding, where Nancy Kern oversees the various nursing degree programs.
Along with giving shots, the Kerns talked with people about symptoms and prevention and would hand out bars of soap, as well as index cards with basic information about hepatitis A and the couple’s private number.
Moyer said of the Kerns, “I think their willingness to do it every week, no matter the weather, no matter what else was going on, really helped them form the relationships that made it possible” to get high-risk individuals vaccinated.
Also, “just having them be out there as friends and well-respected in the community definitely helped get more vaccinations done,” Moyer said.
The outbreak has diminished in Louisville, shifting to more rural parts of the state, but Moyer said local residents shouldn’t let their guard down.
“It could pop back up at any time,” she said. “So, if anyone is not vaccinated, I encourage them to head to their pharmacy or their primary care doctor today to get the shot.”
Although the Kerns are no longer giving out vaccinations on a routine basis, they’re still continuing charity work with the homeless through a small group that they formed called Share the Love Homeless Outreach.
“For us, this is just what we’re supposed to be doing,” Nancy Kern said.