CDC Votes to Prioritize Nursing Home Residents, Health Care Workers for COVID Vaccine

A Centers for Disease Control and Prevention (CDC) advisory committee on immunization on Tuesday voted to recommend that health care personnel and long-term care residents get first priority on a COVID-19 vaccine, when it is authorized.

The CDC’s Advisory Committee on Immunization Practices (ACIP) voted in favor of offering a COVID-19 vaccine first to health care personnel, defined as “paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials,” and long-term care facility residents, defined as “adults who reside in facilities that provide a variety of services, including medical and personal care, to persons who are unable to live independently.”

There was one “no” vote for the interim recommendation; all other committee members voted in favor of the recommendation when a vaccine is authorized by the Food and Drug Administration (FDA) and recommended by the ACIP.


Given the significant toll COVID-19 has taken on long-term care residents, prioritizing them for the vaccine is critical, despite some of the concerns around consent and data regarding the population, one committee member, Dr. Katherine Poehling of the Wake Forest School of Medicine noted on Tuesday.

The federal government has already contracted with retail pharmacy giants CVS Health and Walgreens to facilitate distribution of the vaccine to nursing home residents as soon as one receives the preliminary EUA from the Food and Drug Administration (FDA).

Under that plan, participating nursing homes — which total about 99% of all facilities, officials have indicated — will essentially outsource the entirety of vaccine distribution and administration to the pharmacies, which in turn will bill Medicare, Medicaid, and private insurers for the cost of physically injecting the doses.


The Department of Health and Human Services (HHS) framed the public-private partnerships as the only way for the embattled sector to clear the various logistical hurdles associated with the vaccines, including cold-chain storage, reporting requirements, and the management of multiple doses.

“Within 24 to 48 hours of the time that a EUA is authorized, we expect to be putting needles in people’s arms,” HHS official Paul Mango said during the official program announcement back in October. “So all of this is a pre-staging for what will be a rapid deployment of vaccines.”

The CDC indicated that nursing home employees may receive priority over residents, though the exact timeline was not yet clear — and that their vaccination program may run separately from the resident push.

“Any staff member who was not already vaccinated could be vaccinated through these on-site clinics; however, we strongly encourage staff to be vaccinated as soon as they are eligible, which may occur through mobile clinics and clinics run by health departments for healthcare personnel,” the CDC noted in a FAQ about the CVS/Walgreens vaccination program.

At least one leader in the space has also expressed concern about full adoption of the vaccine among residents and staffers, even once it becomes available.

“I think there’ll be a certain percentage of people that just aren’t going to take it, and I don’t think there’s anything that anybody can do about that,” Sabra Health Care REIT (Nasdaq: SBRA) CEO Rick Matros said last month. “If half your employees decide not to take it, you still need them to come to work because you need people to take care of patients.”

Employers can legally require workers to receive vaccinations, as the New York Times observed in a recent primer on vaccine policy — though individual workers can seek exceptions for medical or religious reasons.

Alex Spanko contributed reporting.