With an official recommendation that health care workers and long-term care facility residents be prioritized when a vaccine is approved, the next issue becomes getting them their shots — and ensuring they feel safe taking them.
The recent recommendation from the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) was the cue for CVS Health (NYSE: CVS) to get its vaccine distribution infrastructure in motion, insofar as it can do so without an official vaccine.
The push took on even greater urgency Thursday, when an advisory panel to the Food and Drug Administration (FDA) moved to recommend Pfizer’s COVID-19 vaccine; the step means that a formal Emergency Use Authorization from the FDA could be coming “within days,” the Associated Press reported.
Though the CDC controls the timing of next steps, to say nothing of the FDA’s approval timeline, CVS’s experience with vaccine programs for such illnesses as the annual flu shot will be a help as it prepares to roll out the COVID-19 vaccine in long-term care facilities as part of a partnership with the federal government, Omnicare president Jim Love told Skilled Nursing News in a December 3 interview.
Omnicare is the long-term care arm of CVS, and it has already worked with long-term care facilities on COVID-19 testing in several states over the summer.
When it comes to the Pharmacy Partnership for Long-term Care (LTC) Program, in which CVS and Walgreens have partnered with the federal government to offer on-site COVID-19 vaccination services for residents of skilled nursing facilities and assisted living facilities, CVS has had more than 25,000 facilities sign up for its immunizations — a number that includes both existing CVS clients and SNFs and ALFs that had not previously been customers, Love said.
It now faces the task of helping with the logistics of getting staff and residents in those facilities immunized against COVID-19, and that will mean addressing concerns about the vaccine for those populations.
“We think it’s about education, and we’re making education materials available,” Love told SNN. “Then the other thing that we have is we’ve got a lot of pharmacists … long-term care clinical pharmacists, we employ more than anybody else in the industry, that will help work with the facilities to educate them, educate the population of residents, and hopefully lower any anxiety about it. But it will be an issue going forward, no doubt about it.”
Omnicare has established a website to provide resources for facility administrators as they get ready for the process of vaccination, with the goal of both explaining the steps and providing them with tools to answer questions that their workers may have, Omnicare vice president Derek Darling told SNN in the same December 3 interview.
But it’s also trying to be aware of questions from health care workers and facility residents about the process of vaccination, any vaccine’s efficacy and what to expect during and after the immunization, he noted.
“What we’re trying to do in that space is to follow the lead of our closest partners, namely the CDC, the Operation Warp Speed team, and also, frankly the partnerships that we have with Moderna and Pfizer and the other manufacturers of the vaccines,” he said. “We’re looking largely at our partnerships with these groups, as well as the entities that will be really at the forefront of creating toolkits and educational materials to educate the general population. And we will be a conduit through which a lot of that that information gets exchanged.”
The education component is going to be critical, given a trust gap that exists between frontline facility workers such as certified nursing assistants and their leaders — a gap that extends to institutions such as the CDC itself, as Lori Porter, the CEO and co-founder of the National Association of Health Care Assistants (NAHCA), told SNN earlier this month.
“My concern is not necessarily the vaccine, if it’s proven safe,” Porter told SNN on December 2. “My fear is that if we don’t educate them, if we allow the facilities to provide the education on the vaccine, there is a trust issue. CNAs do not trust their leaders.”
This is part of the reason Omnicare is counting on the CDC and its other partners, seeing them as critical to ensuring the right information is disseminated to facilities, Darling told SNN. And as Love noted, the approach will be slightly different for each facility.
“What we can do is we can make the educational material available, we can make our people available, and I think we’re going to work with each facility on what helps them, and do what Omnicare does best, which is be partners with the facility on getting the right care to the right residents,” Love said.
Contact information critical
In terms of operations, the on-site vaccine program has some crucial logistical requirements, as detailed in a webinar for CVS’s facility partners that was held Monday and is available on Omnicare’s COVID-19 vaccine resource webpage.
One of the first steps for nursing homes is to make sure that their contact information is updated with CVS, Darling said on the Monday webinar.
“The most important thing that each facility can do right now is to complete and return to us your updated contact information,” he said. “We will be relying upon a variety of methods of communication in the coming months. Phone calls will surely be one of those methods, but perhaps more importantly, e-mail will also be used.”
E-mail is going to be critically important, so facilities have to make sure the right people are receiving them — and ensure that they are doing so in a timely manner.
That’s because e-mail notifications will be sent to LTC facilities this month with three pre-selected onsite clinic dates, which CVS is in the process of scheduling. And in the near term, communications will be going to all primary points of contact indicated by the facility, Ryan Jeanneret, senior director and Omnicare lead for the COVID-19 Vaccine Program for LTC, said on the webinar.
The assigned clinic dates will be sent by three separate emails from a CVS Health distribution list, and at or near the time of the notification, the primary points of contact at the facility will get a package from CVS with consent forms, awareness posters, and other materials.
Then there will be a confirmation phone call with the facility’s primary point of contact, verifying the dates and the total number of patients, residents, and staff that will be vaccinated at each clinic — as well as addressing any questions that haven’t yet been answered, Jeanneret said.
When it comes to those questions, Love and Darling both are aware of the hesitation around the vaccine. But some element of learning on the fly is inevitable with a novel virus.
“This is unique, right?” Love told SNN. “A year ago, no one knew what COVID-19 was; now we got a vaccine that looks efficacious and safe. So we’re going to have to learn. We may have to develop other educational material; we may have to develop other strategies to get those materials out there. We’ll learn as we go, we’ll work closely with the CDC and our other partners on getting them out there.”