Only about 13% of the first COVID-19 vaccine doses have been administered to nursing home residents by the first business week of 2021, raising concerns about the rollout for both the elderly and the general public.
The federal government’s long-term care vaccination initiative has about 3.3 million total doses set aside, but just 429,066 had been administered in the setting as of January 5, according to the most recent data from the Centers for Disease Control & Prevention (CDC); the latter figure represents just the first dose in the two-stage vaccination process.
Around 17 million vaccine doses have been distributed nationwide, with about 4.8 million first rounds injected thus far, the CDC reported.
Pharmacy giants Walgreens and CVS are primarily spearheading the federal nursing home vaccination push after inking a deal with the Department of Health and Human Services (HHS) in October; a CDC advisory board in early December voted to send long-term care facility residents and health care workers to the front of the line for receiving the vaccine.
Both Walgreens and CVS kicked off their vaccination pushes during the week of December 21, with a CVS spokesperson telling news outlet Axios on Tuesday that the effort is proceeding as expected.
“We’ve encountered no delays, save for some difficulties in getting confirmation from facilities on clinic dates and requests to avoid vaccinating on or around the holidays,” the spokesperson said, per Axios.
Complicating the picture is the fact that nursing home operators were not required to participate in the Walgreens/CVS program, and the federal government has left the general logistics of vaccine distribution up to the states.
In New York, for instance, 611 facilities had signed up for the federal program, with first doses administered at 288 sites as of January 4.
“Through state facilitation, 234 more facilities will administer the first dose this week,” Gov. Andrew Cuomo’s office noted in a Monday coronavirus update. “This will ensure that 85% of facilities have administered the first dose to residents by week’s end, with the remaining 15% to be completed over the next two weeks.”
In West Virginia, which opted out of the federal program according to Axios, Gov. Jim Justice on December 30 touted the completion of a plan to provide vaccinations at all 214 of the state’s long-term care facilities.
“We’ve got a plan that, I think, is a terrific plan. But we need to be doing even better,” Justice said in a statement. “Not only do I want us to be ahead, I want us to lap the field, because every time we’re lapping the field, we’re saving somebody’s life.”
The news of emergency vaccine approvals for two separate formulations from drugmakers Pfizer and Moderna brought a ray of hope to nursing home employees, residents, and their families after a year of death, sickness, and isolation.
But even before the rollout began, leaders cautioned that immunizations would not represent a silver bullet for the sector.
“Our day-to-day operations won’t change. The vaccine doesn’t fix the problem. It is just one more tool,” ProMedica Senior Care chief medical officer Mark Gloth told SNN in mid-December. “It certainly will allow us to start exploring other things like enhanced visitations for our communities. But those are all things that I’m looking forward to starting to review the evidence on and have conversations about.”
Operators are also beginning to face predicted resistance to the vaccine among nursing home staff, who have spent the last 10 months on the front lines of a crisis that has shown no signs of abating. In Ohio, for instance, up to 60% of workers declined the vaccine, Gov. Mike DeWine indicated last week, despite more widespread acceptance among residennts.
Lori Porter, CEO and co-founder of the National Association of Health Care Assistants, said last month that many of the certified nursing assistants (CNAs) that her organization represents have lost faith in institutions — including the government and their employers — after witnessing firsthand the COVID-19 disaster in long-term care.
“My concern is not necessarily the vaccine, if it’s proven safe,” Porter told SNN. “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.”