As the Biden administration becomes increasingly frustrated with lagging nursing home booster numbers, the White House seeks to take renewed action.
That’s according to an article published by Politico on Thursday; redoubled efforts have been taken to send lists of senior facilities with zero people vaccinated – potential penalties and fines could be attached, according to the report. The White House is also continuing to contact governors, urging leadership to push immunization rates.
CMS appears to be changing its tone and tenor surrounding booster initiatives, according to the Politico report, with extra effort devoted to areas of the country with the lowest vaccination rates. Agency representatives will be reaching out to leadership in these jurisdictions, Politico reported, “reminding them of what additional steps that can take” to increase numbers.
Modest booster uptake
The Centers for Medicare & Medicaid Services (CMS) penalties have been on the table since November 2021, months after the vaccine mandate for health care workers was put in effect that summer.
More recently, the Biden administration’s six-week booster campaign in November had more of the same. As part of the campaign, CMS referred nursing homes with low vaccination rates to state survey agencies; those that do not comply with offering and educating on Covid vaccines and boosters face enforcement actions.
The White House also released a Covid-19 Winter Preparedness Plan on Dec.15, including a range of initiatives and partnerships with aging services organizations like LeadingAge and the American Health Care Association/National Center for Assisted Living (AHCA/NCAL).
Coupled with the campaigns was the Centers for Disease Control & Prevention’s (CDC) policy change to allow nursing home providers to administer Covid vaccines to all residents and staff.
White House officials told Politico the six-week campaign yielded modest results. All the while, the latest variant XBB.1.5 has been “highly transmissible” and fueling a surge after holiday parties.
As of last week, 50.5% of residents are up-to-date, meaning they have received all shots, including the most recent bivalent booster, according to data published by CMS. Up-to-date nursing home staff is much lower at 22.4%.
Still, nursing homes are doing better than the overall population when it comes to booster shots – only 15.4% of those age 5 and older are up-to-date, 17.7% for those 18 years and older, and 38.1% for Americans age 65 and older, according to the Centers for Disease Control and Prevention (CDC).
All Hands on Deck
Operators that have participated in LeadingAge and AHCA/NCAL’s All Hands on Deck campaign – developed in response to the federal six-week initiative – have done marginally better with booster efforts, at least for resident uptake.
The All Hands campaign has increased bivalent booster uptake, with weekly reporting of booster numbers among members, and continued advocacy and collaboration with the Department of Health and Human Services (HHS), according to LeadingAge.
LeadingAge members reported 63.94% of its nursing home residents were up-to-date on boosters, much higher than the national average published by CMS, the organization said in an email. LeadingAge members week over week have seen a 9.20% increase compared to 5.17% for all nursing homes between Nov. 13, 2022 and Jan. 1, 2023.
“Today’s numbers demonstrate progress,” Colleen Knudsen, media relations manager for LeadingAge, told Skilled Nursing News. There are more collaborations with HHS in the pipeline too, she said.
Still, the association recognized challenges surrounding booster uptake in a letter to HHS Secretary Xavier Becerra.
Operators are still working through misunderstandings about the vaccines, and residents being admitted from hospitals without vaccination.
Other booster efforts involving nursing home associations include the Vaccine Equity and Access Program (VEAP), a CDC initiative. LeadingAge has distributed two phases of grant funding among select members to increase Covid and influenza vaccine access and awareness in local communities.
Grants totalling $20,000 were awarded to five LeadingAge members in December; Phase 1 grants for another collective $20,000 in October were awarded to three LeadingAge members.
“Nursing home providers are making every effort to encourage residents to roll up their sleeves, but increasing uptake requires a collective endeavor by public health officials, other health care providers, and the general public,” AHCA said in an emailed statement to Skilled Nursing News.
Everyday Americans – including nursing home residents – don’t fully understand why the bivalent booster is important, the organization added in its statement.
“In the end, the choice to get vaccinated is up to them and their families. We remain focused on continuing our education efforts, combating misinformation and Covid fatigue, and partnering with [Biden] administration officials and other stakeholders to improve bivalent booster rates in nursing homes,” AHCA said.
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