Thousands of nursing home residents are facing delays in getting vaccinated for Covid-19 now that the federal government isn’t issuing vaccines, and most long-term care operators have yet to start administering shots.
Many nursing homes will not begin vaccinations until well into October or even November, according to an article in the New York Times published Thursday. This is despite the Centers for Disease Control and Prevention (CDC) approving the latest vaccine two weeks ago, and the new shots becoming available to the general public within the last week or so.
This news comes in the midst of a surge in Covid cases and deaths, and on top of reports that only about a quarter of staff members at nursing homes are up-to-date with their Covid shots. The vaccination rates for residents are improved compared to this time last year, and about 62% are currently up-to-date on their vaccines compared to 38% at the start of October of 2022, according to federal data.
Covid deaths at nursing homes, however, rose dramatically by 80% in August compared to July, following a pattern of consistent increases over the summer. During this time, the rate of Covid cases more than doubled. Moreover, about 1 in 4 nursing homes, or 24%, had a resident infection and more than 1 in 3, or 36%, had a staff case.
“The distribution of the new Covid-19 vaccine is not going well,” Chad Worz, the chief executive of the American Society of Consultant Pharmacists, told the Times. “Older adults in those settings are certainly the most vulnerable and should have been prioritized.”
The new Covid vaccine’s roll out has been complicated by the public health emergency designation ending in May when the federal government stopped purchasing and distributing Covid vaccines.
Without a government agreement to purchase the shots, vaccine manufacturers will likely only make large quantities once CDC experts recommended approval, in turn causing delays, according to Elizabeth Sobczyk, the project director of Moving Needles, a CDC-funded initiative to improve adult immunization rates in long-term care facilities.
“Then they need to be FDA inspected — we want safe vaccines — then there is contracting and roll out,” Ms. Sobczyk told the Times. “So I completely understand the frustration, but also why the availability wasn’t immediate.”
And another hurdle to vaccination is the resistance to it among nurses and aides, especially now that the state mandates for workers to be vaccinated have been removed, the story notes.
The Department of Health and Human Services (HHS) – which is currently identifying long-term care facilities with low vaccination rates – is also contacting nursing homes to make sure that proper infection prevention and control protocols are being followed. Skilled Nursing News reached out to the department, but more details were unavailable at the time of publication.
Aside from the approval and manufacturing process being more drawn out due to the PHE’s end, employees are having to get vaccinated privately, and on personal time, which has added another source of consternation and is contributing to the delays.
Moreover, homes are rolling out a new vaccine for a rising and dangerous respiratory virus – RSV – which will be a third shot for many residents, along with vaccines for Covid and the flu.
And all this is expected to lead to more administrative burdens because now nursing homes will have to bill Medicare to be reimbursed for the vaccines. The Covid vaccine is charged to Medicare Part B, which covers outpatient and physicians’ services, but the RSV vaccine must be billed to Medicare Part D, the prescription drug benefit.
“The United States has been phenomenal in screwing up vaccinations,” David Nace, chief medical officer of UPMC Senior Communities in Pittsburgh, told the Times. “This idea that some are under Part B and some are under Part D and some can be billed by a pharmacy — who in God’s name came up with this?”
While Medicare will pay for vaccines for most nursing home residents, employees may have to go through their private insurance and pay potential out-of-pocket costs.
The government will provide free Covid shots for about 25 to 30 million people who lack health insurance or whose insurance doesn’t cover the complete cost of the vaccine. A complete list of medical entities administering shots is available on www.vaccines.gov.
Nursing homes were at the epicenter of the Covid pandemic, which took the lives of more than 200,000 residents and staff members during its first two years.
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