Nursing homes have been slow to roll out COVID-19 vaccines, but federal, pharmacy and nursing home officials said they are on track to finish the job before the end of the month.
Only about 16% of vaccines distributed for use in nursing homes have been injected into residents and the staff who care for them, according to data from the U.S. Centers for Disease Control and Prevention.
But Health and Human Services Secretary Alex Azar said those figures underestimate actual vaccinations, because there is a lag between the time shots are given and when they are recorded.
Azar said the pace of vaccination has been slowed by the need to get consent forms from residents or their family members, but he expects vaccination rates to speed up soon.
“We will be seeing a significant ramp-up of those vaccines getting into nursing home patients,” Azar said in a Wednesday call with reporters.
But Iowa Gov. Kim Reynolds said Thursday that the process is not moving as fast as she expected.
“This is a problem that’s happening all across the country,” she said shortly before meeting with fellow governors and the drug store chains responsible for distributing the vaccine. “None of us are happy with the way this is being executed.”
Nursing home chains appear to be more satisfied.
Dr. Richard Feifer, chief medical officer of Genesis HealthCare, said vaccinations at his company’s more than 350 nursing home facilities are on track.
“The nursing home program is going pretty well at this point,” he said.
Genesis started vaccinating patients and staff on Dec. 21 and is about halfway done, he said.
The American Health Care Association and National Center for Assisted Living, which represents more than 14,000 nursing homes and assisted living communities across the country, also said its original timeline seems to be holding.
“As of right now, we are not aware of widespread issues or delays with this vaccine rollout, and if there were, we would be among the first to sound the alarm,” according to a prepared statement. “We continue to assist a minority of member providers who come to us looking for assistance or clarity, but the majority of providers tell us that their clinics have been scheduled or have already occurred and that overall, the program is running smoothly.”
Feifer said he was concerned vaccine side effects might require staff members to take time off. But the rate of symptoms “has been much, much lower than we anticipated,” he said. “We’ve had very few if any call-outs from staff.”
Still, staff members at many of Genesis’ facilities have declined to get vaccinated, Feifer said. In some facilities, 80% of employees are signing up for the shot, while in others, less than half are willing to get it.
‘We have new patients … every single day’
Both vaccines authorized for use so far—made by Pfizer-BioNTech and Moderna—require two doses to become fully effective.
The government has contracted with CVS and Walgreens to visit long-term care facilities three times with vaccine: first to give initial doses as many people as possible; then to give second doses to those already vaccinated and cover everyone who didn’t get a first dose; and finally to ensure that everyone has received a second dose. Those visits began in late December.
There is no federal plan, Feifer said, nor one in any of the 25 states where Genesis has facilities, for how to vaccinate people who miss those opportunities. “Yet we have new patients and new staff every single day,” he said.
Both companies began delivering doses in December and say they are on track to provide initial doses to all 15,000 U.S. nursing homes by Jan. 25.
But it is slow going.
“Our work with long-term care facilities isn’t a mass vaccination effort—quite the opposite,” Larry Merlo, CVD Health president and CEO said in a statement. “We’re dealing with a vulnerable population that requires onsite and, in some cases, in-room visits at facilities with fewer than 100 residents on average.”
Despite those challenges, both CVS and Walgreens say they remain on schedule and will vaccinate more people as states direct them to and vaccine becomes available.
The companies both plan to expand into more than 30,000 assisted living facilities, each in the coming weeks, and to offer shots to the general public at their thousands of pharmacy locations once doses become available for mass distribution.
People will be able to schedule vaccination appointments via company apps, websites and toll-free numbers.
CVS Pharmacy said it has the capacity to administer 20-25 million shots per month.
Gen. Gus Perna, who has been in charge of distribution for the national vaccine effort, said CVS and Walgreens have done a great job so far of getting vaccines out to nursing homes.
“It’s really positive momentum throughout the country on this,” Perna said.
But the momentum doesn’t feel very fast in Iowa.
“We need CVS and Walgreens to move more quickly,” said Brent Willett, president of the Iowa Health Care Association, which represents most of the state’s nursing homes and assisted living centers. The state has nearly 700 such facilities, with about 31,000 residents and 37,000 staff.
Iowa nursing home residents represent less than 1% of the state’s population, but have accounted for more than a quarter of the state’s deaths from COVID-19.
Kim Bahrenfuss of Davenport, Iowa, was initially told that vaccine would arrive on Dec. 28 in the Kahl Home where her mother, Paulette Hradek, lives. But that date slipped, and now, the first doses apparently won’t be given until Jan. 20.
That means her mother won’t be fully protected until the end of February or early March—a few weeks after her second dose.
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