Frustrations boil at pace of vaccinations at long-term care facilities
In mid-December, a top Trump administration official floated an enticing possibility: All nursing home residents in the United States could be vaccinated against the coronavirus by Christmas. “It’s really a remarkable, remarkable prospect,” Alex Azar, the secretary of health and human services, declared.
It turned out to be a fantasy.
A month later, vaccinations of some of the country’s most vulnerable citizens are going more slowly than many state officials, industry executives and families expected. Their hopes had been buoyed when government officials said long-term care facilities would be at the front of the line for vaccines.
CVS and Walgreens, which are largely responsible for vaccinating residents and workers in longterm care facilities, are on track to make at least initial vaccination visits to nearly all nursing homes they are working with by Jan. 25. The two pharmacy chains have already given out more than 1.7 million vaccine doses at long-term care facilities.
But the progress is uneven across the country and not nearly as comprehensive for different types of long-term care. For example, thousands of assisted living facilities — for older people who need less care than those in nursing homes — do not yet even have an appointment for their first visit from the pharmacy teams, in large part because states have given such facilities lower priority in their vaccine-distribution plans.
“I’ve had facilities call me, and I’ve had people cry, I’ve had people curse, because this was the first sign of hope that they’ve had in many, many months,” said Betsy Johnson, who leads a group that represents Kentucky’s nursing homes and assisted living facilities.
“It’s just human nature to think, ‘OK, but I was supposed to be first — and I don’t even know when my clinic is going to happen,’” Johnson said.
In Pennsylvania, teams from CVS or Walgreens are not scheduled to visit some nursing homes until February, and the vast majority of the state’s assisted living facilities have not yet been scheduled for a first visit, said Zach Shamberg, president of the Pennsylvania Health Care Association.
“There’s a great deal of frustration, there’s a great deal of apprehension, as to when or if this vaccine will come,” Shamberg said.
The pace of the vaccination program has taken on greater urgency as the rapidly spreading virus continues to decimate nursing homes and similar facilities. The virus’ surge since November has killed about 30,000 long-term care staff and residents, raising the total of virus-related deaths in these facilities to at least 136,000, according to a New York Times tracker. Since the pandemic began, longterm care facilities have accounted for just 5% of coronavirus cases but 36% of virus-related deaths.
Even as the vaccination campaign accelerates, the suffering is unlikely to wane. The coming months could be “the deadliest of the pandemic” for people living and working in longterm care, according to an analysis released Thursday by the Kaiser Family Foundation.
The Trump administration announced in October that it had teamed up with CVS and Walgreens to lead a federal effort to vaccinate residents and workers at long-term care facilities, among the first eligible groups.
On Friday, CVS said it had given out just over 1 million doses in more than 12,000 initial visits to long-term care facilities. Nearly 8,000 visits are scheduled for the coming week. Walgreens said it had given out nearly 750,000 doses in nearly 9,000 visits to facilities, mostly nursing homes. The number of visits that Walgreens has scheduled with assisted living facilities “continues to accelerate,” a company spokesperson, Rebekah Pajak, said.
The vaccinations by CVS and Walgreens were always expected to take several months because of the need to visit tens of thousands of facilities three times. The first two visits are for most residents and staff to get the two doses of the vaccine, with the third visit as a backup for people who missed the first clinic.
The idea that all nursing home residents could get their first doses by Christmas was not a realistic prospect even when Azar, the health secretary, floated it 12 days before the holiday. By that point, some states had told the Centers for Disease Control and Prevention that they would not activate the federal program to vaccinate their nursing homes until Dec. 28. The logistics would have been challenging even if states had put a priority on getting their first doses to nursing homes.
Michael Pratt, a spokesperson for the Department of Health and Human Services, said Azar had been speaking only aspirationally about what states were capable of doing, since they had enough vaccine doses to cover all nursing home residents by Christmas. But that would have required that states place less of a priority on vaccinating high-risk groups like heath care workers.
T.J. Crawford, a spokesperson for CVS, said the chain was making first visits to all facilities within four weeks of each state’s activating its vaccination program for nursing homes or assisted living facilities.