Vaccines begin to reach nursing homes
Next few weeks to see 1,442 sites receive doses
Over 2,000 long-term care residents have died of the coronavirus in Virginia, representing about 40% of the state’s death toll.
Seventy-six of the people who took care of elderly patients at those facilities also have died, according to the state health department.
Throughout the pandemic, residents of nursing homes and similar centers have been among the most vulnerable to COVID-19, with cases sometimes spreading like wildfire through their halls and
shared living spaces, making thousands seriously ill. Virginia got unwanted recognition in April for having one of the largest such outbreaks at Canterbury Rehabilitation and Healthcare Center in Richmond, which left over 50 people dead.
So when long-term care facilities began receiving vaccines last week, it brought a long-awaited sigh of relief for many families whose loved ones live or work in those settings.
Some 1,442 sites are expected to receive doses over the next three or four weeks, public health officials said. CVS and Walgreens will administer the vast majority. The national pharmacy chains are partnering with the U.S. Centers for Disease Control and Prevention to take vaccines directly to the facilities so residents don’t have to travel.
Virginia opted to put front line health care workers, followed by long-term care residents, in 1(a) — the top tier priority group for immunizations — based on federal recommendations. Over the past two weeks, the state has received 388,000 vaccine doses collectively from Pfizer and Moderna.
About 64,900, or a little over 17%, had been recorded in the registry as administered before New Year’s Day. Public health officials said they believe that number is low because of lags in reporting, though they wouldn’t speculate as to how off target it might be. No one has received the complete two-shot series because injections must be spaced three or four weeks apart, depending on the brand.
Details on the plans for inoculating so-called “essential workers” and high-risk adults — those considered next in line — also weren’t available earlier last week.
“It’s a very fluid situation,” said Christy Gray, immunization director for the Virginia Department of Health, during a call with news media Wednesday. “We still do not have the approved recommendations of how Virginia is approaching 1(b) and 1(c) yet.”
But the department said CVS and Walgreens are trying to schedule vaccine clinics at long-term care campuses quickly. They are expected to visit each site three times, spaced three or four weeks apart: The initial visit for the first dose, the second for the second dose or first dose for new residents and a third time for the final dose for new residents.
Originally, state health officials believed long-term care facilities in Virginia would receive Moderna doses while the hospitals got shipments from Pfizer. Virginia has since allocated some of the Pfizer shots for the nursing homes program based on the availability of the vaccine and the pharmacies’ ability to provide ultra-cold storage, said Erin Beard, a state health department spokeswoman.
Before receiving vaccines, long-term care facilities rushed to get consent forms signed by residents or individuals making decisions for them. Public health officials grappled with how to deal with cases of residents whose families are unreachable or estranged.
“We want to ensure that the population is obviously not being coerced in any way to get the vaccine,” said Kristin Collins, a policy analyst in the health department’s office of epidemiology.
At Beth Sholom Village of Eastern Virginia last week, administrator Rebecca Moralez scrambled to distribute the forms and allay concerns from residents and staff before their vaccine clinic Saturday.
Like most long-term care facilities, Beth Sholom has dealt with its share of COVID-19 cases. The campus had some infections among its assisted living population last week — a situation that no longer fazes staff because it has become an all-too common reality in elder care settings.
Nursing homes are one of the few industries the federal government requires to test for the coronavirus because of its susceptibility to outbreaks. How often a facility is required to test is based on the positivity rate of the city in which it is located.
With Virginia Beach currently having over 15% of its nasal swab tests coming back positive for the virus, Beth Sholom must test its residents and personnel twice a week, a cumbersome process that has in some ways prepared them for mass vaccinations, staff said. The testing requirements won’t go to once a week until the city’s positivity rate is between 5 and 10%. Once-a-month testing comes only after the city has dropped under 5%.
Initially Beth Sholom believed it would be able to vaccinate all of its nursing home and assisted living residents at the same time. But three days before their clinic, program officials instructed the facility only the nursing home patients — about 105 of their 177 residents — would be eligible right now.
The news was frustrating, but not entirely unexpected, for Beth Sholom director David Abraham, who said both of their programs are connected under one roof. But about 300 staff members would be able to get the shots if they wanted them, he said.
At least 5,800 long-term care facility workers have been infected with the coronavirus in Virginia, according to the state health department. The workplace risks of exposure also put their households at risk of getting sick, Abraham said.
Because the vaccine is optional, Beth Sholom took the extra step of providing some rewards for those who rolled up their sleeves. It planned drawings last week for several $10 gift cards and a few larger ones for $100 and $500 for staff who participated.
“We’ve been in this mode for so long,” Abraham said. “We just felt it was important to provide some kind of incentive to get the ball rolling.
Moralez said they’ve focused as much energy on assuaging concerns from personnel. Like many in the general public and even some medical professionals, elder care workers have been wary because of the rapid speed with which the vaccines were developed.
When an employee expressed some hesitance because of an allergy to a specific type of medicine, Moralez zipped over to her computer and printed off a list of ingredients in the vaccine, just to show it wouldn’t be an issue.
“Our residents are more accustomed to the idea of the vaccine. It’s the younger population that is having more of a difficult time with it,” she said. “The older folks have lived through other stuff.”