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More than 21 million health care workers and around 3 million people living in long-term care facilities, like nursing homes, ought to be the first in line, once COVID-19 vaccines get emergency-use authorization, a federal government’s advisory panel decided earlier this week.
The Centers for Disease Control and Prevention advisory committee recommendation is one answer on how the vaccine rollout may proceed. But for people with family members in nursing homes, there’s a new question: Now what happens?
It’s a pressing inquiry in a pandemic that’s surging with a case count that still doesn’t reflect infections from the Thanksgiving weekend.
Residents and staff at long term-care facilities — which 1.3 million people in nursing homes and 800,000 people in assisted living sites — account for 6% of the coronavirus cases, but 40% of the deaths from the infection, the committee noted. The majority of people above age 75 who are hospitalized because of the virus came from long-term care facilities, the committee added.
Meanwhile, the coming three months will be the “most difficult time” in the nation’s public-health history, CDC Director Dr. Robert Redfield said a day after the advisory committee’s 13-1 vote on the policy recommendation.
How does the facility plan to educate family members so they can make health-care choices?
Will it be covered through the pre-existing paperwork, or a separate form? If a resident is of legally sound mind and differs from family members about the vaccine, the resident has the final decision, said Janine Finck-Boyle, vice president of regulatory affairs at LeadingAge, an association of nonprofit providers of aging services such as nursing homes, assisted living and hospice care.
Last week, AstraZeneca AZN, -1.14% and the University of Oxford said their coronavirus vaccine is up to 90% effective when administered as a half dose, and then a full dose one month later. Effectiveness falls to 62% when two full doses are given one month apart.
It was later revealed that initial half-dose, deemed as the more effective option by the company than two full doses, was given accidentally to participants. They were also 55 or under. That age group was not initially disclosed when AstraZeneca said the half and full dosage was more effective.
The firm defended these errors and apparent lack of transparency. “I’m not going to pretend it’s not an interesting result, because it is — but I definitely don’t understand it and I don’t think any of us do,” Mene Pangalos, AstraZeneca’s executive vice president for biopharmaceuticals R&D, said.
What state agencies should I check in with before choosing a vaccine?
The advisory committee recommendations will help state-level public-health agencies as they draw up plans to distribute the vaccine, one expert said. Those plans may vary slightly as different states take different approaches.
If people want to learn more about the specifics, or make sure authorities know where to find their aging relative, one good place to start is with a call to state-level representatives or the governor’s office, said Finck-Boyle, a nursing home administrator herself for 20 years.
These elected officials may be able to pass along information to state-planning task forces or point callers in the right direction for up-to-date information, she added.
The CDC also has an “interim playbook” that breaks out summaries on various state and city vaccination strategies. Even if these summaries don’t get into specifics, at the very least, they tell readers the state agencies that are in the mix for a vaccination rollout.
How will find out if a vaccine is available for my relative’s nursing home?
Families can start by asking basic questions, said Dr. Judith Beizer a clinical professor at St. John’s University College of Pharmacy and Health Sciences. For example, will families learn via a phone call, or an email or a letter, said Beizer, who has a practice site at a nursing home.
Is the facility bringing the vaccines on site via a pharmacy or their own provider?
Under the Pharmacy Partnership for Long-term Care Program, CVS CVS, +4.15%, Walgreens WBA, +7.48%, the two national pharmacy chains, will bring the vaccines, free of charge, to facilities that choose to participate in the program. It will take three visits over approximately two months to fully administer the two shots to residents and staff, the CDC said.
“ How the care facility plans to get consent is one topic people can ask about as they wait for a COVID-19 vaccine. ”
Contact your relative’s long-term care facility for dates, a Walgreens spokeswoman told MarketWatch. Some 27,000 facilities have picked the company as their vaccine provider, she added.
The facility “will be responsible for informing families about when, where and how residents will receive a COVID-19 vaccination,” she said, adding that it’s up to the facilities to pick locations that are “well-ventilated, clean, and provide ample space for residents and employees to practice safe social-distancing. Walgreens can make accommodations for clinics or patients who need additional support, such as limited patient mobility.”
Walgreens pharmacists and immunizing technicians will be doing the injections, she said, noting the chain’s staff has been administering vaccines for more than 10 years. CVS did not immediately respond to a request for comment.
What should I tell my loved one?
“I would say, ‘We’re excited about the vaccine and we waiting to hear when it’s available in the facility,” Beizer said, adding that it’s important to note this is a two-shot event. Another point to make, Beizer said, is the sooner the vaccination process, the sooner everyone can “go back to more normal visitation.”
The American Health Care Association/National Center for Assisted Living, a professional organization with over 14,000 member facilities offering long-term and post-acute care, said it was hopeful most families would encourage their loved ones to get the COVID-19 vaccine after such a long and tough period of isolation.
“We anticipate more information and materials about the vaccine(s) from the CDC in the coming weeks, which will help inform family members and hopefully address many of their questions. Long term-care staff will need to work in tandem with family members, especially those who are the designated representative for a resident who can help make health care decisions for them, so facilities have proper consent,” the association said in a statement.
Read:Is someone you love in a nursing home? 4 ways to ensure their safety as COVID-19 cases spike
What if I disagree with my relative over a vaccine?
The CDC advisory committee meeting stressed the importance of gaining consent from residents or their health-care proxies before any vaccination. But a time when one survey found nearly half (46%) of older adults said they’d rather wait for someone else to get vaccinated first, there may be disagreement between the resident and the relative; 14% of people surveyed in the age 50-80 range said they didn’t want the COVID-19 vaccine at all.
Relying on “herd immunity” from a vaccine comes with risks. Both Finck-Boyle and Beizer said these are issues that residents and families need to discuss with their doctor and nursing home administrators. But families and residents always have that final say on consent. “They can refuse a vaccine, just like a flu shot,” Beizer noted.
BioNTech SE BNTX, -1.99% and Pfizer PFE, -1.74% announced progress in a vaccine and said a final analysis showed 95% rather than 90% efficacy. On Monday, Moderna MRNA, +9.97% said its vaccine candidate was 94.5% effective.
Johnson & Johnson JNJ, +0.58% ; Merck & Co. MERK, +0.63% ; GlaxoSmithKline GSK, -0.34% ; and Sanofi SAN, +0.31% are also working on fast-track coronavirus vaccines. Moderna, Sanofi and AztraZeneca’s vaccines do not need to be kept ultra-low temperatures.
Last week, AstraZeneca AZN, -1.14% and the University of Oxford said their coronavirus vaccine is up to 90% effective when administered as a half dose, and then a full dose one month later. Effectiveness falls to 62% when two full doses are given one month apart.
It was later revealed that initial half-dose, deemed as the more effective option by the company than two full doses, was given accidentally to participants. They were also 55 or under. That age group was not initially disclosed when AstraZeneca said the half and full dosage was more effective. The firm defended these errors and apparent lack of transparency.
Johnson & Johnson JNJ, +0.58% ; Merck & Co. MERK, +0.63% ; GlaxoSmithKline GSK, -0.34% ; and Sanofi SAN, +0.31% are also working on fast-track coronavirus vaccines. Moderna, Sanofi and AztraZeneca’s vaccines do not need to be kept ultra-low temperatures.
