By Brenda Gazzar, Los Angeles Daily News, December 14 2020
Nursing homes around the region were gearing up Monday, Dec. 14, to receive the first doses of COVID-19 vaccines for their staff and residents while battling the region’s explosive surge of novel coronavirus cases.
Los Angeles County announced last week that it was pulling nursing homes out of a federal COVID-19 vaccine distribution program with Walgreens and CVS in order to have “quicker vaccination and higher vaccine coverage.” Facilities in the county are now readying to conduct vaccinations of their residents and staff on their own with the Moderna vaccine as early as Dec. 21.
Meanwhile, nursing homes and other long-term care facilities in other Southern California counties were readying to receive their first doses as early as Dec. 28.
“We have to accept the cards that we’re dealt with,” said Deborah Pacyna of the California Association of Health Facilities, which represents more than 900 skilled nursing facilities in the state. “I think it’s great people will be inoculated. It’s a great Christmas present for everybody.”
Nearly 5,490 nursing home residents in California had died after contracting the novel coronavirus as of Monday, making up more than one-quarter of all COVID-19 deaths in the state, according to California Department of Public Health data. Forty-six percent of the deaths among nursing home residents occurred in Los Angeles County.
Dr. Barbara Ferrer, director of L.A. County’s public health department, said the first shipment of vaccine doses, which began arriving at sites on Monday, will be used to vaccinate healthcare workers with the priority going to those at the highest-risk acute care hospitals. The second allocation will include all healthcare workers and nursing home residents.
“This is a dynamic situation and there is likely to be bumps along the way,” Ferrer told reporters Monday at a news conference.
Dr. Michael Wasserman, medical director of the Los Angeles Jewish Home’s Eisenberg Village in Reseda, said he was working with Dr. Noah Marco, the L.A. Jewish Home’s chief medical officer, to ensure the process will go as smoothly as possible at their facilities.
“We’re making plans. We’re working with our staff. We’re working with our pharmacy department to make this as seamless and effective as possible,” Wasserman said.
Wasserman said he was proud of the county for pulling out of the federal pharmacy partnership with Walgreens and CVS. He said every nursing home in the county already has a long-term care pharmacy and consultant pharmacist that they already work with, who know their facilities’ staff and logistics.
“To take a large retail pharmacy and overlay it into nursing homes never made sense,” he said.
In addition, L.A. County’s plan allows nursing homes to stagger vaccinations of their staff and residents over time.
This is important, he said, because if all staff are inoculated at the same time, a significant number may have side effects and not come to work.
If that happens, he said, “who will take care of the residents?”
Deborah Pacyna of the California Association of Health Facilities said L.A. County’s announcement initially took “everybody by surprise” as facilities there were ready to hand over the vaccination process to Walgreens and CVS, including administration, documentation, reporting requirements and the actual inoculations, she said. Now, those responsibilities will have to be done by the facilities themselves.
“As they struggle with staffing during the biggest surge of the pandemic, they’re also going to have to take on the vaccination program,” she said.
While having adequate staffing has been a longstanding issue in nursing homes, it’s now a “huge issue” in nursing homes in the state as a result of the coronavirus surge, added Jason Belden, director of emergency preparedness for CAHF.
He said the nursing registries and California National Guard resources are “tapped out” at the moment “so we don’t have a lot of staff.”
“It’s particularly bad in L.A. County because the surge is so bad,” he said. “(But) it’s a problem across the state.”
Belden said their association would also have liked more time to plan for the changes to the vaccine distribution strategy in L.A. County.
But he and Pacyna agreed that the county plan will inoculate nursing home residents quicker and give providers greater flexibility.
“The Moderna vaccine lasts up to 28 days in a regular refrigerator and up to six months if you freeze it,” Pacyna said. “That will allow our facilities to stagger vaccinations of staff and residents so everyone isn’t vaccinated at one time and then experiencing side effects.”
For Pasadena, which has its own public health department, the state has allocated 1,950 doses of Pfizer vaccine for high-risk healthcare and long-term care workers and residents of long-term care facilities, according to city spokeswoman Lisa Derderian. They are expecting the vaccines to be delivered the end of next week directly from Pfizer to Huntington Hospital.
Most nursing homes in the city are enrolled in the federal partnership with CVS and Walgreens, which will be sending teams into nursing homes to vaccinate residents and staff on a timeline determined by the Centers for Disease Control and Prevention, she said in an email.
Whether local jurisdictions are participating in the federal partnership with Walgreens and CVS, Pacyna noted that the inoculations would take time.
“It won’t be an overnight magical change where people don’t have to wear masks anymore and visitors can come and go as they please, but it’s certainly a light on the horizon for everybody,” Pacyna said.
Her association has heard about “vaccine hesitancy” among some nursing home residents, she said. But she said that once people realize that people are reacting well to the vaccine in Britain and Canada, she thinks acceptance will grow.
The CDC, along with the American Health Care Association — CAHF’s national affiliate — is unveiling an education campaign this week. The campaign “should help inform people about the choices that they are making,” Pacyna said.