As anticipated, the national program to offer first-dose COVID-19 vaccinations to all nursing home residents and staff is reaching its goal some three to four weeks after starting in late December, according to Courtney Bishnoi, vice president of quality and programs at the American Health Care Association/National Center for Assisted Living (AHCA/NCAL).

Speaking to Provider, she said the association is very encouraged by the vaccination rollout and ability of the federal program being managed by Walgreens, CVS, and other long term care pharmacies to get the Moderna or Pfizer vaccine distributed to long term care residents.

“I would say from our perspective we are very excited that the vaccination is rolling out to nursing homes and assisted living communities across the country,” Bishnoi says. “The program has completed the first clinic for most nursing homes, and now assisted living is really getting underway.”

She says states prioritizing the long term care and related settings are moving along rapidly to vaccinate, pointing to West Virginia and Connecticut as examples.

“There are a lot of consistencies among states and there are inconsistencies as well, but these states that have prioritized vaccinating the most vulnerable populations in long term care have been working both in and outside the federal program and seeing much success,” Bishnoi says.
As for the clinical impact of the first doses on residents and staff, there has been minimal disruption among both groups.

“We have been pleasantly surprised,” she says. “One of the initial concerns facilities had was the fear of staff callouts due to side effects, and that is not happening. For example, West Virginia has had minimal callouts after the first dose across the whole state.”

There is, however, some expectation of more side effects for residents and staff getting a second dose of the vaccine, as was seen in the clinical trials, Bishnoi says. These effects have included experiencing “flu-like” symptoms for a day.

One major part of the AHCA/NCAL outreach to providers concerning the vaccine is trying to ensure as many residents and staff actually get the vaccine. This has been a larger issue with staff versus the residents, she says, due to misperceptions and misinformation often widely spread on social media.

“Our #GetVaccinated campaign [www.ahcancal.org/getvaccinated] has a ton of resources,” Bishnoi says. The effort has also included quick turnaround on feedback from providers wanting even more, like when facilities requested a video from AHCA/NCAL’s medical experts on the vaccine to share with their communities.

So, the big question of when the vaccine program will result in fewer infections in the long term care setting remains to be seen, but Bishnoi says trial data from Moderna and Pfizer point to 14 days after the second dose as being the time frame for a real impact.

It is then that the effort to make visitation easier at facilities may be able to accelerate. “We will be very excited to see more visitation as a result of high vaccination rates, and we look forward to working with the Centers for Disease Control and Prevention and Centers for Medicare & Medicaid Services to help us loosen restrictions and increase the quality of life for residents and staff who have taken the vaccine.”

As for those staff who do not want the vaccination, Bishnoi says providers who have worked through one-on-one discussions and held employee town halls to correct faulty information on the vaccine and its risks have been the organizations with the highest uptake.

“We have some providers with 100 percent uptake, and we are seeing that direct conversation with staff, and sharing facts without pressuring them, is the best approach,” she says.

There are also stories of success related to making vaccination day fun and creating videos and social media posts to show how residents and staff have risen to the occasion in what is expected to be a great advance against the pandemic, Bishnoi adds.​