Long-term care facilities prepare for COVID-19 vaccines

Operators of local skilled nursing and long-term care facilities are breathing a sigh of relief after learning that they will receive doses of COVID-19 vaccines for their patients and staff as early as next week.

Walgreens and CVS Health started administering vaccines made by Pfizer-BioNTech and Moderna Inc. on Dec. 18 and 21, respectively, in other states as part of the Centers for Disease Control and Prevention (CDC) Pharmacy Partnership for Long-term Care Program. CVS will roll out its program in California starting Dec. 28, Monica Prinzing, CVS spokeswoman for the western region, wrote in an email on Tuesday.

Walgreens is scheduled to provide vaccinations at approximately 800 long-term care facilities across 12 states this week, but not in California. The company will begin clinics in 39 additional states the week of Dec. 28, or once the Centers for Disease Control and Prevention approves more jurisdictions, spokeswoman Emily Delnicki said on Tuesday.

Rhonda Bekkedahl, CEO and executive director at Channing House in Palo Alto, said that on-site vaccinations for residents and staff will begin on Dec. 28 with the second-dose vaccination approximately 21 days later.

“We are very excited to be receiving the first dose of the vaccine this month,” Bekkedahl wrote in an email on Tuesday. “The availability of the vaccine has given our residents, staff and their families hope. Hope that this pandemic will one day be in the past. The presence of this hope, alone, has improved the general morale of everyone on campus.”

The first on-site clinic at Channing House is scheduled with Omnicare CVS. Vaccines will be offered to all residents and staff, about 500 in total, she said. The Omnicare CVS team will administer the shots.

“We anticipate a very high level of interest from our residents and staff. The vaccine, however, is optional to both groups. We are in the process of getting residents and staff registered,” Bekkedahl said.

Channing House is coordinating the collection of consent forms and will assist residents who need help filling them out, she said.

‘We believe the vaccine will begin to resolve all of the quarantine issues, but not for several months.’

Mary McMullin, chief strategy and advancement officer, Covia Communities

“We are communicating updates on the process to residents and staff as we receive information from Omnicare CVS. We will have extra staff onsite on the date of the clinic to ensure efficient flow of traffic and to ensure that proper physical distancing is observed. We will have an observation area where residents and staff will wait the recommended 15 minutes or 30 minutes after receiving the vaccine. Our onsite licensed nurses will be available to respond, if needed,” she said.

Bekkedahl doesn’t anticipate any glitches, but she said Channing House would be ready if something comes up.

“We have done a number of onsite influenza clinics in the past. And, we coordinate weekly and sometimes bi-weekly Covid testing for about 250 people per testing day. So, we have reliable processes in place.”

Changes to their protocols won’t happen all at once or even anytime soon. The most recent information Channing House has received from the California Department of Public Health indicates that infection-control protocols will be in place for an additional three to four months as researchers compile and analyze data on the vaccine’s effectiveness “in the real world,” she said.

“Until we are advised differently by the CDC or CDPH, there will be no changes to the standard precautions: wear a mask at all times in the presence of others from outside your household, do not attend gatherings, maintain physical distancing and practice good hand hygiene,” Bekkedahl said.

Bekkedahl also said Channing House’s skilled nursing staff already qualify to receive the vaccine from Santa Clara County Public Health’s vaccination clinics at the Santa Clara County Fairgrounds. Those vaccination clinics began on Dec. 17 and several staff members are receiving their vaccinations there.

Mary McMullin, chief strategy and advancement officer for Covia Communities, which owns Webster House Health Center and Lytton Gardens in Palo Alto, said both facilities have signed up to receive vaccines from Walgreens.

“We expect to receive 190 first-dose vaccines for Webster House Health Center in the middle of January, but Walgreens has not set a specific date yet,” McMullin said.

Linda Hibbs, executive director of Webster House, has been in touch with the Walgreens liaison and has sent out the vaccine consent forms to Health Center residents, family members, personal representatives and staff. Walgreens personnel will administer the shots, McMullin said.

When the doses arrive, McMullin expects 100% of Webster House Health Center residents and 50% of staff, including certified nursing assistants, nurses and housekeepers, to be vaccinated during the first round. The other half of the facility’s staff members — dining, maintenance workers and directors — will be vaccinated in the second round.

“We believe the vaccine will begin to resolve all of the quarantine issues, but not for several months. We hope that staff, once vaccinated, will gain confidence in the safety of their work,” McMullin said. Covia doesn’t plan to modify or change its quarantine and visiting procedures for several weeks until all staff and residents have received both doses, she added.

So far, they’ve come across one glitch while preparing for the vaccine program, McMullin said.

“The vaccine consent form is provided in English only, so we have to read the form in other languages to staff and residents. This creates a trust issue in that the recipient of the information questions whether we are providing accurate information and questions if the vaccine is safe. We are spending a great deal of time educating residents, family and staff about the safety of the vaccine,” she said.

At Meadow Gardens, a memory care center in Menlo Park, staff is enthusiastically awaiting the vaccines, Dreanna Reyes, memory care director, said. They have applied for the doses for their 19 residents and 20 staff members, but she doesn’t yet know when the doses will arrive.

“The staff and residents are excited about it. The vaccine will help with the worry of family and residents and staff. We are very eager to relieve them of their concerns,” she said.

Walgreens said in a statement that the company plans to administer the vaccine to about three million residents and staff in 35,000 long-term care facilities nationwide. Teams have been specially trained to properly handle the vials, which must be kept at sub-zero temperatures and transported in specific ways. Moderna’s vaccine, for example, can only be transported frozen to avoid shaking the vials.

The company has set up 100 strategically placed hubs around the country to store the vaccines. Pharmacy team members pick up the vaccines at the hub stores, taking only what they’ll need for particular long-term care facilities. The vaccines can be stored for a short time in regular pharmacy refrigerators.

CVS expects to vaccinate up to four million residents and staff at more than 40,000 long-term care facilities through the program, the company said in a statement on Dec. 21.

The company’s pharmacy teams will make three visits to each long-term care facility to ensure residents and staff receive their initial shot and the critical booster.

“The majority of residents and staff will be fully vaccinated three to four weeks after the first visit, depending on which vaccine they receive. CVS Health expects to complete its long-term care facility vaccination effort in approximately 12 weeks,” the company said.

The long-term care facility vaccination program is the first step toward the eventual availability of COVID-19 vaccines at all CVS Pharmacy locations throughout the country — subject to availability and prioritization of groups — which is based on states’ decisions. CVS expects to have the capacity to administer 20 to 25 million shots per month once the doses become available to everyone, the company said.

The roll out of the vaccination programs come as the deadly coronavirus has has killed more than 22,923 people in California as of Dec. 21 and 615 people in Santa Clara County as of Tuesday, and has taken its largest toll on vulnerable seniors in congregate-living communities, according to state and county health leaders.

In Santa Clara County, this vulnerable population makes up about 5% of positive cases but bears 45% of the deaths, county Health Officer Dr. Sara Cody said.

Since Thanksgiving, those numbers are again spiking. Palo Alto’s Webster House Health Center has had 20 residents and six staff members test positive for the coronavirus since the holiday, according to McMullin.

Find comprehensive coverage on the Midpeninsula’s response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.