Residents of long term care homes were supposed to be first in line to receive a precious COVID-19 vaccination, through an innovative federal partnership. But so far the vaccine rollout for the state’s most vulnerable population has resulted mostly in frustration — and now some counties are offering vaccinations to nursing homes and assisted living facilities from their limited supply rather than continue to wait for the federal vaccination program.
Using vaccine doses provided by Contra Costa County, John Muir Health on Wednesday will vaccinate people at Byron Park in Walnut Creek, following last week’s shots given to residents and employees of another facility, Viamonte, which had expected to rely on the federal program. And this week, staff and residents of Laguna Honda Hospital and Rehabilitation Center, one of the largest skilled nursing facilities in the state, received their shots from San Francisco Department of Public Health.
“The feds screwed this up,” said Michael Wasserman, a geriatrician and former president of the California Association for Long Term Care Medicine who has been critical of the federal plan, which is supposed to operate by supplying vaccine directly to CVS and Walgreens for senior homes.
It is difficult, however, to get a comprehensive picture of what is happening with the federal program in California. Officials at the Centers for Disease Control and Prevention did not respond to a request for information, and a CVS spokesperson insisted the company began performing vaccinations in California nursing homes on Dec. 28. But the Bay Area News Group spoke with just one facility — the San Francisco Campus for Jewish Living — that said it is currently receiving vaccinations from CVS.
The stakes are high as cases continue to surge across long-term care facilities. At least 23,335 residents and staff across nursing homes and assisted living facilities were actively infected with COVID-19 this week, according to the latest state data. And at least 9,443 people working and living in these facilities have died of COVID-19 since the start of the pandemic.
Months ago, federal officials announced a plan to help, by tapping Walgreens and CVS to work directly with care homes to vaccinate the hundreds of thousands of elderly Americans in that vulnerable population. That was supposed to occur on a separate track from the vaccinations of health care workers and others, which have been routed through state and county health departments. But by early December, the effort had become mired in delay.
First doses were shipped to those pharmacies directly from the manufacturers before the holidays, but many facilities are only now finding out when the cavalry will come — and in many cases it’s not very soon. At Chaparral House, a skilled nursing facility in Berkeley, executives expected the first vaccines to be given there in December, but have now been told to plan for mid-January.
Chaparral House chief operating officer Chuck Cole said his facility tried to register in October to have Walgreens come out but went months without hearing anything and had to re-register several times before the government’s website showed the community as registered.
“The bravado from the Trump administration and its Operation Warp Speed have not proven to be very accurate or the roll out smooth or speedy,” Cole said.
According to the California Department of Public health, about 90% of skilled nursing facilities and 65% of assisted living facilities throughout the state signed up to receive inoculations via the federal program. For those that did not sign up, the department said, “the local health departments in partnership with the local facility will make a determination about the distribution and administration of vaccines for the facility.”
A Contra Costa County spokesperson said that it is coordinating vaccinations at 80 facilities, including small room-and-care sites. Spokesman Will Harper said the county stepped up because it was told that Walgreens and CVS planned to vaccinate people who live and work in skilled nursing facilities first and then turn to residential care facilities. Given the disproportionate number of coronavirus cases and deaths linked to care homes, he said, the county felt such a vulnerable population “couldn’t afford to wait.”
San Mateo County Health chief Louise Rogers said she was “encouraged” by the recent progress CVS and Walgreens was making to start inoculations in the county, with 11 facilities scheduled so far. Still, she said the county is separately partnering with Safeway pharmacy to provide shots to about 1,300 vulnerable residents and staff of congregate care facilities. She said that was “a role we expected to play as this massive effort ramps up to scale.”
Other Bay Area counties did not immediately respond to questions about whether they were working on similar efforts. In Los Angeles County, officials said in mid-December they would opt out of the federal program in a bid to distribute vaccines faster to senior living facilities.
Walgreens did not immediately respond to a request for comment, but a spokesperson for CVS said things are going according to plan.
“We began making vaccination visits to facilities in California on December 28, which was the date set by the CDC for this state,” said Monica Prinzing. “Per California’s vaccination prioritization guidelines, vaccinations at skilled-nursing facilities were activated first before vaccinations at assisted-living facilities. As a result, we will begin vaccinating at assisted-living facilities on January 11.”
But nursing home advocates painted a much bleaker picture.
“Not only did they have a bad plan, but they didn’t prepare. And what they did prepare is bad,” Wasserman said. CVS and Walgreens “wouldn’t know a nursing home from a senior apartment complex. When they walk in, they don’t understand the workflow, the residents.”
The delays have also left families scrambling for information.
Maddie Napel and her family hoped her brother, who lives in a small group residential home for adults with disabilities, would be among the first to receive a vaccination.
“No one in my family has been allowed to see him since February, and we desperately want to see him — alive and healthy — again,” Napel said.
But beyond a time range of mid-to-late January, Napel’s family has not been notified of a specific vaccine date. Until then, they continue their wait.