Los Angeles County Pulls Nursing Homes From Federal Covid-19 Vaccine Plan -- Update
December 11 2020 - 06:29PM
Dow Jones News
By Anna Wilde Mathews
Los Angeles County is pulling its nursing homes out of the
federal program that is using CVS Health Corp. and Walgreens Boots
Alliance Inc. to deliver Covid-19 vaccines to long-term care
institutions, pushing hundreds of facilities to take over the
administration of the shots themselves.
The decision by the public health department in the nation's
most populous county, revealed Thursday in an emailed letter to
nursing homes, means the facilities will receive vaccine doses
directly, and "you will be doing the vaccination of your residents
and staff on your own," likely starting the week of Dec. 21, the
county said in the letter. The change "will support both quicker
vaccination and higher vaccine coverage," the letter said.
Los Angeles County has 385 nursing homes, according to the
California Association of Health Facilities. The letter referred
only to skilled nursing facilities, and not other types of
long-term care, such as assisted-living facilities.
On Friday, Barbara Ferrer, director of public health, said the
county believes its plan is "the fastest path forward to actually
be able to start vaccinating both residents and staff in skilled
nursing facilities." She said the county would use strike teams to
help administer vaccines in facilities that need it.
CVS and Walgreens have been preparing for weeks for a broad
rollout under the federal program, which also involves some other
pharmacies. The companies have said they would generally come to
facilities three times to administer shots and follow-up doses to
staff and residents. CVS said it is working with more than 40,000
long-term care facilities nationwide. Walgreens said it is working
with around 30,000.
The county had heard from nursing homes that the federal program
didn't offer the "flexibility that they need to vaccinate their
residents and staff in the ways they would prefer," the letter
said. The county said its new setup will allow facilities to
vaccinate people without waiting to schedule a visit from a
pharmacy, and to stagger administration of the vaccine over time as
they choose, among other things. Some nursing-home officials want
to space out when shots are given, so potential side effects don't
affect too many staffers at the same time.
The change by Los Angeles County comes as the first vaccine is
on the cusp of emergency-use authorization, with shots expected to
roll out in the next few weeks. It creates a heavy lift for the
county and the nursing homes to get organized quickly and manage a
complicated logistical effort. The vaccines have sensitive
requirements for refrigeration and administration, including the
need for two doses.
The anticipated rollout of vaccines comes as the U.S. is
experiencing a massive surge of Covid-19 cases and deaths,
overwhelming some hospitals. The toll has also recently been rising
again in long-term care facilities, which have been tied to more
than 100,000 Covid-19 deaths since the start of the pandemic in the
U.S.
The L.A. County letter said the county was planning for its
nursing homes to use the Moderna Inc. vaccine, which has somewhat
less complex requirements than those for the shots from Pfizer Inc.
and partner BioNTech SE.
A spokeswoman for the California Association of Health
Facilities said the county's move was "a complete surprise to us."
She said the county's decision has "pros and cons." There are
significant operational issues, she said, including that facilities
will have to take over documentation and other requirements,
instead of outsourcing the process. But the approach "will allow
facilities to stagger the delivery of the vaccine, avoiding a
scenario where everyone is experiencing side effects at one time,"
the spokeswoman said.
Michael Wasserman, former president of the California
Association of Long Term Care Medicine, who was a member of a
National Academies of Sciences, Engineering, and Medicine panel on
vaccine prioritization, said he supports the county's move.
"The operational decision-making needs to be in the hands of the
individual facility," he said, to set their own timing and work
with staff and residents who may be reluctant to take the
vaccine.
A spokeswoman for the Centers for Disease Control and Prevention
didn't immediately respond to a request for comment.
A spokesman for CVS said it had seen the Los Angeles County
email but hadn't officially been informed the county was opting
out.
"As it currently stands, we're not aware of any jurisdiction
that has opted out of the federal program," he said. "It's also
unclear if a jurisdiction has the ability to carve-out a subset of
long-term care facilities." CVS said it was willing to accommodate
requests to stagger the shots, but the staggering would need to be
done over the three visits outlined in its federal agreement.
A spokeswoman for Walgreens said the company is "confident we
can support the rollout of these vaccines and are working with
states almost daily to support their specific needs as they
evolve." Walgreens is offering at least three visits to each
facility and "can also accommodate special needs if additional
clinics are needed," she said.
Write to Anna Wilde Mathews at anna.mathews@wsj.com
(END) Dow Jones Newswires
December 11, 2020 18:14 ET (23:14 GMT)
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