Vaccination Slow in Some Nursing Homes While Awaiting US Authorization

When Jim Lewis was told earlier this month that his 90-year-old mother, who lives in a nursing home outside of Boise, Idaho, had tested positive for Covid-19, he wondered if he had contracted the virus from an unvaccinated employee.

And he had reason to worry. Just over half of the Creekside Transitional Care and Rehabilitation home workers were not vaccinated at the time, federal data show.

“It was clear that the facility had staff who were hesitant about vaccination,” said Mr Lewis, whose mother and all of his immediate family have been vaccinated.

Idaho was hit hard by the Delta surge this summer and early fall, and nursing homes were unaffected by the highly contagious variant swept through with lower vaccination rates in many states. Ten states, including Florida, Michigan, and Ohio, still report vaccination rates below 60 percent for nursing home staff.

Like the others new York and California, and some large nursing home chains imposed their own authority. But many nursing home administrators expect the federal government to issue new rules that would govern a mandatory vaccination program for all of President Biden’s staff. first announced two months ago. And some facilities and workgroups are still pushing for a test option rather than a shot.

But months of delays and vaccine resistance have had heartbreaking consequences for families like Mr. Lewis, who was once again banned from visits due to epidemics. Creekside did not respond to repeated calls and emails asking for comment.

After the sharp declines earlier this year, Covid cases and Deaths in nursing homes increased in August and Septemberresulted in nearly 4,000 deaths – though nearly 90 percent of nursing home residents in the country are fully vaccinated. Residents are particularly vulnerable breakthrough infections because many of them are older and former foreign minister suffer from serious medical conditions like multiple myeloma Colin Powell He was in treatment when he died of Covid complications on Monday.

The industry critic, geriatrician and former nursing home administrator Dr. “It is medically wrong and unethical for unvaccinated nursing home staff to care for residents,” said Michael Wasserman. “The vaccine works. It has made a profound difference.”

The Biden administration said nursing homes could face a loss of government funding—the industry relies heavily on Medicaid and Medicare funds—if they don’t comply, but regulations for enforcing a mandate have yet to be announced.

Federal officials say they expect to publish the regulations later this month. The rules were delayed from last month after the mandate was expanded. all healthcare workers.

Officials from the Centers for Medicare and Medicaid Services, which will issue the rules, did not comment on future regulations and did not keep anyone available for discussion. It’s unclear whether they’re considering a testing option for nursing homes, according to people working closely with the administration.

Residents and their families say they are frustrated by the months-long delays in providing this extra layer of protection, given that many unvaccinated people are the most direct, day-to-day caregivers and nurses.

Elizabeth, a nursing home resident in Minnesota, said she contracted Covid from an unvaccinated worker earlier this year before she received the second dose of the Moderna vaccine. When asked when staff could be vaccinated at the direction of the president, he was told that the nursing home could focus on testing workers rather than asking them to be vaccinated.

“Nothing happened,” said the resident, who wanted only his middle name to be used for fear of retaliation and not to reveal the identity of the nursing home.

Covid surge in his state prompted governor to act Call to the National Guard last week, to help alleviate the severe health worker shortage.

“I feel like a sitting duck,” he said. While continuing to wear masks, some of the staff are no longer taking the same measures to control the spread of the virus. “It feels terribly insecure,” he said.

Decreased effectiveness of vaccines given to many nursing home residents for the first time has also raised concerns over the past few months.

“People are dying, residents are dying,” said Susan Reinhard, director of the AARP Institute for Public Policy, which has pushed for more transparency about vaccination rates in nursing homes. “They should be afraid.”

A bioethicist at the University of Pennsylvania who mentored Biden during his transition. Ezekiel J. Emanuel said that lower vaccination rates translates to more infections, and mandates are one way to increase those rates. “We have to be clear that authorizations work and they work in every industry that tries them,” he said.

Vaccination rates among hospice staff have increased from 62 percent in early August when Mr Biden announced the assignment to 69 percent in early October, but some facilities are still reporting a staffing rate of half or less, according to the latest information. federal data.

While there are some nursing homes took the lead Mark Neuberger, attorney for Foley & Lardner, who advises healthcare organizations on employment issues, said, on his own terms, that many take a wait-and-see approach.

“Will there be an alternative?” Asked Zach Shamberg, CEO of the Pennsylvania Health Care Association, a state trade group that represents nursing homes and pushes workers to be able to test vaccines instead. “Especially when providers are tackling labor shortages, it is preferable to simply lose those workers.”

Many nursing homes are “very concerned that we won’t see vaccine acceptance rates increase,” he said.

“Our hope is that the small print will allow us to make a test option,” said Mary Susan Tack-Yurek, head of quality and partner at Quality Life Services. The family-owned nursing home chain in western Pennsylvania reports that just over half of the staff have been vaccinated. “Are we satisfied with our staff vaccination rate? No, we are not satisfied with that,” he said.

What You Need to Know About Covid-19 Booster Shots

The FDA has allowed booster shots for a select group of people who are taking their second dose. Pfizer-BioNTech Get the vaccine at least six months in advance. This group includes: vaccine recipients aged 65 and over or living in long-term care facilities; adults at high risk of serious Covid-19 due to an underlying medical condition; healthcare workers and others whose jobs put them at risk. with people weakened immune systems they are eligible to receive a third dose of Pfizer or Moderna four weeks after the second shot.

The CDC said conditions that qualify a person for a booster shot include: hypertension and heart disease; diabetes or obesity; cancer or blood diseases; weakened immune system; chronic lung, kidney, or liver disease; dementia and some disabilities. Pregnant women and current and former smokers are also eligible.

The FDA has allowed boosters for workers whose jobs put them at risk of exposure to potentially infectious humans. The CDC says the group includes: emergency health workers; education workers; food and agricultural workers; manufacturing workers; correction workers; US Postal Service employees; public transport workers; grocery workers.

Currently not recommended. Those receiving the Pfizer vaccine are advised to get the Pfizer vaccine, and those receiving the Moderna and Johnson & Johnson vaccine are advised to wait until these manufacturers’ vaccine doses are approved. FDA, Americans receiving a different vaccine as a booster from the person they originally received. NS “mix and match” approach Boosters for Moderna and Johnson & Johnson buyers can be approved once authorized.

Yeah. The CDC says the Covid vaccine can be administered regardless of the timing of other vaccines, and many pharmacy sites allow people to schedule a flu shot at the same time as a booster dose.

But if these workers left instead of being forced to get the injection, “we wouldn’t be able to work,” said Ms. Tack-Yurek. “There are not enough resources in the National Guard staff to take from other states and make up for it.”

The nursing home chain, which employs about 1,100 people, has been unable to persuade workers to vaccinate, despite holding sweepstakes offering prizes such as the chance to go to Disneyworld or $5,000 in cash. “The answer was very little,” said Ms. Tack-Yurek.

Other nursing home officials reject the option of testing as an alternative. “We already have tests,” said Brendan Williams, CEO of the New Hampshire Health Care Association, whose members are more successful in vaccinating their employees. “It’s just to maintain the status quo.”

Much depends on the communities in which nursing homes attract their workers. If a region has strong opposition to vaccination, it becomes more difficult to direct recruits to get vaccinated and vice versa.

Chuck Cole, chief financial officer of the hospice, said the vast majority of employees who were given paperwork to be vaccinated were willing, with high vaccination rates at Chaparral House in Berkeley, California. “Most people didn’t read beyond the first paragraph,” he said, because they were already convinced they needed to get the shots. “This was very important.”

The nursing director and manager said he was able to persuade those who were waiting by speaking one-on-one with the few workers who were concerned about the vaccine. Only one employee out of about 150 still refuses to be vaccinated.

Covid cases in the United States have dropped significantly over the past month as more people are vaccinated and the Delta surge has decreased in most parts of the country.

State powers are helping to increase protection levels for all age groups and 14 percent Most nursing home residents in the country have already received a booster dose.

And some nursing homes successfully self-imposed The requirements contributed to a higher success rate, said Brian McGarry, a health researcher who studied in nursing homes at the University of Rochester. Genesis HealthCare, a large Pennsylvania chain, said all of its staff were vaccinated, although there were some downturns.

“Although general community infection rates remain very high, we are seeing the benefits of our policy in established security as our Covid rates (and the severity of any infection in particular) have dropped significantly since we created our policy,” Lori Mayer said. A company spokesperson said in a statement.

“Tasks are starting to help,” said Dr. McGarry. The actual enactment of a requirement by a government or facility “is a heavy lever and signals to this group that it is no longer optional.”

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