Army Gen. Gustave Perna

The first vaccinations against COVID-19 in the United States could begin today following Friday’s Food and Drug Administration emergency use authorization of the Pfizer-BioNTech’s vaccine for people aged 16 or more years, Saturday’s unanimous vote to recommend the vaccine by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, and then sign-off by CDC Director Robert Redfield.

It might be a week or more until many assisted living community and nursing home residents and staff members have the opportunity to be vaccinated, however. And even then, industry provider groups say, the vaccine is only the first step in beating COVID.

Shipments of the vaccine to distribution centers began over the weekend. “We expect 145 sites across all the states to receive the vaccine on Monday, another 425 sites on Tuesday and the final 66 sites on Wednesday, which will complete the initial delivery of the Pfizer orders for the vaccine,” Army Gen. Gustave Perna, chief operating officer of Operation Warp Speed, the federal vaccine development program, said Saturday at a press conference.

Redfield, the CDC director, said Sunday that vaccination could begin as early as Monday. “This is the next step in our efforts to protect Americans, reduce the impact of the COVID-19 pandemic, and help restore some normalcy to our lives and our country,” he said in a statement.

Earlier this month, the ACIP recommended that assisted living and nursing home residents and staff members be among the first to be vaccinated, and in a press conference last week, American Health Care Association / National Center for Assisted Living President and CEO Mark Parkinson said that most state and local officials making decisions about whom to prioritize for the limited amount of vaccine that will be available at first appeared to agree with the recommendation.

‘Thousands of facilities before the Christmas holiday

Walgreens, which with CVS Health is vaccinating long-term care residents and staff members for operators that signed up to participate in the federal Pharmacy Partnership for Long-Term Care program, said Friday that it expects to receive its first doses of the Pfizer-BioNTech vaccine on Dec. 21. CVS Health CEO Larry Merlo told CNBC last week that he expected the company to be in “thousands of facilities before the Christmas holiday.”

Almost 35,000 assisted living communities and skilled nursing facilities across the country have selected Walgreens as their vaccine provider, the company said Friday. More than 25,000 long-term care sites had selected CVS Health to provide the vaccinations as of Nov. 18, according to CVS. Participation in the Pharmacy Partnership for Long-Term Care program is voluntary.

“Right now, we’re really focused on vaccine administration where it’s immediately needed, and that’s long-term care facilities and healthcare workers, following all CDC, federal and state guidelines,” Walgreens Senior Vice President of Pharmacy Rick Gates said in a video. In 2021, Walgreens, CVS Health and numerous other pharmacies expect to begin working with states to help vaccinate the general population.

The FDA plans to review Moderna’s vaccine for emergency use authorization on Thursday, and ACIP has emergency meetings scheduled for Friday and Sunday.

‘Can’t come soon enough’

Long-term care trade associations on Friday cheered the FDA’s emergency use authorization of the Pfizer-BioNTech vaccine but said much additional work remains in the battle against COVID-19.

“The delivery of a safe and effective vaccine can’t come soon enough,” AHCA/NCAL’s Parkinson said. The organizations represent more than 14,000 assisted living communities and skilled nursing facilities.

“Given the asymptomatic and pre-symptomatic spread of this virus, combined with the significant increase of community spread across the U.S., time is of the essence, and these vaccines will literally be a lifesaver for thousands of residents and expedite the reopening of our facilities to family members and loved ones,” he said. 

Estimating that a one-month delay in distributing the vaccine to all long-term care residents and caregivers could result in more than 20,000 resident deaths, Parkinson said that it will be vital that governors and state health agencies are ready to distribute the vaccine as soon as possible upon receipt.

LeadingAge President and CEO Katie Smith Sloan also expressed a sense of urgency, saying that authorization of the Pfizer-BioNTech vaccine “brings our nation one step closer to ending a nine-months-long nightmare that has cost the lives of more than 200,000 people age 65 and older — over 80% of all COVID deaths.” She described the vaccine as “a ray of hope for many older adults who have been so cut off from their family and friends” during the coronavirus pandemic. LeadingAge represents more than 5,000 aging-focused organizations.

In the coming days, Sloan added, fast, efficient distribution of the vaccine to older adults is vital. Also, she said, states must ensure that older adults and staff members at long-term care facilities are first in line for the vaccine, and employees, residents and their families must be educated about the benefits of vaccination.

Skilled nursing not necessarily first

LeadingAge previously reported that some of the organization’s members said they were told by their COVID-19 pharmacy partners that “no matter what the state includes in its plan,” CVS Health and Walgreens had been directed by the CDC to “start with skilled nursing facilities first, then move to other long-term care residential providers” such as assisted living communities and continuing care retirement communities, also known as life plan communities.

But the CDC told LeadingAge that this information is inaccurate.

“The CDC and the federal government recognize that there is limited initial supply of vaccine, but have given states the flexibility to either start with SNFs only or start with a wider group of long-term care, including life plan communities and/or assisted living,” LeadingAge said.

Regardless, Sloan said, “A successful vaccination program is only the first step in beating COVID.”

“Congress needs to pass a real relief package now to provide aging services providers with the testing, PPE, and staffing support they need to protect older adults,” she said, also calling on the greater community to reduce the possibility of the virus’ spread by promoting common-sense social distancing, mask use and hand-washing practices. She also called on the incoming Biden administration to follow through quickly to help aging services providers keep older adults healthy and safe.

According to public health experts, herd immunity against COVID-19 can be reached once 70% of the population is vaccinated. Until then, everyone still should take precautions such as mask-wearing, physical distancing and hand-washing.