closeup of booster shot bottle

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As COVID-19 vaccination booster shots open up to all U.S. adults, senior living industry leaders tell McKnight’s Senior Living that they continue to encourage their employees to get the shots and will keep monitoring recommendations from federal agencies and others to decide whether to take further action. The comments come as the holidays approach and the federal government seeks to increase the number of people who are vaccinated against the coronavirus and getting the booster shot.

Late Friday, Centers for Disease Control and Prevention Director Rochelle P. Walensky, M.D., M.P.H., endorsed expanded recommendations for booster shots made unanimously earlier in the day by the agency’s Advisory Committee on Immunization Practices. The committee — meeting after the Food and Drug Administration authorized the use of a booster dose of the Pfizer–BioNTech or Moderna vaccine for all fully vaccinated adults — recommended that all adults aged 50 or more years who received a Pfizer or Moderna vaccine take the booster shot at least six months after they had completed their initial vaccination series (second dose). The committee also said COVID vaccination boosters should be available to all adults aged 18 or more years.

“Booster shots have demonstrated the ability to safely increase people’s protection against infection and severe outcomes and are an important public health tool to strengthen our defenses against the virus as we enter the winter holidays,” Walensky said in a statement. “Based on the compelling evidence, all adults over 18 should now have equitable access to a COVID-19 booster dose.”

Health officials said they hoped that opening up boosters to all adults will increase uptake of the booster, because it will be easier for the public to understand who is eligible.

Previously, a single booster dose of the Pfizer-BioNTech or Moderna COVID-19 vaccines was recommended only for adults aged 65 or more years, those aged 18 to 64 at high risk of severe COVID-19, and those aged 18 to 64 years of age with frequent institutional or occupational exposure to SARS-CoV-2, such as workers in senior living communities. Many eligible individuals remained confused about whether they should get the booster, however, health officials said.

ACIP members noted that 75% of adults aged 50 to 64 already were eligible under previous criteria that authorized vaccination for anyone with an underlying medical condition that put them at greater risk of a severe case of COVID-19. Even those 50 to 64 without underlying medical conditions may be at increased risk of severe COVID, members noted.

“Vaccines and boosters are critical tools for battling the virus and ensuring that everyone — particularly those who are most vulnerable, such as older adults and the people who care for them — is safe,” LeadingAge told McKnight’s Senior Living. “Increased eligibility for boosters is a positive development for all of us.”

The American Health Care Association / National Center for Assisted Living previously had celebrated the CDC and FDA approving the Pfizer and Moderna and Johnson & Johnson boosters for long-term care residents and workers in September and October, respectively.

Now, the CDC “strongly encourage[s]” those who already were eligible ­— adults aged 65 or more years, those aged 18 to 64 at high risk of severe COVID-19, and those aged 18 to 64 years of age with frequent institutional or occupational exposure to SARS-CoV-2, such as workers in senior living communities ­— to get boosted before the holidays “to protect themselves, their families, loved ones and communities.”

As of 6 a.m. ET Sunday, according to CDC data:

  • Of U.S. adults 18 or older, 82.1% had received at least one dose of a COVID-19 vaccine, 70.9% were fully vaccinated, and 19.3% had gotten a booster dose.
  • Of U.S. adults aged 65 or older, 99.9% had received at least one dose of a COVID-19 vaccine, 70.9% were fully vaccinated and 40.6% had received a booster dose.
  • Of the U.S. population aged 50 or more years, 28.9% have received a booster dose.

Although many senior living operators have mandated COVID-19 vaccination for employees, not many are requiring employees to get the booster — yet. With an early September announcement of a booster mandate for employees who had received the Pfizer or Moderna vaccine, Integral Senior Living/Solstice Senior Living is rare among peer organizations. But many providers are trying to increase the vaccination and booster rate among employees by offering onsite clinics and taking other actions.

“We have highly encouraged all to take advantage of the booster dose, and while we have not made it mandatory for our employees yet, we expect the booster will be a requirement at some point in the future,” Jeremy Ross, director of communications at Chicago-based Enlivant, told McKnight’s Senior Living. Enlivant’s new call to action is “Get Your Booster, Get Peace of Mind,” he noted.

The company, which mandated vaccination earlier this year, already has a 95% total vaccination rate among residents and employees across 215 communities, Ross noted.

“We have engaged with employees, residents and families to educate about the booster and scheduled onsite booster clinics for residents and employees,” he said Friday. “The FDA’s latest authorization reaffirms our efforts.” Those efforts, Ross added, will help the company meet its goal of “becoming the most trusted name in senior living.”

Brentwood, TN-based Brookdale Senior Living has a COVID vaccination mandate for employees, and 99.8% of employees who have not received a medical or religious exemption have received at least one dose of the vaccine, according to the company. Brookdale has hosted COVID-19 booster shot clinics in conjunction with its annual flu shot clinics in the majority of its 682 communities across 41 states. 

“As the largest provider of senior living, we were able to get booster clinics ready in days, not months,” President and CEO Cindy Baier told McKnight’s Senior Living. “We strive to remove obstacles that stand between us and our ability to help protect our residents and associates.”

Brookdale Chief Nursing Officer Kim Elliott, RN, added that “as soon as we received the green light for booster shots, we began putting our plans into action and getting booster shots where they needed to go.”

Gregory Johnson, M.D., chief medical officer for the Sioux Falls, SD-based Evangelical Lutheran Good Samaritan Society, said that the organization boasts a 100% employee compliance rate with its COVID vaccination mandate, which has led to a decline in COVID-19 infections and serious illness. 

“We know the vaccine works. We’ve seen it firsthand and support anything that will make our residents, staff and communities safer,” he said. “We know boosters are an important next step to end the pandemic.”

The Good Samaritan Society, Johnson said, is working closely with its pharmacy partners to offer boosters to residents and staff members. “Nearly 60% of eligible residents across our 300 locations in 22 states have already received a booster,” he said. “We continue to educate our people on the benefits, and more are choosing to get a booster every day.”

John Moore, chairman and CEO of Louisville, KY-based Atria Senior Living, touted the company’s vaccine mandate and “virtually complete staff vaccination” at Atria and Holiday Retirement, which was acquired by Atria earlier this year.

“Although we are not currently requiring boosters, we continue to provide them in all of our regular CVS Health flu shot clinics in each community,” he said. “We recommend that our staff and residents take advantage of the booster’s availability, and we will continue to monitor developments as we have all along.”

Leigh Ann Barney, president and CEO of Louisville, KY-based Trilogy Health Services, told McKnight’s Senior Living that as of Friday the organization was in the sixth week of offering boosters at its ongoing vaccine clinics company-wide, working with pharmacy partner Synchrony Pharmacy.

“We continue to see the level of participation from residents and employees increase each week,” she said. “Currently, the booster is not mandated; however, we are monitoring CDC guidelines and recommendations. Trilogy remains committed to doing all we can to keep everyone safe as the COVID-19 pandemic continues.”

The organization does mandate COVID vaccination.

Baltimore-based Erickson Senior Living is not requiring the booster for residents and employees at this time, but “We continue to take a very proactive role in educating residents and staff about the vaccines and boosters and providing convenient access for vaccinations,” a spokesperson said. “This includes conducting over 50 clinics for all of those who live and work at our communities across the country.” 

The booster clinics, which have been taking place since October, have seen participation from more than 23,000 residents and employees, according to the organization.

Vicki Doyle, APR, public relations manager at Watermark Retirement Communities, said the company requires all employees to be fully vaccinated against COVID-19, with limited exceptions.

“Booster shot clinics are taking place at all Watermark communities for easy access for our residents and associates,” she added. “The booster is not yet mandated, but we are reviewing the recent FDA approval of boosters for all adults and will continue evaluating CDC recommendations.”

Traci McBee, a spokesperson for Des Moines, IA-based LCS, told McKnight’s Senior Living that, “From the onset of the pandemic, our priority has been focused on protecting the health and safety of our residents and employees. We firmly believe being fully vaccinated for COVID-19 is one of the most important ways we can keep our residents and employees protected.

“We will use that same lens to evaluate the evolving recommendations on the COVID-19 booster,” she continued.

Randy Eilts, director of public relations and communications for Skokie, IL-based Covenant Living Communities & Services, said that the organization is adhering to vaccine mandates in the states where it operates.

“While we are not making the booster vaccination mandatory, we have embarked on an in-house vaccination education initiative, he said. “It provides employees with more information about the vaccinations so they can make a decision that is right for them.”

Regarding the FDA decision Friday, Eilts said, “It’s good to see that more adults will have the option to receive a booster. Our communities have visitors of all ages, and making the booster available to more adults is a good thing in the long run.”

Heidi Miller LaVanway, vice president of marketing at Discovery Senior Living, said that COVID-19 vaccination is not mandatory there. “We respect the individual choice everyone has regarding their personal healthcare,” she said.

The company, however, “follows CDC recommendations as it relates to COVID-19 safety protocols and encourages everyone to receive a COVID-19 vaccine and the booster shot as approved for various groups of people,” LaVanway said.

“Discovery’s teams help with education, resource identification, and work with third-party vendors to provide vaccination clinics at each Discovery community. Our skilled nursing units are complying with the Centers for Medicare & Medicaid Services mandate for healthcare workers to be vaccinated and have taken all appropriate steps to comply with this mandate,” she added.

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