With the federal Pharmacy Partnership for Long-Term Care on-site vaccination program for assisted living communities and nursing homes ending in the coming weeks, the focus is moving to ensuring that those places can continue to have access to vaccines for residents and staff members.

In a LeadingAge membership call on Monday, the association laid out answers to some frequently asked questions on the topic that soon will be posted on the Centers for Disease Control and Prevention website.

Operators can continue receiving COVID-19 vaccines in three ways:

  • Work with a participating long-term care pharmacy enrolled as a vaccine provider through the recently launched Federal Retail Pharmacy Program
  • Check with the state where the facility is located to determine whether a long-term care pharmacy is enrolled as a COVID-19 vaccine provider.
  • Enroll with the state as a COVID-19 vaccine provider.

The first call providers can make is to a long-term care pharmacy to determine whether they are set up to receive COVID-19 vaccines through the federal government or through the state. If a long-term care pharmacy with which a facility has an existing relationship is not a vaccine provider, then check the Federal Retail Pharmacy Program website to find a participating pharmacy, or contact the state health department to find additional providers in the area.

LeadingAge pointed out that some states are enrolling long-term care providers as vaccine providers, allowing communities to directly vaccinate their residents and staff members on an ongoing basis. Fort Worth, TX-based Civitas Senior Living recently was certified as a COVID-19 vaccine provider by the Texas Department of State Health Services.

In regard to residents and staff members who have not received their first vaccine doses by the third and final on-site federal vaccination clinic at a community, the CDC said that states are providing guidance. Some states have asked pharmacy partners not to initiate first-dose vaccinations at those final clinics due to vaccine availability concerns. In such cases, the CDC suggests referring to the aforementioned options.

For those residents and staff members who are able to receive a first dose of the Moderna or Pfizer-BioNTech vaccine at those third clinics, finding a second dose will depend on the vaccine itself. The recommendations are for facility executive directors and administrators and clinical leadership to determine ahead of time whether a local provider will be available to provide the second dose.

Some long-term care pharmacies will be providing Moderna vaccines through the Federal Retail Pharmacy Program or through state immunization enrollment programs. Staff members or discharged residents will need to seek their second doses in the greater community at a retail pharmacy location or through their local health departments.

Many long-term care pharmacies, however, will not be stocking the Pfizer vaccine due to the cold chain requirements. Staff members and discharged residents who receive a first dose at a third clinic can contact CVS Health, Walgreens or another pharmacy location providing the Pfizer vaccine in their community to schedule an appointment for a second dose. They also can contact the local health department for this information.

“Long-term care facility administrators and clinical leadership should determine if there is a local provider available to administer the second dose of Pfizer-BioNTech vaccine to residents on site at the time it is needed, either by checking with another local pharmacy or by contacting their local health department,” the guidance reads. “If all potential options for administering a second dose of Pfizer-BioNTech vaccine have been exhausted, LTCF clinical leadership may consider counseling residents to finish the vaccine series using the Moderna vaccine.”

The guidance points out that the CDC Advisory Committee on Immunization Practices recommended “in exceptional situations in which the first-dose vaccine product cannot be determined or is no longer available, any available mRNA COVID-19 vaccine may be administered at a minimum interval of 28 days between doses to complete the mRNA COVID-19 vaccination series.”

In the coming weeks on its website, the CDC will provide more detailed guidance for next steps for COVID-19 vaccination in assisted living communities and nursing homes once the on-site federal pharmacy program ends.

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