male patient about to get COVID vaccine from healthcare worker

Communication concerns surrounding long-term care COVID-19 vaccination clinics are causing “anguish” at facilities, according to one provider sharing her experience in a large multi-service organization.

Allison Salopeck, president and CEO of the Cleveland-area Jennings Center for Older Adults, a Catholic, not-for-profit organization for older adults, discussed the rollout of the organization’s initial vaccine clinics on Wednesday during a LeadingAge member call.

The Jennings Center experienced problems with notifications, the need for medical and pharmacy benefit card copies ahead of clinics, the inability to include independent living vaccination at a continuing care retirement community, and other requirements prior to clinics.

“It caused us a lot of anguish,” Salopeck said.

The Jennings Center rolled out its first vaccine clinic at its nursing home on Dec. 22 and its second and third clinics, at assisted living communities, on Monday and Wednesday. A third clinic is scheduled for an assisted living community on Saturday.

Salopeck said that in conversations with other senior living CEOs around Ohio, “there are so many stories about how these things have happened between both CVS and Walgreens.” But she said success comes down to how information is being interpreted and handled at the local pharmacy level rather than at the corporate level.

Separately, American Health Care Association / National Center for Assisted Living President and CEO Mark Parkinson said that although there have been bumps in the process, the Pharmacy Partnership Program for Long-Term Care is “running smoothly.”

“As with any effort of this scale, there will be issues, and vaccine hesitancy is our primary focus at this moment,” he said. “Update among residents and staff is varying widely, but in general, staff seem to be mirroring the general public’s reaction: excitement mixed with hesitation about the vaccines’ development and safety.”

Although staff participation at the first clinic was “disappointing,” at about 35%, Salopeck said on the LeadingAge call, that percentage moved closer to 60% in the later clinics.

“To be fair, we didn’t have a whole lot of time to educate and get out there and talk to people,” she said. The Jennings Center used text messages, robocalls, website FAQs, posters and individual conversations to combat myths about the vaccines and provide factual information to its employees, she said. The organization’s medical director also held a webinar for families, residents and staff before the first clinic to answer questions and provide information on the vaccines. 

Salopeck said it has to be acceptable for people to have questions and “not just say, ‘Do it; it’s going to be fine.’ ”

In a poll, 48% of LeadingAge members on the call indicated that 25% to 50% of their staff members have agreed to receive a COVID-19 vaccine, whereas 36% indicated that 50% to 75% of staff will be vaccinated, 12% said that 0% to 25% of staff will be vaccinated, and 3% said that 75% to 100% of staff have said they will get vaccinated.

In stating reasons for staff reluctance to vaccination, 45% said staff members indicated that they are taking a “wait and see approach,” 27% said there is a mistrust of vaccines or drug development, and 18% cited concern about side effects.

Robin Jump, M.D., Ph.D., an infectious disease specialist with the Louis Stokes Cleveland Veterans Affairs Medical Center, also was on the call and said about half of the VA’s 5,000 employees have been vaccinated. She said the only limitation the large hospital and long-term care facility has experienced is that there haven’t been enough slots for individuals to sign up.

Jump, too, said she has heard about staff member hesitancy to take the vaccine. Some of the reasons for that hesitancy, she added, include concerns about infertility, since pregnant women were excluded from vaccine trials; concerns about side effects; worries about the little known mRNA technology; and concerns that safety steps were skipped during the vaccine approval process.

Jump said there are a lot of unknowns but that it’s important for providers to “model the behavior.”

“When you get your vaccine, get a picture of yourself, and share that,” she said. “Show that you’re doing this and you’re doing OK with it. Describe your experience.”