The federal government plans to begin offering COVID-19 booster shots to long-term care residents and healthcare workers as early as next month, the Biden administration announced Wednesday.
“We are prepared to offer booster shots for all Americans beginning the week of September 20 and starting 8 months after an individual’s second dose,” Health and Human Services public health and medical experts said in a statement. “At that time, the individuals who were fully vaccinated earliest in the vaccination rollout, including many healthcare providers, nursing home residents, and other seniors, will likely be eligible for a booster. We would also begin efforts to deliver booster shots directly to residents of long-term care facilities at that time, given the distribution of vaccines to this population early in the vaccine rollout and the continued increased risk that COVID-19 poses to them.”
The decision to offer the third doses is the result of declining vaccine protection over time, as well as the vaccines being less effective against the delta variant.
Details of the rollout were not available Wednesday, although the administration indicated that the booster shots will be available in largely the same way shots were for the first dose; 80,000 locations across the country will offer them, including more than 40,000 local pharmacies.
Chad Worz, PharmD, executive director and CEO of the American Society of Consultant Pharmacists, told McKnight’s that long-term care facilities would continue to receive their doses form their contracted pharmacy or the same pharmacy from which they have been receiving COVID-19 doses.
“I think more importantly, if the data supports these doses, there is the potential they could be coordinated with the influenza vaccinations, which also occur in the late September, October timeframe,” he said. “These vaccinations would be available to administer concurrently, so this may help with the logistical challenge of administering doses to all residents and staff.”
The opportunity, Worz added, also could result in improved flu vaccination rates.
A spokesman from CVS Health told McKnight’s Senior Living that the company had no details on its potential involvement in administering COVID booster shots to long-term care residents. CVS and Walgreens were part of the Pharmacy Partnership for Long-Term Care program through which many assisted living and nursing home residents and staff members were vaccinated in late 2020 and early 2021.
The CVS spokesman said the company remains “fully prepared” to provide the shots, however. The pharmacy chain has administered more than 30 million COVID-19 vaccines across the country and immediately began offering third doses to immunocompromised individuals when authorized, he added.
A spokeswoman from Walgreens said that the pharmacy chain will continue to follow guidance from the Food and Drug Administration and the Centers for Disease Control and Prevention to administer vaccines to eligible populations.
Associations call for prioritization
American Seniors Housing President David Schless said Wednesday it isn’t likely that the federal long-term care pharmacy partnership will be revived to carry out the boosters this fall.
“It will be necessary for a federal or state program to be organized for assisted living and independent living communities, which would generally not have the capacity and means to run these vaccination booster clinics without assistance on a prioritized basis,” Schless told McKnight’s Senior Living. He added that he anticipates operators remaining highly focused on their “multifaceted efforts to vaccinate all who work in these settings.”
American Health Care Association / National Center for Assisted Living President and CEO Mark Parkinson called for assisted living communities and nursing homes to be prioritized and have efficient access to the vaccines.
“We will continue to engage with public health officials to help advise and hopefully streamline the process for administering booster shots considering the diversity of the long-term care profession,” Parkinson said in a statement. “In the meantime, we must remain vigilant, especially in the face of delta, and continue to promote uptake among currently unvaccinated staff and residents.”
Argentum President and CEO James Balda said that he appreciated the CDC’s recognition that older adults are among the most at risk and for considering requests that seniors and long-term care employees be considered first for booster shots.
“We continue to urge the administration to ensure our communities, including independent living communities, which were previously excluded from priority vaccine programs, to have access, support and resources for administering COVID-19 booster shots in the coming weeks and months,” Balda told McKnight’s Senior Living. “We’ve seen that putting seniors in the front of the line saves lives, so we support boosters — but senior living communities need support to carry this out.”
In a Wednesday letter to HHS Secretary Xavier Becerra, the AARP called on the federal government to work with states to prioritize booster rollouts to at-risk populations.
“AARP believes that states should prioritize any future booster rollout to the general public based on the order of delivery of the initial vaccinations,” wrote AARP Executive Vice President and Chief Advocacy and Engagement Officer Nancy A. LeaMond. “For those individuals most at risk, such as people living in nursing homes or other congregate facilities, homebound individuals and other hard-to-reach populations, we urge HHS to develop specific plans with states to ensure boosters are delivered quickly and effectively.”
Vaccine effectiveness wanes
Federal officials said that the COVID-19 vaccines continue to be “remarkably effective” in reducing the risk of severe disease, hospitalization and death. The decision to offer booster shots was based on an analysis of scientific data from around the world on how long protection lasts.
“The available data make very clear that protection against SARS-CoV-2 infection begins to decrease over time following the initial doses of vaccination, and in association with the dominance of the delta variant, we are starting to see evidence of reduced protection against mild and moderate disease,” Wednesday’s HHS statement said. “Based on our latest assessment, the current protection against severe disease, hospitalization and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout.”
A CDC Morbidity and Mortality Weekly Report article about nursing homes in the CDC’s National Healthcare Safety Network reported that the effectiveness of the mRNA vaccines against the delta variant declined from 74.7% early in the vaccination program (March through May 2021) to 53.1% during June and July 2021.
The guidance on booster shots applies only to those who received the Pfizer or Moderna vaccines. More data on the Johnson & Johnson vaccine, which wasn’t administered until March, is expected in the coming weeks. But federal officials said they anticipate that booster shots likely will be needed for those individuals.
