needle in vaccine vial

Shipments of the first COVID-19 vaccine fanned out across the country, and some long-term care communities will begin vaccinating residents as early as Friday.

Operation Warp Speed Chief Operating Officer Gen. Gustave Perna said during a call with reporters Wednesday that Ohio and Connecticut are working under the Centers for Disease Control and Prevention’s Pharmacy Partnership for Long-Term Care Program to begin vaccinations in long-term care facilities this weekend. He added Florida and West Virginia also are beginning vaccination in long term care facilities, contracting with emergency medical technicians and others for assistance.

By next Monday, the federal program is expected to reach more than 1,100 long-term care facilities. Perna said that effort will “rapidly expand by thousands a day” as Walgreens and Omnicare, the long-term care pharmacy segment of CVS Health, lead the effort to go into more than 70,000 long-term care facilities.

“We are aggressively working on the offense to take care of these great Americans in these facilities,” Perna said.

The American Health Care Association / National Center for Assisted Living said several governors have indicated their state’s long-term care residents and staff will be first in line for vaccines. These include New York, Florida, Iowa, Kentucky and Georgia. AHCA / NCAL President and CEO Mark Parkinson said it’s critical that all governors and state health agencies follow suit.

“A one-month delay in distributing the vaccine to all long-term care residents and caregivers could result in more than 20,000 of our residents losing their lives when a vaccine could protect them,” Parkinson said. “We’re in a life or death race against the clock.”

AHCA / NCAL urged state governors to allocate the vaccine to all long-term care residents and staff by March 1.

The National Community Pharmacists Association, however, expressed concerns about how quickly retail giants will deliver COVID-19 vaccine to long-term care facility residents. 

In a survey conducted by the association and the American Society of Consultant Pharmacists, 82.5% of long-term care pharmacists said they believe that CVS and Walgreens personnel don’t have enough experience with these residents and patients to safely and effectively administer vaccines, and 87.3% say the big chains don’t have the necessary staffing. 

“Patient needs in the long-term care environment can be much more nuanced than the general retail environment, and the survey showed concerns about the potential unintended consequences of allowing the big chains to have exclusive responsibility to immunize those patients,” NCPA CEO B. Douglas Hoey said. 

Next steps

Wednesday, Perna said the next step is expanding vaccine availability. He noted that the CDC and 19 pharmacy chains are collaborating and working through the final details to make vaccines available more widely in mid-January. Perna said it will be driven by state decisions and vaccine availability. 

“This is a powerful collaboration with the pharmacies and the CDC, enabling the governors’ plans to expand vaccination throughout their states as we transition to other critical groups,” Perna aid. 

With the announcement Tuesday from the Food and Drug Administration that Moderna’s COVID-19 vaccine is 94% effective against the virus, and the expected emergency use authorization coming this week, Perna said that additional allocations of vaccine will continue going out to rural areas and long-term care facilities.

The federal government has allocated another 2 million doses of Pfizer’s vaccine to go out next week, with 5.9 million Moderna doses expected to follow. 

Health and Human Services Secretary Alex Azar said the federal government has 900 million vaccine doses under contract for delivery, with an option to increase that amount to 3 billion doses. That total includes 100 million doses of the Moderna vaccine between now and March 31, with an additional 100 million doses in the second quarter; 10 million doses of the Pfizer-BioNTech vaccine; 100 million doses of the Johnson & Johnson single-dose vaccine in active production; and 300 million of the AstraZeneca vaccine.

Azar said he believes that the country will have surplus supplies of vaccines to cover the 260 million Americans over age 16. 

“This is a momentous week in the history of public health,” Azar said. We are not at the end, but at the beginning of the end of this terrible pandemic.”

Bridge to vaccine

Azar and Moncef Slaoui, Ph.D., chief scientific officer for Operation Warp Speed, said that two authorized antibody treatments are available but remain underutilized. Regeneron and Eli Lilly’s antibody drugs are targeted at preventing hospitalization in patients with the highest risk for severe disease, including adults aged 65 and older and those with comorbid conditions. HHS has allocated more than 330,000 antibody doses to states but said that only 5% to 20% of the drugs are being used. 

“We have the tools in our hands right now to bridge to the days upon us,” Azar said.