Nursing home organizations call for long-term care residents, staff to be first in line for COVID-19 vaccine

Residents of long-term care facilities—and the staff that care for them—should be at the very front of the line when COVID-19 vaccine distribution begins, an organization that represents those facilities said Monday.

That includes putting them ahead of others who've also been identified as a top priority for vaccinations by a Centers for Disease Control and Prevention panel, such as front-line healthcare workers in other healthcare settings, according to the American Health Care Association and National Center for Assisted Living (AHCA/NCAL).

"Here is just a grim reality: If you look at everybody that’s in that top tier, there will not be enough vaccine in their first go-around to vaccinate everyone in the top tier," said Mark Parkinson, president and CEO of AHCA/NCAL, on a call with reporters.

"Everyone in the top tier certainly needs to be vaccinated, and we’re not in any way suggesting that there are healthcare workers in that top tier that shouldn’t be vaccinated. We totally get that," Parkinson said. "What we are saying is: With the limited supply that is going to be available over the next few weeks, the absolute top of that top tier should be long-term care facility residents and the folks that take care of them."

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Of course, it's ultimately up to the states to determine how they plan to distribute the first vaccines, expected to become available this month.

Last week, AHCA/NCAL, which represents more than 14,000 nursing homes and assisted living communities across the U.S. that provide care to approximately 5 million people, sent a letter to the National Governors Association with a similar message (PDF). A one-month delay in administering the vaccine at long-term care facilities, they said, could cost the lives of more than 10,000 long-term care residents, they said in the letter.

AHCA/NCAL said it has not heard from any states that do not plan to include long-term care residents among the first to receive access to the vaccine, but lauded New York as a state that has clearly stated long-term care facilities will be first.

"The reason is the realities of the data that just clearly demonstrate if we can do this, if we can get this done in the next 60 days, we can cut the overall COVID death rate by 40% just by getting those initial 4 or 5 million doses out to that very important population," Parkinson said.

Employees at long-term care facilities have been "to hell and back" over the last eight months as they've seen the number of residents dying skyrocket, he said. More than 1,000 long-term care facility employees have died from COVID-19. He expects the early adoption rate of vaccines among employees to be high due to what they've witnessed.

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"With COVID, we’ve had 100,000—probably more than that—people die unexpectedly, oftentimes alone, oftentimes without family or the kind of setting we normally create. It has been traumatic for our residents and it's been traumatic for our staff," Parkinson said. "They have all seen this, and there is real fear in these buildings among residents that they’re going to get COVID, among workers that they could get COVID and spread it to their families and they’ve seen the deaths in these buildings."

When asked whether long-term care facilities and nursing homes would require employees to receive the vaccination, he said it was not yet clear.

"We don’t right now because we are waiting to see what kind of acceptance rate will be among employees. There are some legal questions about whether there can be a mandated use of a vaccine that’s under emergency use authorization as opposed to under normal authorization," Parkinson said. "Our hope is that we get widespread acceptance of the vaccine, but if we don’t, I assure you, our organization as well as individual operators, will be analyzing whether or not they can mandate the vaccine. We’re just hoping we don’t have to go there."