Nursing homes charging ahead to administer COVID-19 vaccine booster shots

Infectious disease specialist on COVID-19, CDC decision on Pfizer booster shots

Nursing home and assisted living facilities are preparing to roll out COVID-19 vaccine booster shots for their residents and staff, while grappling with an acute labor shortage that's likely to get worse as a federal vaccine mandate takes effect.

Expressing "how grateful we are that the Biden administration prioritized nursing homes," Janet Snipes, executive director at Holly Heights Nursing Center in Denver, Colorado, told CBS MoneyWatch that the facility is now working to get individuals' consent for the boosters. "We're not completely finished, but we haven't had anyone decline." 

Holly Heights began reaching out to residents and their families several weeks ago in anticipation the Centers for Disease Control and Prevention approving Pfizer-BioNTech boosters for millions of older or vulnerable Americans, including nursing home residents and those who work at the facilities. Boosters for those who received the Moderna or Johnson & Johnson vaccines are expected to be approved in coming weeks.

Almost all of Holly Heights' 94 residents are fully vaccinated against the coronavirus, and one is partially vaccinated, Snipes said. "The residents were very quick to sign on — all the data showed how vulnerable they are," said Snipes. Among employees, 87% of 140 staff members are fully vaccinated and 6% are partially inoculated. 

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The center shut down one wing and consolidated operations after about 30 employees stopped working early on in the pandemic. "In the very beginning there was a lot of negative news stories about nursing homes and COVID and we lost staff at that time. They were just afraid to work," Snipes said. "Workers everywhere — and health care workers in particular — have COVID fatigue and are retiring at a greater pace." 

"A lot of misinformation"

Nursing homes were at the epicenter of the pandemic last year, as the virus tore through facilities across the U.S. Nearly 136,000 residents and more than 2,000 workers have died of the disease, according to the Centers for Medicare and Medicaid Services (CMS).

With Holly Heights now operating at capacity, Snipes hopes that more employees will get their shots before a federal mandate requiring COVID-19 vaccinations for health care workers at facilities that receive Medicare and Medicaid funds takes effect, with the deadline not yet announced.

"We don't have anyone who has quit yet. One nurse has said she'll work to the very last day and then quit," said Snipes, who added that six other nurses have refused to get the shots. "There is just a lot of misinformation out there."

In announcing the emergency regulation was being developed, CMS estimated about 62% of nursing home staff as vaccinated nationally. The emergence of the Delta variant drove a rise in infections among nursing home residents from a low of 319 cases on June 27 to nearly 2,700 cases as of August 8. Many of the recent outbreaks occurred in facilities in parts of the U.S. with the lowest staff vaccination rates, the agency stated

"We're very encouraged and excited to offer boosters to our seniors," said Dr. Mark Gloth, chief medical officer at ProMedica Senior Care, which operates more than 335 skilled nursing and assisted living facilities with some 18,500 residents in 28 states. 

ProMedica has already been giving third shots of Pfizer and Moderna to those with compromised immune systems. "This booster dose goes beyond that it addresses individuals that over the course of time had that waning immunity to COVID, particularly in light of the Delta variant," Gloth told CBS MoneyWatch. 

One of the few silver linings of the pandemic is that it prioritized older Americans for research and funding, according to Gloth, whose company has partnered with Brown and Case Western universities to monitor the effectiveness of the vaccines in the elderly. 

"Seniors are historically very much underserved when it comes to research initiatives," Gloth said.

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While more than 90% of ProMedica's residents age 65 and older are vaccinated, the rate is lower among the company's workforce, acknowledged Gloth. "We appreciate some will elect to leave the health care sector entirely. It's been a difficult year," he added. 

The CDC's approval last week of the Pfizer booster for some Americans was also cheered by Genesis Healthcare, which runs more than 250 skilled nursing centers and senior living communities in 23 states, as well as the American Health Care Association and National Center for Assisted Living, or AHCA/NCAL. 

"We are thrilled to receive word that we can begin providing our nursing home patients and residents with a third dose of the Pfizer vaccine," a Genesis spokesperson said in an email. "We expect this third dose will better protect our patients, residents and employees. We are moving very quickly to get our patients and residents boosted as soon as possible, having prepared our teams for this approval even prior to the CDC's announcement." 

"This decision is another layer of protection that we need to fight this virus that uniquely targets our vulnerable long-term care population," Dr. David Gifford, chief medical officer of AHCA/NCAL, stated Friday in a news release. 

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