Federal Covid-19 Vaccinations Begin in Nursing Homes

THE WALL STREET JOURNAL

A federal effort to administer a Covid-19 vaccine to workers and residents in long-term care facilities is set to begin Friday in Connecticut, Florida and Ohio, with a broader rollout in a dozen states starting Monday.

The program, which is being led by CVS Health Corp. and Walgreens Boots Alliance Inc., faces major challenges to get the shots rolled out to the approximately 15,600 nursing homes and 29,000 assisted-living communities in the U.S. These include getting the consent of staffers and residents, the complexities of storing and administering the Pfizer Inc. and BioNTech SE vaccine and concerns over ensuring potential side effects from the shots don't sideline too many workers at once.

Under contracts with the federal government, CVS has signed up more than 40,000 long-term care facilities for vaccination and Walgreens has around 35,000. Other pharmacies are also involved in the program.

The vaccination program comes as Covid-19 cases and deaths in nursing homes are surging. In the week ending Dec. 6, there were 4,525 deaths in nursing homes, according to data released Thursday by the Centers for Medicare and Medicaid Services. That was a 56% rise from the 2,893 deaths in the week ending Nov. 15.

The Dec. 6 figure was the highest weekly total since the start of the federal survey data in late May, barring one initial week of data that incorporated some earlier results.

Overall, there have been more than 115,000 deaths linked to U.S. long-term care facilities, according to a Wall Street Journal tally.

Gen. Gustave Perna, chief operating officer of Operation Warp Speed, the federal government's coronavirus response program, said Wednesday that about 1,100 facilities around the country are set to begin vaccinations on Monday. Facilities in West Virginia and two Florida counties received shots this week, as did staffers in a few other places around the country. In those cases, states decided to move in advance of the federal program's launch and some nursing-home staffers were vaccinated through hospital systems.

CVS said it plans to visit four nursing homes in Ohio and three in Connecticut on Friday. Walgreens said it expects to be at eight to 10 sites across Ohio, Connecticut and Florida.

Both companies said they would be vaccinating at facilities in a dozen states next week, with 11 starting Monday. The early states include New York, Nevada, Oklahoma and Kentucky. Walgreens said it had around 800 long-term care vaccine clinics scheduled for next week.

CVS said it is receiving shipments from Pfizer at around 180 of its approximately 1,000 planned vaccine-distribution hubs this week. Walgreens, which will have around 800 hubs, said it expects some shipments this week and some over the weekend.

Chris Cox, a CVS executive who is overseeing the vaccination rollout for the pharmacy chain, said the effort has gone smoothly. Although the East Coast snowstorm appeared set to delay one box of vaccination supplies destined for a nursing home in Connecticut, CVS was able to get the delivery expedited so it would arrive in time.

"We're really at the stage now where our field and store teams are just flat-out to the wall, working around the clock," he said.

After the vaccine arrives at hubs, teams of pharmacists and other staffers will fan out to individual facilities to administer shots. The vaccine will be kept in special coolers. Nursing-home staffers will generally get their shots in a central location, but residents can be visited in their rooms. The Centers for Disease Control and Prevention has told the nursing-home industry that eligibility isn't limited to workers involved directly in care, but also includes people who work in dietary services and other employees.

"We're going to learn a lot over the next couple of days," said Rick Gates, a senior vice president at Walgreens.

Before the pharmacy teams arrive at facilities, nursing homes are supposed to secure consent from residents and staffers, but nursing-home companies have said the process faces hurdles, both technical and due to reluctance among some staffers and families. For some residents, nursing homes must get the agreement of a family member.

Nursing-home operators said they were informed in recent days of visits scheduled in the coming weeks, and they are scrambling to secure consents after CVS sent a new digital form this week that they could use to collect them. Some nursing-home executives have said the process has been confusing, but the digital form will help.

"There's a lot that needs to be figured out, worked out and implemented, " said Richard Feifer, chief medical officer of Genesis Healthcare Inc., the biggest U.S. nursing-home operator.

The company owns a Connecticut facility slated for vaccination Friday. "It would have been nice if all these steps were finalized earlier," Dr. Feifer said. He called the entire preparation process "very accelerated, very stressful and challenging." But, he said, "we are absolutely going to find a way" to get everything ready in time.

Regarding consent forms, Mr. Cox said CVS is "really taking the feedback from all of the facilities, and made it a much easier process."

Some nursing homes have also said they want to stagger the doses administered to staff in case some suffer side effects. CVS and Walgreens are planning three visits to each facility, but both said they had some flexibility if a nursing home needed to stagger doses more than that.

--Jon Kamp contributed to this article.

Write to Anna Wilde Mathews at anna.mathews@wsj.com and Tom McGinty at tom.mcginty@wsj.com

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