Covid-19 Vaccine Booster: Only half of Nursing Home residents received the booster

The Covid-19 vaccine provides important protection against serious illness, but studies show that its effectiveness may decline over time. This is especially true for older people over the age of 65. Early studies also suggest that there is an increasing need for boosters to maintain adequate protection against Omicron mutants.

On September 24, the US Centers for Disease Control and Prevention recommended that all elderly and residents in a long-term care environment receive a booster dose of the Covid-19 vaccine. This guidance was later extended to all adults at least 6 months after completion. Two months after the first two-dose series of Pfizer / BioNTech or Moderna vaccines, or Johnson & Johnson.

By the end of October, a month after the initial recommendation, about a quarter of fully vaccinated nursing home residents had been boosted, according to data released by the CDC on Friday.

Currently, only about half (51%) received boosters two months after the initial recommendation. However, nearly 80% of nursing home residents are eligible to receive boosters.

When the Covid-19 vaccine was first approved for emergency use in the United States a year ago, reaching residents of nursing homes as soon as possible was a top priority. Many of the most deadly outbreaks across the country are elderly people in a collective environment, with one in five people dying in Covid-19 in the United States (about 143,000 dead) in nursing home residents and staff. It is occurring between.

The federal government has partnered with large pharmacy chains such as CVS and Walgreens to provide vaccine doses early and directly to care facility residents. However, this series of programs of similar scale for booster immunization has not been realized, and nursing homes are to face many logistic hurdles.

“In my sense, every nursing home understands this on their own,” said Brian McGarry, an assistant professor at the University of Rochester School of Medicine. The study focuses on aging.

“We’ve heard from some nursing homes that there is a shortage of pharmacists, as well as many aspects of the economy and medical care,” McGarry told CNN. “They are trying to serve the general public and there is no staff to send people to nursing homes to run an in-house clinic.”

At a media briefing last week, Sara Rosak, vice president of health and wellness strategy at the National Chain Drugstore Association, said the strategic shift was “a change in the moment of response and what is needed at the moment.” Over the past year, millions of pharmacies across the country have built a large infrastructure for the Covid-19 vaccine. Currently, the focus is on “pushing people to the place of vaccination.”

However, it is “flexible,” Roszak said, and facilities can request help or pharmacies that are part of the federal retail program can register for direct cooperation.

After reaching record lows in late spring and early summer, new Covid-19 cases began to increase among nursing home residents in July.

Nationally, about 87% of nursing home residents are fully vaccinated, making up much more than 60% of the general population.

The early waves of community expansion led to worsening waves within local nursing homes, but the recent waves of community expansion were less severe within nursing homes.

Risks from staff and visitors remain

However, residents of nursing homes are not isolated from the risks that Covid-19 continues to pose.

Only about three-quarters of nursing home staff were fully vaccinated in the first series of one or two doses (less than two-thirds in some states) and were fully vaccinated. Only about a quarter of the staff receive boosters. Federal data.

“It is very disturbing to have unvaccinated staff. The work is very intimate, very intimate and personal, and even with good PPE, there is a risk of exposure there. It will be higher, “McGarry told CNN. “Vaccines seem to make a difference.”

McGarry et al. Last week revealed that nursing homes with the lowest staff vaccination rates had more than double the number of resident Covid-19 cases and nearly three times the death toll from nursing homes with the highest staff vaccination rates. I published the paper I did.

“Getting those first doses to unvaccinated staff should be at the top of the list, and just below that, getting boosters for all qualified people. “

A CMS spokesperson told CNN, “We are concerned about the risks that unvaccinated medical staff pose to our staff and have pursued vaccination requirements to address this risk.” Nursing home operators are encouraged to use all freely available tools to increase immunization of residents and staff, including educational resources and vaccination clinics. .. “

Nursing homes now have tools for managing viruses (such as easier-to-use PPE equipment and better testing), but many have lifted blockade restrictions and allowed visitors.

Nursing homes can and should implement vaccination requirements for staff-but the same rules do not apply to visitors, McGarry said. “It certainly creates new vectors. They are wildcards.”

Based on CDC data, booster intake for nursing home residents is about the same as for the average elderly.

Resident booster coverage ranges from 81% in North Dakota to 30% in Arizona. It tends to be higher than average in the northeast and Great Plains regions and lower than average in the south.

Federal data includes information submitted by December 5 by facilities accredited by the Medicare and Medicaid Service Centers in the United States. Coverage can be higher than reported, as data for the last week is not yet complete and the percentage of nursing homes reporting data to the CDC varies from state to state.

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