CDC report finds nursing homes lagging in COVID vaccinations : NPR

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COVID-19 continues to threaten nursing homes across the U.S. A new report from the Centers for Disease Control and Prevention (CDC) reveals that only four in 10 nursing home residents have received their latest dose of a COVID vaccine since last fall. Sarah Bowden examines why vaccination rates are so low among these at-risk Americans.

SARAH BOLDEN: Molly Loveland works at a nursing home about 30 miles outside of Pittsburgh. She's taking some time off right now. Her daughter, Maya, was born in May.

(baby cries)

Molly Loveland: She's got really long legs. She weighs probably 8 pounds now, but she's still really tiny.

BODEN: Loveland will be returning to work soon, but she worries about catching COVID-19 at the nursing home and spreading it to her baby. There are signs the US may see a summer surge in COVID-19 cases, just like last year. Loveland says summer COVID-19 is especially hard on patients.

Loveland: It seems like the high temperatures, especially in the summer, because it's humid, it's hot, it's muggy, it makes the respiratory problems even worse. It feels like summer COVID is worse than winter COVID.

BOWEN: And the coronavirus pandemic this winter has already hit nursing homes hard in the U.S. At the peak of the pandemic in January, the CDC found that nursing home residents were eight times more likely to be hospitalized than the overall population of people over 70.

Dr. Rajeev Kumar is president of the Medical Association of Clinicians Providing Long-Term Care. He says part of the problem is that the federal government is no longer covering the cost of vaccinations. Vaccinations remain free for patients, but clinicians must bill each person's insurance company separately.

Rajeev Kumar: From the pharmacy side, it would have been much smoother if we had said, “I gave 150 doses of the vaccine today, I'll pay for 150 doses.” Now, we have to get individual invoices, which is a bit of a hassle.

BOWEN: That makes it much harder to vaccinate all the nursing home residents. And Bowden says there's more skepticism about the vaccine than there was when it was first rolled out. Loveland says she's even seeing that skepticism among her patients at work.

Loveland: That's the pitfall of Facebook. A lot of my patients are now on social media, and a lot of people's personal opinions on Facebook are influencing the way they think.

BOWEN: But there are ways to combat misinformation. Look at North Dakota and South Dakota. More than 60% of nursing home residents in both states have been vaccinated since the fall. Sanford Health is the state's main health care system and runs dozens of nursing homes in both states. Dr. Jeremy Cowells is Sanford's chief medical officer.

Jeremy Cowells: The right thing for us to do was to say, number one, leverage the power of our larger organization to make sure we have the vaccines we need.

BOWDEN: Some nursing homes in Sanford have seen more than 60% or even 70% of their residents vaccinated since October. To make this happen, Cauwels says they've taken advantage of the fact that many of the nursing homes have primary care clinicians who are employed by the health system and can convince their patients to get vaccinated.

COWELLS: By being consistent, by being compassionate, by having compassion for the people sitting in front of you that day, we can restore some hope and some faith in medicine in general.

Bowden: Speaking directly to patients can be helpful, but critics say it's the bare minimum nursing homes should be doing.

Richard Mollot: Trust has been destroyed again and again.

BORDERN: Richard Mollot is president of the Coalition of Long-Term Care Communities, a watchdog group that monitors nursing homes. He says the bigger problem is that many nursing homes consistently ignore residents' concerns, serve poor quality food and provide substandard, if not dangerous, care. All of these issues have been exacerbated since COVID-19 caused extreme stress across the industry. Many staff members left during the pandemic, and studies have found that nursing homes have not fully recovered from these mass departures.

Mollot: The result would be a much lower quality of care, much more disrespectful interactions between residents and staff, and a lack of trust.

BOWDEN: For Mollot, that's the reason for the low vaccination rates. He says it's unacceptable because nursing home residents are so vulnerable to the virus.

Molly Loveland's maternity leave is about to end, and she'll be returning to the bedside at a workplace where she says her managers often ignore patients' concerns.

Loveland: I think the more a facility puts in for its patients, the more respect it will get from patients.

BODEN: So when management tells patients it's time to get their latest COVID-19 vaccine shot, Loveland says they aren't listening.

For NPR News, I'm Sarah Borden in Pittsburgh.

GONYEA: This story comes from NPR's partnership with KFF Health News.

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