Nursing homes face the daunting task of getting consent before vaccination with the coronavirus vaccine.

Obtaining consent is one of the most difficult hurdles when authorities mobilize to inoculate residents of these facilities, many of whom suffer from dementia or Alzheimer’s disease.

In such cases, the facility will need to track relatives and attorneys, which can take days or weeks. In some cases, disagreements over whether family members should vaccinate their loved ones require resolution of the dispute.

Even healthy-minded residents may be worried about the new vaccine and may need time to weigh the risks and benefits and consult with their relatives.

Federal health officials prioritized vaccines for long-term care residents and staff after the outbreak devastated the facility. Killed more than 113,000 residents and staff And it accounts for more than one-third of all US covid-19 deaths. Secretary of Health and Welfare Alex Azar recently said the government has the ability to inoculate all caregivers by Christmas. However, vaccinated retail pharmacies have shown that the process can take months as a result of logistical and consent challenges that require multiple visits to the facility. The process occurs over a period that is predicted to be the most deadly period of the pandemic.

“It’s a mess,” said Mike Wasserman, medical director of a California facility and former president of the California Long-Term Care Medical Association, who is talking about deploying to other nursing homes. “The federal government does not provide a good direction, the direction is changing day by day, and we can get different stories from different people at different levels.”

Nursing homes and other long-term care facility operators are struggling to resolve conflicting directions.

The government partnership with Walgreens and CVS to distribute the vaccine has given the discretion to secure permits in the way companies desire. The Centers for Disease Control and Prevention, which oversees the partnership, advised that verbal consent was sufficient.

But the pharmacy wanted more, so it imposed much stricter consent rules than those used by nursing homes to vaccinate against seasonal flu. The pharmacy got better after receiving the complaint.

Proponents say the turmoil could have been prevented if the Trump administration first instructed pharmacies that verbal permits would suffice.

“A few months before the vaccine was approved, we knew we needed to address these complex logistical issues once the vaccine was launched,” said the California Nursing Home Reform Advocate. Said Mike Dark, a staff lawyer at California. “If people in need of the vaccine do not receive it, we will see more deaths and more infections.”

By encouraging coordinated education campaigns and safe family visits, the federal government took steps to reach out to the facility prior to vaccination, allowing residents to discuss decisions directly, Dark said. Stated.

The CVS initially stated that it would require three hardcopy written consents from each resident or its agent. They planned to mail the form to a facility where some nursing home operators fretted did not arrive a week before the shot was administered. Homes and supporters complained that these requirements were annoying and frustrating, especially when they needed to track family signatures.

A spokesman said the CVS now allows decision-makers to give verbal consent and accepts email consent from medical decision makers for those who cannot. ..

A Walgreens spokeswoman said the form was distributed to the facility a few days before the vaccination clinic and could be marked to show verbal consent. Walgreens executive Ed Kaleta said last week that pharmacies have become more flexible about what they accept to show their consent.

“Many long-term facilities say that consent forms can be done verbally or electronically. Therefore, for facilities that allow the creation of consent forms, it is clearly easier to do so. We comply, “he said in a webinar hosted by the Alliance for Health Policy.

Peter Van Rankle, secretary-general of the Ohio Healthcare Association, a long-term care industry group, said facilities that needed enough time for consent remained confused by the diversion.

“If you were there and talking about talented people a few days before the clinic worked,” Van Rankle said. “When I had to go out to find someone and get their consent, it didn’t work for a few days. It would have been nice if I had more time to get my consent.”

HHS and Operation Warp Speed ​​officials, who oversee the distribution process, did not answer questions about whether the federal government should rationalize consent rules or start the process early.