COVID vaccine slow to reach residents of nursing homes in California

As public health officials strive to clear a backlog of unused COVID-19 vaccines by opening the process to anyone 65 years of age or older, new data shows they have failed to deliver quickly vaccines to the vast majority of California’s most vulnerable residents, which were supposed to be the priority.

As of Sunday, only about 5% of residents of long-term care facilities participating in the statewide vaccination program – including people living in nursing homes and assisted living centers – had been vaccinated , according to data from the California Department of Public Health obtained by The Times.

And while the vaccines became available in the United States in mid-December, only 3% of California facilities participating in the program had been scheduled for their first visit to a vaccination team starting on Sunday, the data showed.
“I find it infuriating,” said Lee Collins, whose 91-year-old mother is in an assisted living facility in Beverly Hills where no one had been vaccinated midweek and no start date had been set. vaccinations, according to state data. . “I thought the elderly were supposed to be the priority, but that obviously didn’t happen.”

Previously unpublished data, contained in an email from a state health department official to an advisory committee comprising geriatricians and advocates for the elderly, lists 17,400 California long-term care facilities have signed up for the vaccination program run by the Centers for Disease Control and Prevention and large pharmaceutical chains CVS and Walgreens.

The vast majority of these establishments, over 90%, are assisted living residences, which generally house the elderly who can no longer take care of themselves. They often have cognitive problems such as dementia, but are not sick enough to require the higher level of medical care provided by skilled nursing facilities.

Almost none of the approximately 360,000 residents of assisted living facilities on the list had been vaccinated Sunday.

“It’s tragic,” said Dr. Matthew Lefferman, a geriatrician whose practice consists primarily of residents of small assisted living centers dotted around Southern California. None of those homes had received the vaccine by midweek, he said.

While most of these facilities weathered the first wave of coronavirus fairly well, “the recent outbreak has been devastating,” Lefferman said. Of nearly 600 patients, at least 35 have died from COVID-19 since December.

“We know the vaccine has been coming for months now, so why is it taking so long?” Lefferman asked.

The answer: It wasn’t until Monday that state health officials, who set priorities for the immunization program, allowed pharmacies to begin immunizing in assisted living facilities, according to a statement sent to The Times by CVS.

The state’s first priority was skilled nursing facilities, where pharmacies began vaccinating on Dec. 28, according to CVS and the CDC.

But even at the program’s 855 California skilled nursing facilities, only 26% of residents had been vaccinated by Sunday, the data showed.

A spokesperson for the California Department of Public Health did not respond to questions about the data or timing of authorizations, referring the inquiries to pharmacies and the CDC.

The numbers are more encouraging in LA County, where public health officials have chosen to monitor immunizations themselves at skilled nursing facilities. Sixty-six percent of residents were vaccinated last week, county officials said, and they hope to complete the process by next week.

However, assisted living homes in LA County are still allocated to CVS and Walgreens. As of Sunday, almost none had started receiving the vaccine, data showed.

The slow rollout of the vaccine in these facilities is a problem not only because their residents are dying from COVID-19 in terrifying numbers – nearly 40% of deaths nationwide have been in nursing homes – but they are filling up Also disproportionately the intensive care beds in hospitals, which are hopelessly scarce in many areas of the state, including Los Angeles.

“How do we manage this outbreak if we don’t keep these people out of the hospital?” asked Mike Dark, a lawyer with California Advocates for Nursing Home Reform.

There are reasons for the delays. A surprising number of residents and staff at facilities have been reluctant to get vaccinated. Obtaining informed consent from residents with dementia can be time consuming, especially if a family member must be traced to give consent. And there is all the bureaucracy needed to fill out the forms and enter the data so that vaccines can be tracked efficiently.

But none of this should have come as a surprise, advocates for the elderly say, and all levels of government should have been better prepared to administer vaccines faster.

Now, as federal and state health officials dramatically increase the number of people eligible for the vaccine, and local officials plan to turn Dodger Stadium and other large sites into mass vaccination sites, advocates fear that Residents stuck inside the facilities are left behind in the rush for injections.

“My mother is not mobile. Even though I was inclined to take it to a [mass vaccination site]I can’t put her at that risk, and she can’t line up indefinitely, ”Collins said. “People living with assistance are there for a reason. I can’t drag her around town trying to get a vaccine.

Collins learned on Thursday that her mother’s facility is expected to start immunizing next week.

But the delay has always been a source of deep frustration. Collins said she was particularly annoyed when acquaintances with only a loose connection to the medical industry bragged about being vaccinated under rules that also prioritize frontline health workers.

“I have a friend who is a nurse, but she hasn’t practiced since the pandemic started – she got the vaccine,” Collins said. “Her husband volunteered at a clinic once upon a time, and he also received the vaccine.

Paul Jaconette’s mother, 94, who lives in Nazareth House, an assisted living facility in Cheviot Hills, has also not been vaccinated. He learned on Wednesday that the first round of shooting was scheduled for January 22.

He is frustrated with the delay but grateful Nazareth House is finally scheduled. Trying to take her mother to a vaccination center outside the facility would have been intimidating.

“I live in Santa Barbara, she is in Los Angeles,” Jaconette said. With the severity of the COVID-19 outbreak in Los Angeles right now, “It’s like you don’t even want to drive in the county. We have no way of getting him anywhere for a vaccine, ”he said.

The vaccination campaign and the promise it contains to end her mother’s isolation cannot come soon enough.

“It took its toll on her and really exacerbated her dementia,” Jaconette said.

On a call this week, she knew what day it was but did not know the month. At one point, she announced that she was about to do her hair and go for a walk.

When he reminded her that it was not possible, she said, “Oh yeah, that’s right, I’m in quarantine.”