Why Long-Term Care Facilities Are Struggling To Get Residents And Staff Vaccinated

Published: Thursday, January 14, 2021 - 1:28pm
Updated: Monday, February 22, 2021 - 11:40am
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LAUREN GILGER: As more people around the state are being allowed to sign up for vaccination every day, residents and staff at long term care facilities — who were included in the first group of those to get the vaccines — are still in the process of getting their shots. And while progress is being made, there is still a long way to go before everyone in this high-risk group is protected. And joining me now to talk about where things are and where things are going is KJZZ’s Kathy Ritchie. Good Morning, Kathy.

KATHY RITCHIE: Good morning, Lauren.

GILGER: OK, so we know that long-term care residents and staff are still being vaccinated. Where are they in that process at this point? 

RITCHIE: Yeah, so most of the skilled nursing facilities — those are the ones that are regulated by the Centers for Medicare and Medicaid — have had their partner pharmacy come in and administer the shot. So quick background, almost all of the long-term care facilities are partnering with a pharmacy chain like Walgreens or CVS to come in and administer the vaccine to residents and staff. Assisted living, I’m told, will start next week. And roughly 2,000 assisted living facilities are participating in that pharmacy partnership.

GILGER: So what are some of the challenges here? Are residents or staff pushing back on getting the vaccine? 

RITCHIE: Yeah, great question. I'm hearing residents are getting the vaccine in fairly high numbers. It’s the staff that have concerns and many are choosing not to get vaccinated. Last week, I reported that staff are reluctant, you know, for a lot of different reasons. And this isn’t an Arizona problem, Lauren. I talked to Christopher Laxton about this. He’s the executive director of the national organization AMDA — the Society for Post-Acute and Long-Term Care Medicine.

CHRISTOPHER LAXTON: The truth of the matter is, you know, estimates are up to 60% of nursing home staff are hesitant. And that hesitance goes for everything from, "I'm gonna wait and see" to "I'm never, this is never gonna come into my body." The reasons are all based on misinformation and sort of a misunderstanding of what this is. You have to remember, frontline staff, in particular the (certified nursing assistants), get most of their information from Facebook and from peer discussion.

GILGER: So this vaccine of course is not mandatory at this point. Do you think that might change then?

RITCHIE: You know, Laxton told me it’s tough to make any vaccine mandatory. The flu shot is not a mandatory vaccine. He did say employers can make it a condition of the job, but that’s about it. Another issue Laxton brought up is trust.

LAXTON: They don't trust their leadership, they have no reason to — they're not treated well. And they get all kinds of misinformation. I think it's also important to point out that many of our frontline staff are members of communities of color. And so there's a long history of vaccine hesitancy. You know, the Tuskegee project comes up frequently when we have conversations with African American CNAs.

GILGER: Right, right, and of course that was a 40-year experiment involving African American men and was ultimately found to be very unethical. Let’s also talk about staffing, Kathy, among these long-term care facilities. I know from your reporting that that is another issue entirely here.

RITCHIE: Yeah. Absolutely. It's a huge issue. There are lots of issues that will require both, I think, cultural and policy changes if we want to see improvements for direct care workers who do provide very personal, high-touch care for our loved ones.

GILGER: I want to ask you more about challenges, as well. I know there were some hiccups with the rollout of the vaccine. What are you hearing?

RITCHIE: Well, obviously, long-term care is a little different because of those partnerships. You know, one of the long-term care providers that I talked to, he said he had a fairly smooth experience. He did encounter some staff not wanting the vaccine. So he's been spending a lot of time educating his workforce. Laxton did point out a challenge involving the pharmacies themselves who are coming into these places.

LAXTON: What we've heard is that, firstly, the pharmacists generally have never set foot in a nursing home, don't really understand how nursing homes work. Secondly, they say, "We're going to come in on day X and administer the first dose to everybody." Then the administrators might say, "Well, that's not a good day for us" for a variety of reasons. They may be having a staff training, or there may be a surveyor in the building, or there may be all kinds of things going on. "Can you come at a different day or you know maybe split that and do half of our people one day and half the next?" They basically say, "No, we can't. It's this or nothing."

GILGER: All right. And lastly, Kathy, let's shift gears and talk about the latest roll out of Phase 1B here, which includes people ages 75 and older. How is that going?

RITCHIE: Well, I talked to Dana Kennedy from AARP Arizona about that. You know, there were some hiccups that first morning that we had heard about. You know, there was some confusion. You have to set up an account first before setting up the appointment. And it also requires an email address. And frankly, not everyone uses email. This population may not be as tech-savvy as other age groups. I think one big hurdle facing the counties and the state will be vaccinating homebound seniors. And these are people who rarely leave their home except for doctors appointments. They may rely on things like Meals on Wheels.

GILGER: Yeah, that's a tough population to reach. Let's take a listen to what Dana had to say.

DANA KENNEDY: It is not an easy task to get this vaccination out to our most vulnerable population by any stretch of the imagination. And it's going to take a lot of people working together. And it's also just going to take neighbors helping each other, to be quite honest with you.

GILGER: All right. And that is KJZZ's Kathy Ritchie joining us this morning with more reporting on all of this. Kathy, thank you so much.

RITCHIE: Of course. Thank you.

GILGER: And the state Department of Health Services also just announced yesterday that an estimated 750,000 more Arizonans are about to be prioritized for the COVID-19 vaccine as the state allows those ages 65 and older to register. That starts next week on Jan.19.

EDITOR'S NOTE: This story has been updated to clarify the abbreviation for certified nursing assistant.

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