Perhaps more worryingly, a significant portion of Massachusetts nursing home staff continue to be unvaccinated against COVID-19, despite aggressive initiatives to convince those hesitant. Only 59 percent of nursing home staff are fully immunized, according to state data. Now, Executives at nursing homes who witnessed the explosion in COVID infections and deaths a year ago fear their own nurses, aides and other workers could endanger the health of their residents.
“It’s a topic of conversation between all vendors,” said Elissa Sherman, president of LeadingAge, a trade association which represents non-profit nursing homes and privacy centers. “We have to do everything we can to try to get as many people vaccinated as possible.”
One of the state’s largest elderly care operators, Hebrew SeniorLife, has previously said its 1,125 nursing home staff must be vaccinated, but stopped before executing the warrant. Others, fearing that they will have difficulty filling positions, have so far relied on a softer approach.
Highlighting anxiety is the news of a recent deadly cluster in Kentucky. An unvaccinated employee sparked an outbreak of COVID-19 at a nursing home where most residents – but only about half of the staff – had been vaccinated. A total of 26 residents were infected, including 18 who had been vaccinated, and 20 workers were infected, including four who had been vaccinated, according to a study by the Centers for Disease Control and Prevention. Three residents died, two of whom were unvaccinated.
The large number of infections among the vaccinated residents underlines the particular risk of these homes, with their close quarters and their lives largely indoors and the residents’ often weakened immune systems. Nationally, less than 0.01% of people vaccinated have been infected with the coronavirus, according to CDC data.
In Massachusetts, state data shows the total number of COVID-19 cases in nursing homes has fallen from several hundred a week in late January to about 30 a week recently. But senior leaders know that number can increase rapidly if clusters of cases erupt.
A much-publicized federal program sent drugstore chains CVS and Walgreens to nursing homes and other long-term care facilities across the country from late December to early March to administer vaccines to staff and residents. When he concluded, 84 percent of Massachusetts nursing home residents at the time were fully immunized, state data showed.
But since then, as residents have been released or died and unvaccinated others entered care, that number has declined. Today, about 81% of Massachusetts nursing home residents are fully immunized, data shows.
“It looks like they’re creating a new type of petri dish where we could have a resurgence if we don’t get a [vaccination] program implemented consistently, ”said Daryl Cameron Every, a senior lawyer from Milton who meets various COVID vaccination policies as it helps older people make the transition between and among hospitals, geriatric psychiatric facilities and nursing homes.
She recently fought a geriatric mental institution, which said it was not responsible for getting a vaccine for a 70-year-old client with dementia and delusions who had been there for months. At the end of March, as the man was about to be returned to an Ayer nursing home, administrators said they did not have the refrigeration needed to handle the vaccines themselves and were awaiting advice from the ‘State, Every said.
Her client was finally admitted to the nursing home on April 21 – still unvaccinated – and was in quarantine awaiting a vaccination, which finally took place on Thursday, with a one-dose injection of Johnson & Johnson .
“It was a bit like banging your head against a wall,” said Julie Curcuru, the man’s daughter, of the months-long mission to get her father vaccinated. She said the nursing home initially offered to transport him outside the facility to get the vaccine, but the family refused because he had become severely disoriented and restless during a previous move. , thinking he was in an airport.
“I still don’t believe this population can be overlooked,” Curcuru said. “I guess we can learn from that and get better before another pandemic.”
The Baker administration says it is helping nursing homes by sending “rapid response teams” to facilities where residents have lower vaccination rates.
But the state’s process for getting vaccines against patients entering nursing homes leaves a few weeks of quarantine waiting, unable to participate in group activities or eat in communal dining rooms, the said. Dr. Asif Merchant, medical director of four retirement homes in the Western Metropolitan area and partner of a company that manages medical services for 45 nursing homes in Massachusetts.
“This means that a person cannot have visitors in their room,” said Merchant, who has been pushing for more state aid for facilities and families under siege.
The problem, say nursing home administrators, is that State response teams typically only provide a second dose of Pfizer vaccine to residents who have already received their first injection of Pfizer elsewhere. Few nursing home pharmacies have the cold storage capacity to store Pfizer vaccine.
But for nursing homes whose residents need a first dose of Pfizer, or any dose of other vaccines, administrators and families have been largely alone. In late February, the state ordered nursing home administrators to contact their own long-term care pharmacies to provide the vaccines. He also told administrators to direct their unvaccinated staff – many of whom are still hesitant to get vaccinated – to mass vaccination sites or other places, rather than allowing them to be vaccinated at their workplace.
The end result was that some new nursing home residents across the state remain unvaccinated, leaving them quarantined and vulnerable.
During this time, many of the people who take care of them also do not get the vaccine.
Recognizing the problem, the state last month allowed nursing homes to vaccinate staff directly in the facility.
But the rules, focused on preventing vaccine wastage, still require nursing homes to “make sure there are enough residents and staff in need” before ordering doses for any of them. between them. This means families and nursing homes should wait until they have at least 10 unvaccinated residents or enough staff on hand before ordering Moderna, which comes in 10-dose vials, or at least five for Johnson & vials. Johnson.
Vaccinations have dramatically reduced infections, but unvaccinated nursing home staff remain a threat. Health Secretary Marylou Sudders said on Monday that most of the infections were among workers in nursing homes.
Now, retirement homes are redoubling their efforts to persuade reluctant workers to get vaccinated, offering staff paid time off, gift cards, raffle prizes, event tickets, giveaways, t-shirts, and more, said Tara Gregorio, president of the Massachusetts Senior Care Association, a group industry professional.
They also called on nursing assistants, housekeepers and department heads to act as “vaccine ambassadors” to encourage their peers, she said. And they have provided educational videos and flyers in multiple languages, including Haitian Creole, Chinese, Spanish, and Portuguese, hosted by respected doctors.
Amid the high-stakes campaign, talk about prescribing shots has spilled over into the industry, but nursing home administrators are worried about what could drive out already scarce staff.
“I believe the tenure is on the horizon and look forward to it firmly later,” said Lou Woolf, president of Hebrew SeniorLife.
With significant resources and a stable staff, the Harvard affiliate organization is unusual in the industry. At least 75 percent of workers at Hebrew SeniorLife nursing homes are fully immunized and 6 percent are waiting for a second vaccine, well above the state average.
A year before the pandemic, Hebrew SeniorLife had to get his first flu shot. Administrators achieved 100% compliance by imposing what at the time seemed an onerous condition: Holdouts would be required to wear face masks 24/7 during flu season.
“It was totally embarrassing then, but not now,” Woolf said. “We don’t have that hammer anymore.”
Kay Lazar can be contacted at [email protected] Follow her on Twitter @GlobeKayLazar.