Read on Twitter
1) Vaccine Rollout Tweet: Start with positives: Side effects for first dose of vaccine do not appear to be having a significant impact. NHs with strong leadership and great culture can effectively implement. High rate of acceptance amongst residents.
2) General concerns: Staff acceptance ranging from 30-80%, average seems to hover around 40%, may unintentionally provide “staggering” opportunity. Need education around increasing vaccine confidence. Side effects may increase with second dose, creating greater staffing concerns
3) Many issues on the ground that are a combo of poor federal planning, CVS/Walgreens rigidity and unprepared state and local HDs. Despite previous entry of patient data into online systems, CVS having staff reenter data when they come to deliver the vaccine (seriously!);
4) CVS refusing to vaccinate residents because they don’t have a “new” Medicare card; Confusion over consent forms. Rigid vaccination schedule that isn’t person centered. Facilities that signed up not getting timely confirmation.
5) Administrative snafus, corporate rigidity and human error can’t be allowed to get in the way of #DoingTheRightThing. NH and RCFE staff and leadership are not perfect, we can’t allow that to cause vaccines to be delayed. The mantra needs to be: Don’t Hesitate; Vaccinate!!
6) There does not appear to be a unified dashboard for tracking the rollout in NHs across the country. Metrics we should have are # of NHs where vaccinations have begun w/ number of residents given 1st & 2nd doses in the numerator and total # of residents in the denominator.
7) We need the same data for staff. Seem to be lacking a unified system that would allow us to track staff who work in multiple facilities and residents who are given a first dose and then discharged home or to the hospital.
8) One possible recommendation: Allow CVS/Walgreens to leave Moderna vaccine with facility in order to allow facilities to stagger and maximize vaccine administration (this will require understanding of state board of pharmacy rules and regulations).
9) RCFEs and ICFs are an even greater challenge. Comprise large and small ALFs and group homes. There are 10’s of thousands of these facilities across the United States. The system for bringing vaccinations to these facilities was even more poorly planned than was NH rollout.
10) The implementation in RCFEs and ICFs will be incredibly problematic. It is likely that the large ALF companies, which primarily house wealthy white older adults, will be vaccinated first. The multiple small group homes, small ALFs, and ICFs will be delayed.
11) Dealing with COVID-19, whether in reducing infections or deaths, or maximizing vaccine dissemination, has never been about the best facilities! It’s about the mediocre and the worst facilities. All planning should be for the lowest common denominator.
12) Expecting NHs & ALFs to effectively execute the delivery of care and/or an effective vaccine dissemination on their own is naive at best. Those suffering and dying are the most vulnerable members of our society and people of color in lower socioeconomic strata.
13) The number of NH & ALF residents and staff who are dying has increased yet again. Delays in the rollout of the vaccine only lead to more deaths in these already ravaged demographic groups. Don't Hesitate; Vaccinate! @CALTCM @AMDApaltc @AmerGeriatrics @HealthInAging
