Image of nurse administering vaccine to patient's arm

Starting today, long-term care facilities nationwide can opt in to a pharmacy partnership program that will provide and administer future COVID-19 vaccines to residents and staff with no out-of-pocket costs, federal officials have announced.

Participants can choose to work with Walgreens or CVS Health (which owns long-term care pharmacy business Omnicare) to arrange on-site management of the vaccination process when a drug or drugs become available, officials said in a Friday press briefing. 

Those eligible to participate in the Pharmacy Partnership for Long-Term Care Program include skilled nursing facilities, nursing homes and assisted living facilities. In addition, the program is: 

  • voluntary
  • free of charge to facilities
  • available to all staff members who have not yet been vaccinated for COVID-19 through other means (such as satellite, temporary or off-site clinics)
  • available in most rural areas

Federal agencies meanwhile are working to ensure “appropriate reimbursement for these services and that no American being vaccinated for COVID-19 will have to pay out-of-pocket,” stated the Department of Health and Human Services, which is jointly coordinating the program with the Department of Defense. 

Sign-up and current pharmacy contracts

The two major pharmacy chains were chosen as program partners based on their ability to handle the complex logistics of nationwide vaccine distribution and administration, said Paul Mango, HHS deputy chief of staff for policy. 

Skilled nursing facility and assisted living operators who wish to participate must fill out an online survey that is being sent to them by the National Healthcare Safety Network. They also will have the option to request continued use of current pharmacy contracts if the pharmacy is approved by the state as a vaccinator. 

“Those that choose not to participate in the program need to be prepared to have the resources to address all aspects of COVID-19 vaccination through their state health departments or other resources,” added Jay Butler, M.D., deputy director for infectious diseases, Centers for Disease Control and Prevention.

“The CDC has informed the states that long-term care facilities will have this option and will continue to reach out to those that are eligible for this program,” he said.

Long-term care pharmacies and pharmacists, meanwhile, are lobbying to work alongside the national chains in the vaccination effort.

Chad Worz, PharmD, BCGP ASCP, Chief Executive
Chad Worz, PharmD, BCGP

“We are confident that in the coming week, contracts will be signed allowing LTC pharmacies to participate alongside CVS and Walgreens,” said Chad Worz, PharmD, executive director and CEO, American Society of Consultant Pharmacists. “We encourage facilities to speak with their contracted pharmacies about their capability to provide the vaccine in the early phase [of distribution],” he said.

ASCP is concerned about the government’s arrangement to send new personnel into facilities to perform inoculations, Worz added.

“The delicate relationship between [long-term care pharmacies and pharmacists] and their facility clients is critical to safe and effective handling and administration of all dangerous medications,” he said.

The role of CVS and Walgreens

Facility operators who do choose to work with CVS or Walgreens can anticipate the need for about three visits over approximately two months to inoculate residents and staff. Two doses may be needed, depending on the vaccine used, reported the HHS and DoD. 

Federal agencies will also provide ancillary medical supply kits to program participants, officials announced. The kits will include items such as needles, syringes, alcohol prep pads, surgical masks, face shields and vaccination cards. They will to arrive on site alongside or in advance of the vaccine delivery, according to the DoD.

The strategy behind the new public-private vaccination initiative is based in part on lessons learned in a distribution pilot program conducted by the CDC in Florida, Minnesota, North Dakota and California beginning in August, Mango said.

Under the partnership, CVS and Walgreens have agreed to handle the following:

  • Scheduling and coordination of onsite clinic dates
  • Ordering of vaccines and associated supplies
  • Ensuring cold chain management for the vaccine
  • On-site administration
  • Reporting of required vaccination data to the local, state or territorial agencies as well as federal public health authorities within 72 hours of administering each dose

The companies must also adhere to Centers for Medicare & Medicaid Services requirements for COVID-19 testing for long-term care facility staff, since vaccinators will be entering the facilities, Dr. Butler said.

Waiting for a vaccine

Federal officials hinted on Friday that the necessary ingredient of this program — a safe, effective, approved vaccine or vaccines — soon will be available. Data from the makers of some leading candidates, namely Pfizer and Moderna, “are forthcoming very shortly,” Mango said.

No matter when clinical trial results are announced, drugmakers will need time to submit an application to the Food and Drug Administration and wait for emergency use authorization. That will likely take “several weeks,” Mango added.

It is expected that initial supplies may be limited, necessitating coordinated efforts to get vaccines to the most vulnerable Americans first, officials said. 

“Our planning efforts need to focus on those at highest risk for developing severe illness from COVID-19, as well as those who are critical to the response and providing direct patient care,” the CDC’s Dr. Butler said.

The long-term care pharmacy partnership program was announced the same day states were due to submit their plans for vaccine distribution to the CDC.