Doctor/Nurse injecting syringe on arm of a Senior Patient.

While nursing home advocates like LeadingAge and the American Health Care Association lauded last week’s federal loosening of restrictions on facilities giving COVID-19 booster shots in order to increase uptake, at least one stakeholder group hasn’t joined the bandwagon.

“Window dressing” is how the executive director and CEO of American Society of Consultant Pharmacists described changes announced Thursday in the White House’s Covid-19 Winter Preparedness Plan.

The main shift in the CDC COVID-19 Vaccination Program restriction is to allow long-term care providers to skip reporting vaccination data to a state, local or territorial Immunization Information System unless required by law, ASCP’s Chad Worz, PharmD, told McKnight’s Long-Term Care News Monday.

“Within 24 hours of administering a dose of COVID-19 Vaccine and adjuvant (if applicable), Organization must record Vaccine Administration Data in the medical record of any vaccinated resident or staff member and, if required under the state Immunization Information System (IIS) statute, report such Vaccine Administration Data for all doses administered to the relevant state, local, or territorial IIS,” says the sub-provider agreement, which is effective until March 15, 2023.

“If otherwise not required under state law, Organizations subject to this sub-provider Agreement are not required to report Vaccine Administration Data to the IIS under this Agreement.”

Not all it seems

Worz said what seems to make things easier for LTC facilities to receive and administer vaccines to residents removes a bright spot from the previous arrangement.

“LTC pharmacies could always create a relationship with staff nurses to administer.They were just ultimately responsible for the entire process,” he explained. “The waiver seems to eliminate that responsibility to report administration back to the pharmacy. Unfortunately, this will muddy the water with regards to surveillance. The silver lining to the process as it existed prior to this waiver was the reporting into the state IIS systems.  

“Now, it sounds like we don’t care if it gets reported or not,” Worz added. “This might make it somewhat easier, but I doubt it moves the needle very much and it opens the door for manipulated data, no data, and potentially safety concerns if, like prior to COVID-19, people received extra or failed to receive a vaccine based on poor history information on the resident.”

More than 86% of nursing home staff and residents have completed their primary COVID vaccinations, but less than 47% of residents per facility and just over 22% of staff have updated their vaccines with boosters, or gotten their second primary dose in the last 60 days, according to the latest government figures

According to the CDC, only 14% of Americans aged 5 and up have gotten a booster shot. Worz also worries that the agreement change could be used to blame the nursing homes later for the perceived poor uptake.

“This is already happening, and no one seems to want to give credit to the sector for having four times the booster rate of the public for residents and two times the rate for staff,” he said. “To me, this speaks to poor messaging overall on the bivalent booster. No one is convinced. We are making inroads to the most vulnerable in nursing homes and we need to double down on messaging for that group, but too many want to continue pressing everyone to get it regardless of the lack of data in many groups.”