A doctor injecting a senior with a vaccine booster shot

The CDC’s independent vaccine advisers voted 13-1 Thursday to recommend updated COVID-19 vaccine boosters from two manufacturers for all US adults, including seniors and others who have already had two previous boosters.

Vaccines were expected to ship immediately.

The nation’s long-term care facilities and staff should be well versed in what comes next, said Gregory Johnson, MD, chief medical officer at Evangelical Lutheran Good Samaritan Society, one of the nation’s largest not-for-profit providers of senior care and services. 

“I think it’s exciting that because we anticipated a positive response from [the CDC] vaccination sub-committee, people are poised to take action right now, and we would expect to see vaccines as early as next week,” Johnson said. “I feel like when we get questions like, ‘How will you distribute it,’ we say, ‘We’ll distribute it like we’ve been distributing vaccines for the last two years.’

“It’s actually a fairly well-oiled machine at this point for both residents and staff.”

Johnson said the trials and tribulations of the past two-plus years have not only honed processes but also systems for vaccine distribution.

“We learned a lot from Operation Warp Speed, when the government worked with long-term care pharmacies to leverage the infrastructure that’s already there to supply medications like blood pressure medication or even flu vaccines, historically,” he said. 

“We learned to use that same infrastructure, and that is what everyone will use this time as well. That is what Good Sam will employ.”

Good Samaritan was one of the first major skilled nursing providers to require staff vaccination, and it has strongly encouraged administration of ensuing boosters.

But many operators have struggled to convince as many residents and staff to receive boosters as received the initial vaccine series. According to the Centers for Medicare & Medicaid Services, more than 56% of nursing home residents are up to date on vaccinations, while 42% of nursing home staff are. Those numbers compare to about 87% coverage with the primary vaccine series.

The Food and Drug Administration authorized the latest boosters to battle the original strain of the coronavirus as well as Omicron subvariants BA.4 and BA.5. Pfizer’s booster is authorized for people as young as 12. Moderna’s is for those 18 and over.

“I think regardless of vote,  we need to focus on at-risk people and older adults, especially those in long-term care who are the most vulnerable,” said Chad Worz, PharmD, executive director and CEO of the American Society of Consultant Pharmacists. “In that vein, we need to speed the vaccines to the long-term care pharmacies for rapid deployment into the LTC settings. This was done with the original vaccine and glossed over with subsequent therapeutics which were made widely available immediately.

“Pharmacies and pharmacists have stepped up during the pandemic to deliver vaccines into arms in LTC and that needs to continue [with a ] variety booster approved,” he added.

Staff at many nursing homes are ready to coordinate vaccinations, said Tammy Lundstrom, MD, senior vice president and chief medical officer at Trinity Hospital, who leads the COVID-19 response for Trinity Health.

“We would offer vaccination with updated boosters to all colleagues and patients as soon as they become available,” she said. “Since immune protection after booster seems to decrease faster in those age 65 and older, it will be particularly important to strongly encourage all those in nursing homes and CCRCs to get the updated bivalent booster as soon as it’s available, as well as to receive influenza vaccine. Both can be given safely on the same day.”

The FDA said on Wednesday that people needed to wait at least two months between a previous booster and the new shots, a stance that the CDC also pursued on Thursday.

The New York Times reported Thursday afternoon that doses had begun shipping. CDC Director Rochelle Walensky made a formal recommendation of the boosters Thursday evening.

This story has been updated to include comment from Chad Worz of the American Society of Consultant Pharmacists and to reflect the CDC director’s final decision.