COVID-19 booster shots are being fast-tracked for approval by federal health officials, and residents in nursing homes could be among the first to receive them. 

If and when that happens, however, experts are warning officials not to repeat the mistakes of the past and this time utilize long-term care pharmacies to distribute the doses. 

Michael Wasserman, M.D.

“That should not even be a question,” geriatrician Michael Wasserman, M.D., told McKnight’s Long-Term Care News on Friday. “We should’ve learned CVS and Walgreens were not the ones to do this. Long-term care pharmacies know what they’re doing. They have consultant pharmacists working with them. This is all doable.” 

The federal government is racing to approve COVID booster shots within the next two weeks and immunocompromised adults would be the top prioritized group to receive them, according to a weekend report by the Washington Post. The aim is to allow Americans with weakened immune systems who have not responded well to COVID-19 vaccination to receive a third and potentially immune-boosting injection.

Some experts have suggested the authorization could eventually extend to the elderly and nursing home residents, who were among the first to receive the COVID-19 vaccine.

Wasserman noted that based on data he’s seen so far, he’s not sure how necessary a COVID booster shot is for residents at this time. He stressed the importance of getting others around them fully vaccinated. 

“I really cannot say based on the evidence that I’ve seen that that’s going to make a big difference, whereas getting all of the staff fully vaccinated has clearly become our most pressing need,” Wasserman explained. 

“If residents are vaccinated, they’re highly protected but the only way they’re exposed now to the virus is from staff and visitors. So getting the staff and visitors fully vaccinated is critical,” he added. 

LTC pharmacies key for distribution 

However, if the decision is made to give boosters to nursing home residents, he said it’s imperative that federal health officials fully engage long-term care pharmacies to distribute the shots. 

“That was necessary with the initial [vaccine] rollout,” Wasserman said. He also noted West Virginia’s success in getting long-term care residents vaccinated quickly and said any holdups could potentially hurt residents.

“Long-term care pharmacies know the workflow of nursing homes,” Wasserman said. “We saw that when there were delays in getting nursing homes [and other long-term care facilities] vaccinated because CVS and Walgreens did not understand nursing homes … [officials] must use the existing distribution channel of long-term care pharmacies.” 

One long-term care physicians’ group foresees a delivery strategy that uses both the big commercial pharmacies and their long-term care cohorts.

Image of Christopher Laxton, executive director, AMDA
Christopher Laxton, executive director, AMDA

“We’ve seen a [delivery] model with CVS and Walgreens. That may be a way to go again with boosters,” said Christopher Laxton, CAE, executive director of AMDA – The Society for Post-Acute and Long-Term Care Medicine. “I would suggest at a minimum we would involve our pharmacy care partners in delivery and in making sure the infrastructure is there to make the booster doses — once they are available and justified — deliverable quickly,” he told McKnight’s.

But the pharmacy partnership system wasn’t perfect, Laxton added. Though pharmacy partnership was an effective model that delivered a lot of vaccines, “there are still pockets where it was hard to get the vaccine delivered,” he said.

Long-term care pharmacies, outside of CVS and Walgreens, are already in place and effective for delivery, Laxton said. There may be some logistical challenges, “nonetheless I think it’s doable — and now would be the time to think about it.”