Image of masked clinician and patient talking in clinic visit

With Phase 1 of the federal COVID-19 vaccination program ending soon, the focus is shifting to ensuring continued vaccine access for long-term care residents and staff members.

While long-term care operators await federal guidance, industry advocates have laid out answers to frequently asked questions on the topic: How to facilitate a smooth transition to a new vaccine supplier, and how to guarantee second doses for anyone who receives their first dose at the third and final onsite vaccine clinics.

In a LeadingAge membership call on Monday, the association said that long-term care operators can continue receiving COVID-19 vaccines in three ways:

  • Work with a participating long-term care pharmacy enrolled through the Federal Retail Pharmacy Program.
  • Check with the state where a facility is located to determine whether a long-term care pharmacy is enrolled as a COVID-19 vaccine provider. Your existing pharmacist may or may not be enrolled.
  • Enroll with the state as a COVID-19 vaccine provider: Some states will allow long-term care providers to directly vaccinate their residents and staff members on an ongoing basis. 

Receiving a first dose at the third and final clinic

Pharmacies will follow state guidance on whether to initiate first-dose vaccinations at final onsite clinics, according to the Centers for Disease Control and Prevention. Some states have asked pharmacy partners not to do so because of vaccine availability concerns. In such cases, the CDC suggests referring to the aforementioned options.

But for residents and staff members who are able to receive a first dose of the Moderna or Pfizer-BioNTech vaccine at the third and final clinic, the CDC has the following advice and information:

  • Clinical leadership and other long-term care administrators should determine ahead of time whether a local provider will be available to provide the second dose.
  • Some long-term care pharmacies will provide Moderna vaccines through the Federal Retail Pharmacy Program or through state immunization enrollment programs.
  • Staff members or discharged residents will need to seek their second doses in the greater community at a retail pharmacy location or through their local health departments.

Facilities in states that are delivering the Pfizer-BioNTech vaccine through the Pharmacy Partnership for Long-Term Care likely will have a challenge accessing a second dose due to the Pfizer drug’s unique storage requirements, cautions the American Health Care Association / National Center for Assisted Living. 

When all other options for finding a second dose source are exhausted, clinical leadership should consider the following options, said the AHCA / NCAL:   

  • Counsel residents to finish the vaccine series using the Moderna vaccine. The Advisory Committee on Immunization Practices recommends this option in “exceptional situations” and that the second dose be given within 28 days.   
  • Delay timing of the second dose administration up to six weeks or 42 days for either the Pfizer or Moderna vaccine.

The CDC is expected to provide additional guidance on its website in the coming weeks.