What's the Latest on the Vaccine? An Interview with CDC's Ruth Link-Gelles

Regulation | December 08, 2020 | by Jill Schumann

Ruth Link Gelles, Doctoral Epidemiologist at the Centers for Disease Control and Prevention, joined LeadingAge’s Coronavirus Policy Update on December 7 for an interview with Ruth Katz.

Ruth Link Gelles, Doctoral Epidemiologist at the Centers for Disease Control and Prevention, joined LeadingAge’s Coronavirus Update Call on December 7, 2020 for an interview with Ruth Katz. 

(Listen to the interview here.)

Q: After people are vaccinated, how soon will they be protected and for how long?

A: There will be more information over the next few days when the FDA meets on Thursday to review the Pfizer vaccine data for possible Emergency Use Authorization (EUA), though some answers will only be known over time. It will take a long time until enough people are vaccinated to release us from the responsibility of wearing masks, social distancing and taking other infection control precautions.

Q: Once a vaccine is approved, when might we expect the vaccine to start shipping?

A: If the process moves forward as anticipated, the FDA will meet Thursday; the Advisory Committee on Immunization Practices (ACIP) will meet Friday; the FDA will issue the EUA on Saturday and ACIP would vote Sunday or Monday. Vaccinations would then begin the week of December 14th. The Moderna vaccine is scheduled for review beginning December 17. The Pharmacy Partnership could be activated beginning December 21, depending on what each state prioritizes.

Q: Tell us more about the Pharmacy Partnership

A: Pharmacies have been providing vaccines for more than a decade. CVS and Walgreens have been a long-running partner and have a dispersed geographic footprint as well as knowledge of long term care. This partnership was created to deliver vaccines to vulnerable communities as quickly and efficiently as possible. These vaccines are not like the flu vaccines that nursing homes are used to administering. There are complicated requirements for storage and data reporting, so the CDC determined that the Pharmacy Partnership would be a good way to go.

Q: Does the Pharmacy Partnership have its own allotment or is it part of each state’s allocation?

A: It is part of each state’s allocation and states will decide the order of rollout.

Q: What responsibilities will the facility have in the Pharmacy Partnership vaccination process?

A: The Pharmacy Partnership is an end-to-end program. The pharmacies do the ordering/ receipt of the vaccines, administration, and required reporting, as well as providing all related supplies such as PPE, sharps containers, and even bandaids. Pharmacies are reaching out directly to facilities to explain the process and work out the details. Facilities need to work with families, residents, and staff to educate them and get informed consent. The will also need to determine the logistics of administration such as whether to have a central clinic location, which residents need to be vaccinated in their individual rooms, etc.

Q: How many times will a pharmacy come onsite?

A: Pharmacies will likely come an average of three times – for smaller facilities it might be two times and for large facilities it might be more. Both the Pfizer and Moderna vaccines require two doses.

Q: What is the priority order for vaccinations?

A: The ACIP has made recommendations that healthcare workers and long term care residents be vaccinated in the first phase. However, the final decisions are up to each state and it is likely that it will take time to get all of the high priority individuals vaccinated and this will vary state to state. When states activate the Pharmacy Partnership, nursing facilities will be in the first wave and assisted living, congregate IDD, HUD 202s, etc. will be in the second wave. Both residents and staff will be vaccinated. The CDC has not defined healthcare workers narrowly, so they include pretty much any one working in the defined long term care settings.

Q: What about independent living, home health, home care and hospice?

A: Independent living in Life Plan Communities is not included in the Pharmacy Partnership program, but the doses are pegged to the number of certified beds. If census in SNF and AL is low, it may be that pharmacies can vaccinate in some independent livings, but they are not the target group. Home care, home health and hospice workers are important healthcare workers, but are not part of the Pharmacy Partnership. States are planning for healthcare workers not in the Pharmacy Partnership and will be providing information about how they plan to conduct the vaccinations.

Q: Will HUD 202 staff be able to participate in the Pharmacy Partnership?

A: That depends on how closely the staff members are working with residents. It is important to vaccinate those with the highest risk first – that would include onsite service coordinators. The request is that people who can work remotely wait to let the direct service folks go first.

Q: Will the Pharmacy Partnership vaccine go to people who have had COVID?

A: That is not yet clear - we will likely learn more as data is released.

Q: Should pregnant nursing staff get the vaccine?

A: That is not yet clear – we will likely learn more as data is released.