COVID cases are on the rise again in nursing homes, and the largest nonprofit provider advocacy is asking the White House to create and stick to an annual vaccination schedule to help combat vaccine fatigue and mistrust about managing the virus.
According to information released by the Centers for Disease Control and Prevention last week, COVID fell to the 10th leading cause of death for all Americans last year, down from the fourth leading cause in 2022.
While that indicated good news about the ability to treat the virus, cases are once again spiking across the US this summer. The CDC tracker indicates that COVID levels in parts of the country – California, Florida, North Carolina and Texas – are “high.”
In nursing homes, the COVID has been steadily increasing since May, when cases had dropped to 1,554. But that rebounded to 9,915 by Aug. 4 — similar to numbers seen during last winter’s spike
The number of nursing home deaths attributed to COVID are also on the rise. In May, that was at 52 – the lowest reported since COVID emerged in early 2020. But there were 114 reported deaths during the week ending Aug. 4.
Amid the mounting concern, major nursing home advocacy organizations have been asking for more support nationally.
After participating in the July 18 White House Long-Term Care Leadership Summit 3.0, LeadingAge sent a sternly worded letter to Maj. Gen. (ret) Paul Friedrichs, MD, FACS, director of the Office of Pandemic Preparedness and Response Policy, detailing barriers to vaccination the group has heard from its members. The barriers boiled down to vaccine fatigue, mistrust stemming from the frequently changing federal recommendations for virus mitigation, and the influence of family and friends.
“Sadly, it appears that efforts to provide the public with the most up-to-date information and tools for mitigating COVID have backfired,” read the letter, signed by LeadingAge’s director of Nursing Home Quality & Policy Jodi Eyigor. “COVID mitigation strategies for healthcare settings changed frequently throughout the public health emergency, and while flu shots are recommended only once per season, COVID vaccine recommendations have also changed frequently over the years, with new variant vaccines introduced seemingly every few months and additional doses often required for high-risk populations. This has led residents/families and staff to subsequently conclude that COVID mitigation measures and COVID vaccines are ineffective, since recommendations have been updated so many times.”
The letter also said residents, their families and facility staff “have all been overwhelmed by the number of vaccines,” and they became “confused’ about the number of vaccines required.
“[M]any are reluctant to continually inject vaccine product into their bodies, particularly more than once per year,” the letter said. “Some protection is better than none, but we will get none if we keep moving the target.”
LeadingAge suggested the COVID vaccine be put on an annual schedule similar to flu shots, but that the two vaccines remain separate.
Additionally, the letter raised concerns about the early end to the CDC Bridge Access Program, noting there are no funds set aside for the agency’s Vaccines for Adults program. LeadingAge also said that the continued costs of COVID vaccines are “still too great to be absorbed” by facilities, and that pharmacies for on-site clinics aren’t willing to risk reimbursement issues due to that high cost.
LeadingAge wants a whole-of-system approach throughout the entire healthcare continuum so that all healthcare providers who are involved with seniors, especially those who have long-standing relationships with LTC facility residents.
“Nursing home critics often contend that there is no trust in nursing homes or nursing home staff,” Eyigor wrote. “While our members care deeply for the older adults they serve and work hard to earn their trust, we must leverage the trust that older adults have in the healthcare providers that they have known longer. The residents/families may not trust the staff of the nursing home where they have lived for only a few short months. But they trust the cardiologist they have been seeing for the past 10 years, and this cardiologist needs to start talking.”
A LeadingAge spokeswoman told McKnight’s Long-Term Care News that nursing homes and assisted living facilities can still request COVID test kits through a weekly distribution from the US Department of Health and Human Services, and that program is expected to run through 2025.
In an emailed statement to McKnight’s on Friday, American Health Care Association Chief Medical Officer Dr. David Gifford said that their members are also seeing “significant challenges with vaccine reluctance.”
“Long-term care communities do not operate in a vacuum,” Gifford said. “The challenge in battling vaccine reluctance (misinformation, hesitancy, and fatigue) is not unique to the long-term care community but is systemic among the US population at large. There is not one thing that will fix this challenge—it really takes a multi-pronged approach. Increasing uptake requires a collective endeavor by public health officials, other health care providers, and the general public.”
