States taking back Covid shots unused by nursing homes

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Some states trying to stretch their limited supply of coronavirus vaccines are planning to reroute doses earmarked for nursing homes, as they face mounting pressure to get shots into arms more quickly.

The states say tens of thousands of coronavirus shots designated for nursing homes and other long-term care facilities through a federal program are going unused, while health officials are speeding through the weekly supply of vaccines for the broader public after vastly expanding eligibility for the shots.

States including Maine, Michigan, Minnesota and Oklahoma are now insisting they must reclaim a portion of shots meant for the long-term care facilities or refuse allotting doses to them until they use up more supply.

“We are stressing to our districts to get vaccine moved from freezer to Oklahomans, preferably within a seven-day time period,” said Keith Reed, deputy commissioner of Oklahoma’s health department. “And this vaccine is really just sitting right now.”

Every state but West Virginia joined a federal nursing home vaccination program the Trump administration created to ensure protection for a population that’s particularly susceptible to the coronavirus. Some states have complained about the pace of that program, even though the retail pharmacy giants providing the shots — CVS and Walgreens — reported Monday they had met their goal of finishing the first round of vaccinations in nursing homes.

States revising their allocations said they’re correcting for a mismatch in supply, now that many states have cleared vaccinations for people 65 and over, and other high-risk groups. Their new strategy also comes as the Biden administration said it’s working to untangle conflicting information about the nation’s vaccine supply, as states warn they’re running out of doses while data shows many are still sitting on the shelves.

Utah is halting new shipments for long-term care facilities this week and is instead redistributing 8,775 shots to local health departments and other providers, said health department spokesperson Tom Hudachko.

“We’re not looking at this as a result of CVS or Walgreens failing to fulfill their obligation,” Hudachko said. “In fact, just the opposite: They’ve done a fantastic job in Utah of getting through their first clinics. It’s just clear to us that the federal allocation was too high.”

Minnesota is pulling 30,000 doses from the long-term care program that will instead go toward vaccinating teachers and childcare providers who are newly eligible, a state spokesperson said. Maine has transferred about 3,400 doses from CVS and Walgreens to hospitals and independent pharmacies. Michigan is sending 120,000 shots to other providers that were originally intended for long-term care facilities, according to Lynn Sutfin, a health department spokesperson.

States stressed that revising the allocations — which two state officials said must get sign off from the federal government — won’t hinder the pharmacies’ ability to vaccinate nursing homes and assisted living communities. Spokespeople for CVS and Walgreens confirmed that in some cases, the pharmacies received more vaccine than they needed and are working with states to determine how best to reclaim or defer those doses.

The Centers for Disease Control and Prevention is also helping states with reallocation, a spokesperson said.

“Now that pharmacies have made substantial progress in efforts to bring vaccination directly to the more than 70,000 long-term care facilities nationwide — and we have a better grasp of how much supply is needed to finish vaccinating these medically fragile residents and the frontline staff caring for them — we are working with pharmacy and jurisdictional partners to draw down on, or temporarily pause, those allocations where appropriate,” the agency spokesperson said.

LeadingAge, an association of nonprofit aging services providers, hasn’t heard of reallocated doses being diverted from residents or staff already scheduled to receive vaccines. However, spokesperson Lisa Sanders said the group will monitor how states change their plans.

“Our primary concern is that older adults and the people who care for them are prioritized because they haven’t been throughout this whole pandemic,” Sanders said. “If reallocation means they are not going to be prioritized, that would be concerning."

Oklahoma said its decision to pause allocations to long-term care facilities for at least two weeks will give the state an additional 21,450 shots to help vaccinate people 65 and older. Reed, the state’s deputy commissioner, said the state “will not put our elderly at risk by withholding vaccine from them.”

“I want to be very clear on that; we’re watching that very closely,” Reed said. “But it’s obvious at this point that there is sufficient vaccine within CVS and Walgreens to continue this program for several weeks at the pace they’re going.”

Over 2.7 million doses have been administered in long-term care facilities through the federal program, according to a CDC tracker. Until recently, about a quarter of distributed doses had been provided to residents and staff, but the agency has stopped publicly reporting data on distribution to the facilities.

The number of doses the federal government provided to each facility were based on doubling its bed count. But some facilities have less demand than projected because resident occupancy is low, or many staff are refusing the shots.

Other states, such as Virginia and Texas, are also deciding whether to reallocate doses from the pharmacy partnership, said officials in those states. However, they have not made final decisions.

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