How will NJ distribute COVID-19 vaccines now that nursing home residents are at the front?

Scott Fallon
NorthJersey.com

With nursing home residents moving to the front of the COVID-19 vaccination line alongside health care workers, New Jersey officials are revising their distribution plan to cover 45,000 residents and the 95,000 employees who care for them. 

Gov. Phil Murphy said this week the expected first round of 76,000 doses will be split between health care workers and nursing homes, but offered no details.

Questions still remain: Will it be an even split? How long will it take to vaccinate every home? Which nursing homes will get the vaccine first?

Answers will be needed quickly, as the U.S. Food and Drug Administration approved emergency authorization for Pfizer's vaccine Friday night, and could approve Moderna's vaccine within days. 

But even though preparations like stockpiling vaccines and distributing consent forms are already underway in New Jersey, it's still murky how health officials will determine the rollout.

“There are no specific metrics but we will be monitoring closely to ensure this process is fair and equitable,” said Nancy Kearney, a state Health Department spokeswoman.

Nursing home residents previously had been further down the priority list, behind front-line health care workers. That changed last week when a CDC advisory panel voted to add nursing home residents to the "Phase 1a" group of the first Americans to get the vaccine.

Volunteers in Moderna's COVID-19 vaccine clinical trial are injected with either a placebo or the  vaccine  candidate. In a double-blind study, neither the researcher nor the volunteer knows which it is. The nurse holds a syringe ready for injection on Oct. 23, 2020 at Hackensack University Medical Center.

The move was an "absolutely logical choice" since these residents are among the most vulnerable population that would likely inundate hospitals again without the vaccine, as they did in the spring, said Mark Cameron, a professor at Case Western University's medical school who is studying how nursing home infections spread.

"We're targeting a group where the virus has the greatest opportunity to invoke tragedy and do permanent harm," he said. "So there's a cascade of benefits that comes with" vaccinating them first. "You begin to reduce the burden of patients not only needing hospitalization but also needing critical care."

Few states will benefit more from a vaccinated nursing home population than New Jersey. Almost half of the state's more than 15,000 confirmed coronavirus deaths were residents of long-term care facilities. 

NJ COVID update:When latest modeling predicts second wave will peak

For subscribers:'You have to be out of your mind': Why restaurants are still opening in NJ during a pandemic

Gov. Phil Murphy's administration was faulted for prioritizing hospitals over nursing homes in the distribution of masks, gowns and other personal protective equipment, according to a report he commissioned.

But the head of New Jersey's leading nursing home trade group said he expects a much more equitable distribution of the vaccine.

"We've been working very closely with the Murphy administration on the vaccine even before we were moved into phase 1a," said Stuart Shapiro, the interim CEO of the Health Care Association of New Jersey. "We're expecting it to be a smooth rollout to our members."

But who gets what — and when — is still not known, Shapiro said. 

Story continues below the gallery

Walgreens and CVS will send staff to nursing homes nationwide to administer the vaccinations under a contract with the federal government. 

CVS has plans to inoculate 100,000 residents and staff at 1,100 long-term care facilities and assisted living facilities in New Jersey, said Tara Burke, a company spokeswoman.

The Murphy administration will determine how much of their initial vaccine allotment CVS will receive, and when vaccinations can begin, Burke said. "Based on what we know so far, we’ll be administering vaccines in several states before Christmas," she said.

A Walgreens spokesman could not provide any details Wednesday about its New Jersey plan. 

Preparations are already being made at the New Jersey Memorial Veterans Home at Paramus where at least 89 residents and one caregiver died during the spring COVID surge — one of the largest death tolls nationally among nursing homes. 

Consent forms were being distributed to its 194 residents, or to their guardians if the resident is incapable of making a decision. The plan calls for residents to receive the vaccines from Walgreens workers in their room. Walgreens wants to observe the residents for at least 15 minutes after being injected. The staff will be injected in designated areas. 

Shapiro said he expects the Walgreens and CVS teams to make multiple visits to the same facility since they have to vaccinate a staff that works round-the-clock, every day of the year.

While vaccines are not mandatory for staff, nursing home administrators hope the vast majority will get the shots. “As health care workers, we hope they will fully understand the value of the vaccine,” Shapiro said.

Cameron said it's important that at least 75% of a facility's residents and staff get vaccinated to control COVID's spread. 

Inoculation of staff may have to be staggered to avoid a significant portion of the workforce to be sidelined by temporary side effects from the vaccine, such as a fever or aches and pains. “We’re hopeful the callouts will be relatively small,” Shapiro said.

Cameron said it's difficult deciding who gets the vaccine first. But just having an effective vaccine ready nine months after the pandemic began is a feat in itself. 

"No matter what the prioritization is, we are starting to save lives when we start vaccinating," he said. "That's the most important thing here." 

Scott Fallon covers the environment for NorthJersey.com. To get unlimited access to the latest news about how New Jersey’s environment affects your health and well-being,  please subscribe or activate your digital account today.

Email: fallon@northjersey.com 

Twitter: @newsfallon