JUDY WOODRUFF: As we reported, President Biden is trying to ramp up how quickly vaccines
can be given to Americans and to increase the supply for this summer. That includes
a plan to get 200 million more doses combined of the Moderna and Pfizer vaccines.
From the outset, federal health officials have made vaccinating residents of long-term
care facilities a priority.
But, as John Yang reports, more than a month into the campaign, there are concerns about
how long that effort alone is taking.
JOHN YANG: Judy, to understand that priority, consider this. By one count, long-term care
facilities -- that's nursing homes and assisted living centers -- account for about 6 percent
of COVID cases, but 40 percent of virus-related deaths.
And now some state officials are worried that vaccination are moving on to other parts of
the population before long-term care residents are inoculated. As of today, the Centers for
Disease Control and Prevention says that 2.7 million doses have been administered at long-term
care centers. That's about 11 percent of all doses nationwide.
David Grabowski is a professor of health care policy at the Harvard Medical School.
David, thanks so much for joining us.
Given this, that everyone acknowledges this is a high-risk population in high-risk locations,
the CDC says inoculating these people will save lives, is this going fast enough?
DAVID GRABOWSKI, Harvard Medical School: I don't think, John, it's actually going fast
enough.
You cited the number this the introduction right there. Roughly 40 percent of the deaths
occur in long-term care facilities. This is the population we need to protect. We need
to get this population and their caregivers vaccinated as quickly as possible.
The 2.7 million vaccine doses, that sounds like a big number, but consider there are
roughly three million individuals living in nursing homes and assisted living facilities.
When you add their caregivers, you're up to about five million individuals that need to
be vaccinated.
Each of those individuals will need two doses. And so, yes, 2.7 is a big number, but it's
probably just about one-fourth of the way there. And so we have a long ways to go in
terms of vaccinating this population.
JOHN YANG: What are the hurdles to moving faster?
DAVID GRABOWSKI: The hurdles are large.
Unlike the general population, where you set up a vaccine clinic and the population goes
to the clinic, here, you have to bring the clinics to the long-term care facilities.
And there are 30,000 nursing homes and assisted living facilities around the country.
And so, in order to get the population vaccinated, the federal government contracted with CVS
and Walgreens. The good news is, those are big companies. And, in some states, that process
is working relatively well. But, in other states, it's going far too slow.
And in a number of parts of the country, those companies only have so much bandwidth. They
can only be in so many long-term care facilities per day. So the process, John, is just moving
too slow.
JOHN YANG: You say the bandwidth is not wide enough. How do you solve that problem?
DAVID GRABOWSKI: Sure.
So, by contracting with these two companies, CVS and Walgreens, they only have so many
pharmacists and they only have the ability to be in so many nursing homes. It's actually
interesting. The state that did the best in terms of vaccinating nursing home residents
and caregivers was West Virginia.
The interesting thing about West Virginia, they opted out of the federal program, so
they didn't work with CVS and Walgreens directly. They went ahead and contracted with a series
of pharmacies in order to vaccinate residents and their caregivers. They did end up working
with Walgreens, but a bunch of other local pharmacies as well.
They got the National Guard involved. It was an all-hands-on-deck approach, John. And it
actually ended up working quite well. And they were first in the nation in terms of
vaccinating nursing home residents.
JOHN YANG: Another issue we hear a lot about is the hesitancy of the staffers, the caregivers
at these long-term care facilities to get the vaccine. How do you solve that?
DAVID GRABOWSKI: This is a huge issue.
So, the numbers we're hearing, about half of all staff aren't getting vaccinated. So
that's much lower than the number of residents. We're hearing about 80, 85 percent of residents
are choosing to get vaccinated, but far too few staff are getting vaccinated.
Some facilities, it's quite good, but some facilities, it's 20 percent, 25 percent of
staff. So, we have a long way to go there.
How do we get better? I think we need to change the narrative here. The approach to date by
the federal government has been, let's provide more staff with information. That's very necessary.
We do need to convince them that this vaccine is safe and effective. They're quite worried
about side effects. They're quite worried about safety.
But they're also quite distrustful of nursing home management and leadership. They're distrustful
of the government. It's not just the message they're hearing. It's who they're hearing
it from.
JOHN YANG: We're at a point where we're turning a page. We have a new administration coming
in, rethinking this whole thing. If you were to be advising the new Biden administration,
what would you tell them?
DAVID GRABOWSKI: I would tell them three things.
First, we need to go faster. And CVS and Walgreens are doing a great job in some parts of the
country, but it's going far too slow in others. Let's get other pharmacies involved in those
areas of the country where things are moving too slowly.
Second, we need to address the hesitancy. The rates among staff are far too low. We
need to not just provide them with information. We also need to change who is providing that
information. We need to rely on relationships, and we need to build trust with staff in terms
of messaging.
And then, finally, we have been flying blind. We have these national numbers on vaccine
doses. We have very little information on the ground in terms of what's happening in
facilities.
JOHN YANG: David Grabowski, professor of health care policy at the Harvard Medical School,
thank you very much.
DAVID GRABOWSKI: Thanks, John.