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The Health 202: Nursing home residents are getting vaccinated. Staff are refusing at worrying rates.


The program is a partnership involving the federal government, major pharmacies including CVS and Walgreens and long term care facilities. Once a facility enrolls in the program, pharmacy staff provide in-house vaccine clinics, typically on three separate occasions to allow residents and aides multiple opportunities to receive the shots.

The program achieved “moderately high coverage among residents” in its first month, the report’s authors wrote – an encouraging conclusion, given the frustration that has surrounded the initial vaccine rollout in the U.S.

But vaccine uptake was much lower among staff, just 37 percent on median.

The hesitancy among long-term care workers – which experts say isn’t terribly surprising  – leaves major gaps in the quest to shield nursing homes from the virus. The problem is two-fold: unvaccinated staffers can transmit the virus to the sizeable minority of residents who refused the vaccine – or to new residents who may not have a chance yet to get immunized.

“I think it’s great the majority of residents are getting the vaccines, but we know the main pathway into the nursing homes is staff,” said David Grabowski, a professor of health policy at Harvard Medical School who focuses on aging. “Then it leads to these major outbreaks.”

Surveys have shown significant vaccine hesitancy among health care workers, stemming from a variety of reasons including mistrust in government authorities and medical systems, and online misinformation. David Grabowski, a Harvard University health policy professor, recently told my Post colleagues the hesitancy “shouldn’t surprise anyone familiar with long-term care facilities, where low wages and poor labor conditions — and earlier missteps fighting the coronavirus pandemic — have created a well of mistrust, especially among the Black and Latino workers who dominate the industry,” 

It’s also possible those figures could be an underestimate, the report conceded. For example, sometimes long-term care staff are encouraged to seek vaccines elsewhere, and some may have declined the vaccine at a facility’s initial clinic with intentions to get it at the second or third clinic. Still, the data underscore yet another challenge facing public health officials in trying to persuade vast swaths of the country to accept the new vaccines.

The only state that opted out of the federal program did extremely well on its own.

West Virginia managed to beat nearly every other state at long-term care immunizations.

The state was the only one to forgo the pharmacy partnership program, instead drawing on its own vast network of local pharmacies to get the job done. One-and-a-half months into the vaccine rollout, it has outpaced every other state except Alaska, administering at least a first shot to 10.9 percent of residents.

“By the time a lot of people…were sitting around on their hands wondering what in the world to do, we had all our nursing homes vaccinated,” West Virginia Gov. Jim Justice told The Post yesterday. “This is not rocket science but you gotta move.”

West Virginia has emerged as a success in the nation’s otherwise chaotic coronavirus vaccine rollout. Gov. Jim Justice says the state took a “real practical approach” to its vaccine distribution by bringing vaccines to the people instead of trying to bring residents to the vaccine. The state is using mom-and-pop pharmacies to distribute shots instead of chain stores. They’ve also put the National Guard to work. “We saved a lot of lives here. It’s not rocket science, but you’ve got to move.” (Washington Post Live)

Fatalities in long-term care facilities have been severe, but there are some positive signs.

Thirty-six percent of all covid-19 deaths in the U.S. have occured among residents and staff in long-term care, according to The Covid Tracking Project. In Minnesota, Rhode Island and New Hampshire, it’s more than 60 percent.

But after weeks of steadily rising, cases and deaths in long-term care centers are starting to fall.

The CDC also reports more women have been vaccinated than men.

The agency released a second report yesterday, this one looking at the gender, racial and ethnic breakdowns of who received the vaccine as of Jan. 14.

The report shows 63 percent of the nearly 13 million people vaccinated in that period were women, 55 percent were older than 50, and 60 percent were White, Akilah Johnson reports. Race and ethnicity information was missing for about 48 percent of people who received at least one dose of the vaccine, though the data on gender and age was nearly complete.

Larry Levitt, a senior vice president at the Kaiser Family Foundation:

“About 14 percent of those who received at least one shot nationally were categorized as multiple or other race/ethnicity, 11.5 percent as Latino, 6 percent as Asian, and 5 percent Black,” Akilah writes. “The study notes that the demographics of those people vaccinated somewhat reflect the demographics of health-care workers and residents of long-term care facilities — the people in the Phase 1 vaccination priority group — while cautioning that the analysis is hamstrung by the missing information.”

Ahh, oof and ouch

AHH: The White House is buying 8.5 million rapid coronavirus tests that can be taken at home with no prescription and yield immediate results.

“The $231.8 million contract will allow the Australian company Ellume, which manufacturers the tests, to quickly scale up its production and create a manufacturing facility in the United States,” William Wan reports. “Once running, that factory will be able to produce 19 million tests per month.”

“For the past year, many experts have called for the development of cheap, rapid home tests as a way to catch and stop viral transmission,” William writes. “Because so much of the transmission occurs among people showing no symptoms, giving Americans an inexpensive way to test themselves regularly would be a breakthrough. But even as testing technology improved, the cost and availability of such tests lagged and remained prohibitive.”

Ellume’s home coronavirus test was the first over-the-counter, rapid coronavirus home test to be authorized by the FDA, approved Dec. 15. But the test was expected to be available only in limited quantities.

“The purpose of today’s announcement is to move to mass production and scale,” said Andy Slavitt, President Biden’s senior adviser for covid-19 response, at a Monday news briefing.

OOF: New York Gov. Andrew Cuomo has all but declared war on his own public health bureaucracy.

At least nine senior New York state health officials have left the department, resigned or retired in recent months, the New York Times reports. The stream of high-profile departures in the middle of the pandemic came as morale plunged in the Health Department and senior health officials expressed alarm to one another over being sidelined and treated disrespectfully.

Cuomo declined to use the longstanding vaccination plans that the State Department of Health had developed in recent years in coordination with local health departments. Instead, he adopted an approach that relied on large hospital systems to coordinate vaccinations not only of their own staffs, but also of much of the population.

“In recent weeks, the governor has repeatedly made it clear that he believed he had no choice but to seize more control over pandemic policy from state and local public health officials, who he said had no understanding of how to conduct a real-world, large-scale operation like vaccinations,” they write. “After early problems, in which relatively few doses were being administered, the pace of vaccinations has picked up and New York is now roughly 20th in the nation in percentage of residents who have received at least one vaccine dose.”

“When I say ‘experts’ in air quotes, it sounds like I’m saying I don’t really trust the experts,” Cuomo said at a news conference last Friday. “Because I don’t. Because I don’t.”

OUCH: A Trump campaign pollster has concluded the former president lost the election largely due to his handling of the pandemic.

A 27-page post-election autopsy completed by Trump campaign pollster Tony Fabrizio shows that voters in 10 key states rated the pandemic as their top voting issue, and President Biden won higher marks on the topic, Josh Dawsey writes. The report also indicates that Trump lost ground among key demographic groups he needed.

“The internal report cuts against Trump’s claims that the election was stolen from him and that Biden could not have fairly beaten him — and mirrors what many Trump campaign officials said privately for months,” Josh writes.

The states studied were Arizona, Georgia, Michigan, Pennsylvania, Wisconsin, Florida, Iowa, North Carolina, Ohio and Texas, comparing states that Trump held with states Biden flipped.

The report says that voters found Biden more competent to deal with the coronavirus crisis and in both groups gave him higher marks on being honest. Although Trump “dominated” among voters focused on the economy, according to the analysis, “Biden won Coronavirus voters, which was a bigger share.”

It also outlines how Trump lost key demographic groups that he needed to win, while lauding some of his gains among minority groups.

“POTUS suffered his greatest erosion with White voters, particularly White Men in both state groups. However, he made double digit gains with Hispanics in both groups, while his performance among Blacks was virtually the same as 2016. POTUS lost ground with almost every age group in both state groupings,” the autopsy reads, adding that the worst loss was among White college-educated voters.

Sugar rush



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