Now that a COVID-19 vaccine has reached Kansas, residents and employees of long-term care homes are expected to be among the first groups of people offered the vaccine.
The question is how many of them will choose to take it. Public health officials and the homes’ operators strongly endorse the vaccine, but polls have shown that many Americans remain skeptical or opposed.
‘It’s definitely a real challenge,” said Ali Ellis, marketing director for Midwest Health, which operates eight Homestead senior living communities in south-central Kansas. More than 2,500 seniors live and about the same number of employees work in those communities.
“With any medical treatment, it’s totally their choice,” Ellis said. “While we hope they take it, any and all medical decisions are always their decision.”
Long-term care homes have experienced the deadliest clusters of COVID-10 across Kansas and the nation. The coronavirus has caused or contributed to at least 113 deaths in federally licensed homes in Sedgwick, Butler and Harvey counties, according to records of the Centers for Medicare and Medicaid. There have been additional deaths in state-licensed homes.
Since the homes have been closed to most visitors since the spring, it’s assumed that the virus has been spread by employees in many cases.
Rachel Monger, vice president of government affairs for Leading Age Kansas, a long-term care industry group, agreed the vaccination “won’t be mandatory for residents, because of course everyone has the right to refuse medical treatment.”
If a resident refuses to be vaccinated, Monger said, “I’m sure the home will try to do some education to see if something can be worked out.”
Monger said it’s unclear if the homes can require their staff to be vaccinated, adding that “it’s very uncommon for an employer to mandate a vaccine for their employees.”
The nation’s medical authorities say a vaccine is the only way the pandemic will be stemmed before it causes tens of thousands of more deaths.
The American Medical Association, for instance, said physicians “know that vaccines will save lives and help us turn the page on this virus. Vaccines have eradicated smallpox, nearly eliminated chickenpox and polio, and minimized the impact of countless other diseases. To achieve a similar result from COVID-19 vaccines requires trust in the process to develop, distribute and administer a safe and effective vaccine and broad willingness to get vaccinated.”
Widespread vaccinations are expected to present a number of supply and logistical issues.
The first people to receive the vaccine in the Wichita area were nurses and other staff at Ascension Via Christi St. Francis Hospital, on Dec. 14. The first phase of Kansas’ vaccination plan calls for medical personnel in direct contact with COVID-19 patients and the residents and employees of long-term care homes to receive it first.The state estimates that’s about 35,000-40,000 people, each needing two doses. But the state only expects to get 23,750 doses in the first deliveries.
As more vaccines become available, distribution will expand to other essential workers and at-risk populations in Phase 2, likely next spring. Then, as production ramps up more, the state will move to Phase 3 sometime next summer and provide the vaccine to everybody who wants it.
But the exact order of who gets it and when remains vague.
The first two approved vaccines need to be stored at temperatures ranging from -15 to -80 degrees Celsius. While the state doesn’t need to purchase extra or special freezers, getting the vaccine from storage into the hands of hospitals and clinics across the state, and ultimately into Kansans, is complex.
The Pfizer vaccine, for example, can be stored for up to six months at one of the state’s five ultra-cold freezer storage locations.
But to leave the ultra-cold storage facility and get to individual clinics, it will need to be packed in special containers filled with dry ice. Those thermal containers can keep the vaccine at a safe temperature for up to five days.
When a clinic is ready to administer the vaccine, workers will thaw it, dilute it and place it in a syringe, which has to be used within six hours.
Get any of those steps wrong and the vaccine becomes ineffective and has to be thrown out. Monger said most care homes are working with two large pharmacy chains — CVS and Walgreens — that are partnering with the federal government to administer the vaccine in those homes.
“It’s each home’s responsibility,” she said, calling it “a big logistical lift that they’re trying to get their arms around.”