Long-term care delayed, pharmacy distribution network planned
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By Lilo H. Stainton
As New Jersey enters the second week of its COVID-19 vaccine rollout, state officials are facing criticism for not moving faster to ensure nursing home residents had the earliest possible access to immunizations.
But New Jersey health commissioner Judy Persichilli said the timeline — which shows vaccinations in nursing homes starting Dec. 28 — reflects the state’s desire to include as many vulnerable individuals as possible in the federal pharmacy partnership to immunize those in long-term care and other congregate living facilities. The rollout has also been complicated by unexplained shipping delays and federal program requirements, she suggested.
Persichilli and Gov. Phil Murphy took much of Monday’s media briefing to provide updates on the pharmacy program, which initially appeared to be targeted to serve just long-term care, and federal plans to ship the vaccine. As of Sunday afternoon, 26 hospitals in New Jersey were immunizing at-risk health care workers and 8,740 people had received the first of the two shots of Pfizer’s vaccine, Murphy said.
Here’s what else we know as of Monday:
Persichilli said the Department of Health missed a deadline to begin vaccinations one week earlier as a result of the volume of data that needed to be uploaded into a federal computer system. The sizable upload related, in part, to the DOH decision to include not just long-term care residents but also elderly residents in federal housing and individuals with disabilities in state care.
“This was the work the (health) department was engaged in and it was the decision the (health) department made to once again include as many vulnerable individuals as possible that resulted in our start date of December 28th,” Persichilli said. “It was a decision made to give access and hope to those in need, not the least among us, but for those who should be first,” she said, adding, “this proved to be a more complex task than first imagined.”
What the program looks like
As a result, the federal program with CVS and Walgreens will provide vaccines to residents at some 1,800 congregate living sites in New Jersey, officials said. The process will begin at nursing homes and other long-term care facilities; the state is waiting for a detailed schedule:
- Long-term care — 91,700 residents and 90,000 staff
- Federal senior housing sites — 21,600 residents
- Continuing care retirement — 2,440 residents
- State-run developmental centers — 1,250 residents and 4,300 staff
- Group homes and long-term housing for disabled individuals — 7,600 residents
“All of these individuals are at high risk,” Persichilli said. “Due to the number of individuals involved, this will take some time, but the vaccinations will be rolled out in an orderly manner with vaccinations taking place at sites where the residents reside.”
The state operates five facilities for individuals with significant intellectual or developmental disabilities and 650 group homes through contracts with community-based provider groups; thousands of other residents live in private homes. The DOH has launched rapid testing and provided other resources to assist in the pandemic response, but controlling the spread of infection in these facilities is a challenge.
“Remember, it’s a two-shot deal, so this is a big program,” Persichilli added, noting both the Pfizer and Moderna vaccines require two shots, several weeks apart. “It will take a while.”
Persichilli said the timeline was also complicated by federal rules that required the state to have 50% of the doses needed to vaccinate this entire group of congregate residents in advance of launching the process; this was later reduced to 25% when shipping delays emerged nationwide. Murphy announced last week that New Jersey could receive one-third fewer vaccines initially than expected as a result of these changes.
Persichilli said Pfizer — the first company to receive federal emergency approval — is expected this week to provide 34,125 vaccines for New Jersey’s congregate living program. Another 28,000 Pfizer doses for this program are to be shipped in the weeks to come, she said.
New Jersey is also anticipating fewer doses of the Moderna vaccine, which received emergency authorization last week, than initially expected, but deliveries will began Monday as planned. Persichilli said the first shipments would go to 18 hospitals, two federally funded community clinics and two urgent care centers. These facilities are slated to vaccinate health care workers in the community at risk for contracting the virus.