State officials attempted to clarify issues surrounding the arrival and plans for the COVID-19 vaccine, coming under fire for a delay in getting the shots to residents and staff in long-term care facilities.
“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,” said New Jersey Department of Health (NJDOH) Commissioner Judith Persichilli at a press briefing Dec. 21. “This proved to be a more complex task than first imagined.”
The commissioner gave a detailed overview of the vaccination program and the decisions NJDOH made to include as many vulnerable populations in congregate settings into the program as possible. Due to a missed federal deadline, New Jersey will start administering shots on Dec. 28 along with 36 other states.
Long-term Care Facilities
In October, the Center for Disease Control and Prevention (CDC) partnered with CVS and Walgreens to create the federal pharmacy partnership program to provide vaccinations to nursing homes and assisted living facilities. The agency later expanded the types of facilities admitted into the program to include those living in high-risk congregate settings.
“Within the disability community there are strong advocates who have been unrelenting in letting the department know how critically important it is to get these residents and their loved ones vaccinated as soon as possible,” said Persichilli. “The advocates gave voice to the voiceless and opened our eyes to the thousands of individuals in New Jersey relying on the department to make this decision.”
As a result, NJDOH is attempting to includes approximately 91,700 residents and 90,000 employees in nursing homes and assisted living facilities, 9,300 residents in state developmental facilities and group homes, 21,600 individuals living in HUD senior housing, 4,300 members of the staff and 1,250 residents with intellectual and developmental disabilities in five state developmental centers and the 7,600 individuals in 650 group homes.
“This was a massive undertaking,” remarked Persichilli.
According to the commissioner, besides the sheer numbers, many of these facilities did not have the information systems technology (IT) to support the requirements to get into the program. The task of uploading their information from all the facilities fell upon NJDOH. When the paperwork was finished a day too late to start vaccinations Dec. 21, the federal government denied the state a waiver to start vaccinations that week.
“This was the work that the department was engaged in, and it was a decision the department made to once again include as many vulnerable individuals as possible,” said Persichilli. “This resulted in our start date of Dec. 28.”
Complicating matters, the CDC strict rules regarding when the long-term care program can be started has been changing as they started planning as well as when the vaccines became available, according to the commissioner.
Pharmacies such handling the programs were originally required to have 50% of needed doses reserved for the program a week prior to the launch. But due to the recent reduction of Pfizer allocations, the CDC changed the requirements to 25%.
Frontline Workers First
In the first week of Pfizer allocations, the state reserved 21,450 doses to build up the reserve for the long-term care facilities, while allocating 54,600 doses to protect frontline staff in hospitals.
“That decision was made to protect staff that will be needed in the event of a second surge,” stated Persichilli. “For frontline workers in our acute care hospitals, especially in our emergency rooms and critical care units, the vaccine certainly offers a ray of hope during the dark days of this virus.”
The changing information about anticipated doses and shipments of both Pfizer and Moderna has been an obstacle for state officials to wrestle with. The previously expected second tranche of Pfizer doses was 86,775; that was reduced by 38% to 53,625. For the month of December, the expected total is now 183,300 doses, a 33% decrease of the orgicial forecast.
No Replacing Persichilli
For the total shipments from Pfizer and Moderna for the month, the expected amount is 392,800, a drop off of 20%.
Gov. Phil Murphy, who has dismissed recent calls to replace Persichilli, stressed the state is going to have to deviate from its plans as circumstances dictate.
“This is not going to be a straight line…it’s a little bit like we’ve been saying about the school year, it’s not a normal school year,” said Murphy. “It is one of the most ambitious federal government initiatives ever undertaken.”