Michigan makes big strides on nursing home vaccinations

Every person who wants a coronavirus vaccine who lives in a skilled nursing facility in Michigan has had the chance to get at least a first dose, said Dr. Joneigh Khaldun, the state's chief medical executive, in written testimony Tuesday submitted to the House Energy and Commerce Oversight and Investigations Subcommittee.  

As of Jan. 28, 104,209 doses of COVID-19 vaccines had been injected into the arms of residents and staff, she said. 

And by the end of February, Khaldun said she expects all of the staff and residents at the state's 4,400 long-term care facilities, which include nursing homes, assisted living and skilled nursing facilities as well as adult foster care homes and homes for the aged, will have had a chance to get at least a first dose. 

However, it is unclear what that might mean for strict visitation rules at nursing homes and other long-term care facilities that have kept families separated from their loved ones for nearly a year.

When asked by the Free Press on Tuesday whether widespread vaccination at long-term care facilities might lead to a loosening of visitor restrictions, Lynn Sutfin, a spokesperson for the state health department, said she didn't know. 

"I do not have any information on that at this time," she said.

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Khaldun said Tuesday that "while we are thrilled that many in this population have quickly received this lifesaving vaccine, the rollout has not been without its challenges."

Among them is that responsibility for vaccinating residents and staff in long-term care facilities in Michigan was not divided equally between CVS and Walgreens, which won federal contracts to give the shots. 

State health officials worked with the U.S. Centers for Disease Control and Prevention to bring in a third organization to help manage getting vaccines to people who live and work in long-term care facilities in Michigan, Khaldun said. 

Managed Health Care Associates Inc., which has a network of independent pharmacies that already work with long-term care facilities in the state, is giving COVID-19 shots at 1,192 facilities statewide, Sutfin said. Among the pharmacies working in the network are Pharmacy Care Advocates (PCA), Genoa, Guardian, and Hometown.

Manda Ayoub, chief operating officer for Pomeroy Living, said the first round of shots are complete at all seven of its skilled nursing, rehabilitation, assisted and independent living facilities in metro Detroit. 

"I have to tell you, the resident participation was amazing," she said. "In most of my buildings, 96% to 98% resident participation."

But the staff was more hesitant, Ayoub said. Initially, just 35% to 55% of employees agreed to get a vaccine when they were offered it the first time. 

"A lot of people didn't want to do it during round one but are doing it during round two," she said, watching and waiting to see whether any of the people who got the first doses had adverse reactions.   

"We've been sharing our stories on how we felt post-vaccine, and a lot of people who weren't doing it have chosen to do it during round two."

State and federal health officials, she said, have yet to tell long-term care facility leaders whether a high rate of vaccination among residents might mean they can open up again to visitors.

"They have given us no guidance on how vaccines will play a part in visitation," Ayoub said. "I look forward to hearing from the state of Michigan and CMS (Centers for Medicare and Medicaid Services) if residents and families who are vaccinated can visit one another without plexiglass in between them and 6 feet of distance."

Kevin Evans, executive director of the Martha T. Berry Medical Care Facility in Mount Clemens, said it's a complex formula that determines when nursing homes and other long-term care facilities can open up visitation, and nothing in those rules mention vaccination rates. 

"It's not a simple thing," he said. "I would love to open it up, but I would actually be violating the (public health) order to do that."

With Elizabeth Hertel as the new director at the state Department of Health and Human Services, Evans said, perhaps a change could come in visitation requirements once the majority of residents get their second shots. 

"I didn't know the mind of (former Director Robert) Gordon, and I don't know the mind of this one, either," he said. "I believe that if they're approached, there's logic to it, but I don't know what their thoughts are in that respect."

Now that a highly contagious variant of coronavirus that originated in the United Kingdom has been detected in Michigan, Evans said many people are concerned about the risk of opening up to a population that is most vulnerable to the virus.

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While he understands that concern, Evans said he remains confident his staff could keep residents safe if visitors were allowed once again. 

Walgreens provided the residents and staff at Martha T. Berry with vaccines on Jan. 19, Evans said. About 80% of residents opted to get a shot, and less than 40% of the staff was vaccinated. 

Second doses for those who got the initial immunization are scheduled for Feb. 16, he said, and anyone who opted out the first time will have another chance to get vaccinated. 

"I have an expectation that a lot more of my staff will be getting it this time around," he said. "A lot of our staff … were just so unsure of it happening so fast, I think they wanted to gauge the reaction that people had to the first dose. And when they finally found out that we didn't have any severe reactions, just some minor things, I think they said, 'OK, nobody's dying from it.'

"We're expecting an additional probably 60 or 70 of our staff in February" to get a vaccine, bringing the total percentage of residents and staff likely to have at least one dose of the vaccine by the end of the month to 90% and 50%, respectively. 

So far in Michigan, novel coronavirus has infected 562,510 people and killed 14,672. Of the deaths statewide, nearly one-third — 5,420 people — were in long-term care facilities, according to state data.  

Contact Kristen Shamus: kshamus@freepress.com. Follow her on Twitter @kristenshamus.