VACCINE NEWS

COVID-19 vaccination in nursing homes.
As reported last Wednesday, CMS has announced plans to mandate COVID-19 vaccination for staff working in nursing homes. This announcement was a directive from the Biden Administration and we expect to see the interim final rule in September. There is still so much we don’t know about this pending requirement. CMS put out a press release and shared the White House fact sheet, but is otherwise unable to discuss the details due to the rulemaking process. Here are some of the pressing questions for which we do not yet have answers:

  • When will the rule come out? When will it be effective?
  • By what date must nursing home staff be fully vaccinated?
  • Who will be considered “staff” for purposes of this rule?
  • Will there be any exemptions from this rule, such as medical exemptions or religious exemptions?
  • How should nursing homes handle staff who decline vaccination, including those who decline for medical or religious reasons?
  • What will happen to nursing homes that employ unvaccinated staff?

Also in the White House announcement and supported in a joint statement from HHS, including the CDC, the Biden Administration announced plans for COVID-19 boosters for all individuals. This plan is pending approval from the FDA and CDC’s Advisory Committee on Immunization Practices (ACIP). The plan is to make booster shots available to any individual 8 months after the second dose of a 2-step vaccine beginning the week of September 20th. Consistent with current FDA approval, CMS has announced that it will cover the cost of additional doses for certain immunocompromised people. Again, we have many questions:

  • Will CMS update payment structures and codes to cover the cost of additional doses for all individuals if recommended by ACIP and approved by FDA?
  • Will payment structure and codes be available in time for the Biden Administration’s September 20 target date?
  • Is the 8-month time frame a hard and fast rule? What about those who were vaccinated more recently? Must they wait 8 months before receiving the third dose or could they receive the third dose sooner, such as when they receive their annual flu shots in the fall?
  • This plan relates to those who were initially vaccinated with either the Pfizer or Moderna vaccine. What about those who were vaccinated with the Johnson & Johnson vaccine beginning in March 2021?
  • We are hearing that some states have declared that all residents in nursing homes are considered “immunocompromised” in order to ensure they are able to receive a third dose of vaccine. Here is a letter from Kentucky Governor Andy Beshear to that effect. We understand that individual providers may be considering this course of action as well. What are the implications of such a declaration?
  • Would individuals then need to follow CDC recommendations for immunocompromised individuals, meaning that all individuals would need to follow guidelines for “unvaccinated” individuals for things like masking, social distancing, quarantine/isolation, etc.?
  • Would this now require care planning and related documentation for immunocompromised individuals?

Despite the numerous questions and limited information, LeadingAge is working on strategies for advocacy and to support our members as they prepare for these changes. We will keep you abreast of our actions and welcome feedback and questions.

Frequently Asked Questions: COVID-19 Vaccine Boosters  
HHS announced a plan to begin offering COVID-19 vaccine booster shots this fall. CDC’s independent advisory committee, the Advisory Committee on Immunization Practices (ACIP), will continue to meet and discuss data on the evolution of the pandemic and the use of COVID-19 vaccines. ACIP will make further recommendations on the use of boosters for the public after a thorough review of the evidence. Below are answers to commonly asked questions about COVID-19 vaccine boosters.

  • Q: When can I get a COVID-19 vaccine booster?

A: Not immediately. The goal is for people to start receiving a COVID-19 booster shot beginning in the fall, with individuals being eligible starting 8 months after they have received their second dose of mRNA vaccine (either Pfizer-BioNTech or Moderna). This is subject to FDA approval and CDC’s Advisory Committee on Immunization Practices (ACIP) authorization and recommendation.

  • Q:  Who will be the first people to get a booster dose? 

A: Once FDA approves and ACIP recommends a booster dose, the goal is for the first people eligible to be those who were the first to receive their shots in the earlier phases of the vaccine rollout and those who are most at risk. This includes healthcare providers, nursing home residents, and other seniors.

  • Q: Why are we waiting to start offering COVID-19 vaccine boosters?

A: The COVID-19 vaccines authorized in the United States continue to be remarkably effective in reducing risk of severe disease, hospitalization, and death, even against the widely circulating Delta variant. However, COVID-19 constantly evolves. We’re looking at all available data to understand as much as we can about how well the vaccines are working, including how new variants, like Delta, affect vaccine effectiveness. Once FDA approves and ACIP recommends, the goal is for people to start receiving a COVID-19 booster shot this fall.

  • Q: Will people who received Johnson & Johnson’s (J&J/Janssen) COVID-19 vaccine need a booster shot?

A: It is likely that people who received a J&J COVID-19 vaccine will need a booster dose. Because the J&J vaccine wasn’t given in the United States until 70 days after the first mRNA vaccine doses (Pfizer-BioNTech and Moderna), the data needed to make this decision isn’t available yet. We expect more data to come in the next few weeks. With those data in hand, we will keep the public informed with a timely plan for J&J booster shots as well.

  • Q: Can people who received Johnson & Johnson’s (J&J) COVID-19 vaccine get a booster dose of an mRNA vaccine?

A: There’s not enough data currently to support getting an mRNA vaccine booster dose (either Pfizer-BioNTech or Moderna) if someone has gotten a J&J vaccine. People who took the J&J vaccine will likely need a booster dose, and more data is expected in the next few weeks. With those data in hand, we will keep the public informed with a timely plan for J&J booster shots as well.

  • Q: If we need a booster, does that mean that the vaccine is not working?

A: No. The COVID-19 vaccines are working very well to prevent severe illness, hospitalization, and death, even against the widely circulating Delta variant.  However, with the Delta variant, we are starting to see reduced protection against mild and moderate disease. For that reason, we are planning for a booster shot to maximize vaccine-induced protection and prolong its durability.

  • Q: What’s the difference between a booster shot and an additional dose?

A: An “additional dose” refers to people who are moderately to severely immunocompromised receiving an additional dose of an mRNA COVID-19 Vaccine (Pfizer-BioNTech or Moderna). This is because they may not have received adequate protection from their initial 2-dose vaccine series.

A “booster dose” is a supplemental vaccine dose given to people when the immune response to a primary vaccine series was adequate but is likely to have decreased over time.

LEADINGAGE KANSAS NEWS

Don’t Miss This Friday’s Update Call
Join us each week to hear the latest on COVID and other important information for organization. Anne Yeakley, KDADS CARE Program Manager will join us this Friday to talk about PASRR and CARE. Register here.

LEADINGAGE NATIONAL NEWS

Nursing Home Advisory Group Meets Tomorrow at 1 PM CT
Make plans to join LeadingAge for the monthly Nursing Home Advisory Group virtual meeting. This meeting will feature information on Quality Data, Policy Updates, and garner member feedback.  Join the meeting here.

If you can’t join tomorrow, the next meeting will be Tuesday, September 28, 2021, at 1 PM CT and serve as a Nursing Home Town Hall. During that time, you can share your concerns and top issues to help shape the LeadingAge Policy Priorities for 2022.

This Week’s Online Coronavirus Policy Updates
Join us today and Wednesday at 2:30 PM CT for our online policy updates. Today, David Grabowski, Professor of Health Care Policy at Harvard Medical School and national commentator and expert on nursing home policy, will join us to talk about the vaccine mandate plans announced by CMS on August 18th and other hot policy and operational topics. On Wednesday, Christy Zeitz from LeadingAge member Fellowship Square communities will share how her staff is working to bolster morale amid trying times. Register now to join us. 

New Insights and Tools from LeadingAge
LeadingAge staff experts are developing essential advocacy, guidance, and tools, and curating the most relevant resources for aging services providers, including: 

THANK YOU TO OUR GOLD PARTNER

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Nicole Schings
Nicole Schings is the Director of Member Services and Business Development. Nicole joined the association in 2018, and oversees our Member Services program, our Partnership and Associate Member relationships, and our online education system. A graduate of Washburn University, Nicole uses her 22 years of experience in the association world to enhance the support of our members, problem solve their issues and bring new partners into the LeadingAge Kansas family. Outside of work, Nicole is passionate about geocaching and moments spent with her dog, Blu. You can reach Nicole directly at 785.670.8048.

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