Maine’s effort to vaccinate thousands of nursing home residents and employees against COVID-19 could take months and likely won’t lead to reopening long-term care facilities anytime soon, in part because some people in those groups have indicated they aren’t willing to be inoculated.
About 6,200 nursing home residents and the estimated 9,200 workers who care for them are expected to be offered the vaccine by visiting clinicians from pharmacies starting as soon as next week. Federal and state health officials have identified residents of long-term care facilities and front-line health care workers as the first groups to be vaccinated because both have been hit hard by the pandemic.
But informal polling by nursing home administrators in Maine shows only 60 percent of staff members and 60 to 70 percent of residents or their family members are willing to be vaccinated, according to the Maine Health Care Association, which represents the 93 nursing homes across the state.
The lack of universal buy-in troubles some nursing home officials, who see the vaccine as a step toward eventually resuming normal operations. They’re scrambling to secure written consent from residents and employees since Pfizer’s vaccine was approved Friday and is being delivered to Maine in shipments that started this week.
The gap also worries and upsets some family members of nursing home residents, who haven’t been allowed to hug their loved ones since the pandemic forced long-term care facilities to close their doors to visitors last spring. If some residents and employees remain unvaccinated and unprotected, nursing homes would have to maintain heightened COVID-19 precautions and remain closed to visitors and others for an extended period.
Concerned family members include Mary Altenbern of Buxton, whose husband, Charlie, 68, has Alzheimer’s and lives at Pinnacle Health & Rehab at South Portland, formerly the South Portland Nursing Home.
For months now, Altenbern has visited her husband three days each week, standing outside the door at the end of Charlie’s wing. Whether it’s raining or snowing or skies are clear, she presses up against the glass and talks on her cellphone while a staff member holds a phone to Charlie’s ear.
“Yes, I’d like to have my husband vaccinated. I want to hold my husband and dote over him again,” Altenbern said. “But what good’s it going to do if other people don’t get vaccinated and when can I get vaccinated so I can be with him again?”
Mary Altenbern, whose husband, Charlie, lives in a nursing home in South Portland, stands outside her home in Buxton. “Yes, I’d like to have my husband vaccinated,” she said, “but what good’s it going to do if other people don’t get vaccinated?” Shawn Patrick Ouellette/Staff Photographer
The first batch of 12,675 Pfizer doses expected to be delivered to Maine this week includes 6,825 doses for nursing home residents and employees and the remainder are for health care workers at greatest risk for exposure to COVID-19, according to the Maine Center for Disease Control and Prevention.
Who gets inoculated after that has been outlined broadly in a phased COVID-19 vaccination plan that prioritizes people with underlying health conditions, elderly Mainers and others, but relatively healthy members of the general public may have to wait until summer or fall to be vaccinated.
The Maine CDC expects to receive 74,875 vaccine doses overall in the first three weeks of the rollout, including the Moderna vaccine that’s up for emergency review and approval this week. The state has an estimated 75,000 health care workers with direct patient contact and about 6,000 residents of nursing facilities.
Maine nursing homes began seeking consent from employees and residents or their family members after the federal Food and Drug Administration granted emergency use authorization to Pfizer’s vaccine late Friday.
The consent forms are drug-specific and separate consent forms will be required for the Moderna vaccine, said Nadine Grosso, spokeswoman for the nursing home association.
Grosso said nursing homes won’t force employees or residents to be vaccinated, and they will respect individual opinions and decisions whether to be inoculated. However, without widespread vaccination, most nursing homes will have to maintain heightened COVID-19 precautions and remain closed to visits from family and friends for months.
“We’re hoping for as high a percentage of takers as possible,” Grosso said. “This vaccine is key to us getting back to some sense of normal and reopening to family and other visitations that we all miss so much.”
Grosso said vaccinating nursing home residents and employees is expected to take several weeks, possibly a few months, especially if there are more of the unanticipated delays that have plagued vaccine development and production.
Dr. Robert Hunold, medical director of Cove’s Edge, a skilled nursing and rehab facility in Damariscotta, said “there’s a lot of concern” among its 25 patients, 40 residents and 120 staff members. About half of the facility’s employees and a slightly larger percentage of residents or family members have said they would be vaccinated.
“That’s going to be a huge issue, not only because we wouldn’t be able to protect the most vulnerable among us,” Hunold said during a recent Zoom vaccine briefing with MaineHealth staff members. “But if this (vaccine) is our ticket back to normal, how can we open nursing homes if (some) residents don’t get the vaccine?”
Public confidence appears to be increasing as inoculations have begun worldwide, said Dr. Mark Eggena, an infectious disease expert at Pen Bay Medical Center in Rockport who is a former immunology and vaccine researcher.
“Hopefully that changes people’s minds because obviously we know what happens when you don’t get the vaccine,” he said. “I would recommend (the vaccine) to my mother and I’m looking forward to giving it to my children.”
Dr. Dora Anne Mills, MaineHealth’s chief health improvement officer, noted that about two-thirds of the 259 Mainers who have died with COVID-19 were long-term care residents. Mills said she was anxious about the vaccine last summer, when political controversy over its development was running high, but now she’s confident that it’s safe and effective.
“If I had a loved one in a nursing home, I would have no hesitancy in getting this vaccine to them,” Mills said, adding that she also would be inoculated and would encourage her two grown children to do the same.
Nursing homes began planning for the vaccine rollout several weeks ago, when they chose to receive vaccines from CVS, Walgreens or other independent pharmacies, Grosso said. The pharmacies are providing consent forms and scheduling vaccination clinics, when clinicians hired by the pharmacies will visit nursing homes and administer the vaccine.
Because both the Pfizer and Moderna vaccines require two doses, delivered a few weeks apart, pharmacy teams are expected to visit each nursing home at least three times, to deliver initial doses and booster shots, Grosso said. Nursing home administrators will determine which employees are vaccinated first, but the goal will be to have all employees and residents inoculated as soon as possible.
Katharine O’Neill, the director of housing and communications at The Cedars in Portland, said Walgreens will likely host three immunization clinics there, starting as early as the end of December.
The first residents in line to be immunized will be the 102 people who live in the nursing home, O’Neill said. The Cedars also is home to older adults in assisted living or independent apartments. The Cedars staff will receive their vaccinations in stages because of potential side effects.
O’Neill said The Cedars will be circulating consent forms in the coming days and that most residents are “enthused” about the approval of a vaccine. She said she plans to get the shot when she can. “Without a doubt,” she said.
“There’s hope,” O’Neill said. “That is definitely what the residents here have been saying. Hope is coming, and there is an end to this.”
The administrator of Portland’s Barron Center said she didn’t have enough information yet to discuss vaccine distribution, according to a city spokewoman. The city-owned nursing home has partnered with CVS but did not have an inoculation timeline as of Monday.
Maine Veterans’ Homes, an agency established by the Legislature that operates six nursing homes across the state, including one in Scarborough that suffered an outbreak early in the pandemic that killed 14 residents, didn’t respond to requests for information about its vaccination efforts.
Pinnacle, the nursing home in South Portland, signed on with Walgreens and added a “declination page” to the consent form provided by the pharmacy chain.
“We wanted it on record that we offered the vaccine and they declined,” said Laurie Bagley, RN, who is director of nursing at the facility that has 64 residents and 105 staff members.
Jeff Ketchum, the nursing home’s longtime administrator, said residents and employees have offered mixed reactions to the prospect of getting vaccinated. Ketchum isn’t undecided.
“I will be getting the vaccine,” he said. “I want to be able to protect the people in my care, and I don’t think (pharmaceutical companies and federal authorities) would put out something that’s unsafe.”
Staff Writer Megan Gray contributed to this report.
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