Thread by @DiseaseEcology

Hundreds of nursing home residents are dying each day due to slow vaccine rollout in SNFs.

CDC vaccine tracking page shows this huge failure.

We are failing to vaccinate the population where most deaths have occurred: nursing homes.
Thread
covid.cdc.gov/covid-data-tra…

As most know, ~40% of all deaths in US (& other countries like UK) have been in nursing homes.
kff.org/policy-watch/c…

As a result, nursing home residents were put, w/ health care workers (HCW), in top priority tier for vaccination. Great! But allocating vaccines to this group did NOT magically result in shots in arms. That requires huge logistical plan. Unfortunately that plan has not gone well.

Only 7.7% of allocated vaccines have been given, compared to 25.4% for non-nursing homes.
Why rollout has been so slow throughout US? Partnership b/w/ CDC & pharmacies (CVS, Walgreens, MHA: cdc.gov/vaccines/covid…) was supposed to make it fast w/ "end to end management"

Locally, it's clear to me that slower rollout in nursing homes vs HCW is b/c:
-Local public health dept was tasked w/ getting vaccines to HCWs; they worked urgently to get vaccines to hospitals & helped set up plans for hospitals to administer vaccines to their own staff.

-Nursing home residents & staff don't live at pharmacies, so pharmacies have to find way to get people to them.
-Some residents aren't able to provide consent (dementia, etc.) & contacting family delays process

This has meant that while HCWs have been getting vaccinated for 2 wks+, nursing homes are just starting now. Given huge surge in cases in CA (& elsewhere) this has lead to many preventable deaths.

How many? Crudely, 2.5K deaths/day*40%=~1000 deaths/day, nationally. Real # likely less due to previous exposure, but almost certainly 100s/day.

Note that we have already distributed enough vaccines (2.2M) to vaccinate every health care resident (1.2M) & most staff (~1.2M)! But we haven't put these vaccines in arms, so people are still getting sick & dying while vaccines for them are sitting in freezers.

-Some health depts saw these challenges & chose to give initial doses to nursing home residents, rather than HCWs, to prioritize this group. This has led to delay in getting the doses allocated to HCW to that group (HCW doses were still prioritized by delayed in distribution).

As many others have written (e.g. @ashishkjha:

https://twitter.com/ashishkjha/status/1344698686488633346

), these are all foreseeable challenges & given that vaccines have been in development for 11 mo, it would have been great to have had a plan & resources in place.

Instead, public health depts are struggling financially. In my CA county the health dept is furloughed (cityofsantacruz.com/Home/Component…). You heard that right - we furloughed public health during the pandemic.
reuters.com/article/us-hea…

The new $8.75B in recent bill for vaccine rollout will help, but we can't hire large teams needed and set up plan in 1d. Thus, it's going to be bumpy going forward.
Vaccinating nursing homes should be a top priority.
reuters.com/article/us-hea…