AUSTIN (KXAN) — After getting her first dose of the COVID-19 vaccine, Diana Naylor was thrilled. Then, minutes later, she felt guilty.
“I just kind of felt it was unfair that we should be receiving it, and he was not receiving it,” she said.
She was referring to her 94-year-old father, who lives in an assisted living facility in Angleton, Texas. Naylor has been expecting him to get vaccinated for weeks.
“He felt like there was hope,” she said. “He started getting excited. We were really excited!”
Families like hers first became hopeful last year when U.S. Health and Human Services Secretary Alex Azar floated the possibility of vaccinating every nursing home resident by Christmas. Yet, as Texas enters the sixth week of vaccine distribution, vulnerable residents of some long-term care facilities and their families are realizing it could be at least February before they are fully vaccinated.
The majority of the skilled nursing, assisted living and other types of long-term care facilities in the state are enrolled in the CDC’s partnership with CVS and Walgreens to distribute both doses of the vaccine.
581 skilled nursing facilities (SNFs) in Texas enrolled with CVS and 484 enrolled with Walgreens.
Earlier this year, both pharmacies promised to complete the first round of distribution in these homes by Jan. 25. On Monday, both companies released data showing they are on track.
CVS said they expect to visit the remaining SNFs by Jan. 21. Data from Walgreens showed less than 30 SNFs in need of their first dose.
Meanwhile, the pharmacies have not scheduled vaccine clinics for hundreds of assisted living or other long-term care facilities — homes where older and medically fragile Texans receive care.
Assisted living facilities (ALFs) are regulated by state governments, while a federal agency regulates and distributes resources to skilled nursing facilities. As a result, some advocates claimed the stream of testing and PPE resources throughout the pandemic wasn’t as steady for assisted living. They noted efforts to stop the spread of the virus were often focused on skilled nursing homes — where the most intense medical care is given.
A spokesperson for Walgreens told KXAN assisted living homes in Texas weren’t far behind in the distribution process. He estimated the first round of vaccinations would be complete across the 970 ALFs and other long-term care facilities enrolled with them by the end of the month. Their data shows 571 facilities marked as complete; 180 more had vaccine clinics scheduled in the next week.
The spokesperson for Walgreens called it a “positive trend,” noting their nationwide capacity to vaccinate these homes was “growing by the day.”
“States and facilities are continuing to finalize their plans on an ongoing, and sometimes daily basis. We are activating vaccinations as those plans are finalized,” he said in a statement.
In total, 1,431 ALFs and other types of facilities have enrolled with CVS in Texas. So far, 972 have received their first round of vaccines; 124 were scheduled in the next week.
“Each day feels like… an eternity for him,” Naylor said of her father in assisted living. “He’s at the point in his life where he’s like, ‘I don’t know how much longer I have, and I don’t want to live it stuck in a room.”
She said it was frustrating to know people in Phase 1B like herself were able to get the vaccine, while her father — supposedly in the top priority group — was still waiting. His facility was scheduled for this week, and Naylor said she just hopes it happens.
In a virtual discussion with the Kaiser Family Foundation this week, Rina Shah, the group Vice President of Pharmacy Operations & Services at Walgreens, explained they would be coming out to homes a total of three times during the distribution process.
“In case someone didn’t get their first dose at the first clinic, and they got their first dose at the second clinic, we can then come back on that third one to make sure we are completing that effort — ensuring everyone gets their vaccine,” Shah said.
She said some of their pharmacists and staffers worked through the holidays, forgoing vacation, to ensure these vaccines began arriving at long-term care facilities. Still, she said there were challenges facing the rollout.
Shah noted the biggest hurdle was vaccine hesitancy — meaning Walgreens would show up with a certain number of doses for residents and staff, but often staff members would decide not to receive their vaccine.
“So, what our pharmacists have been doing have been doing has been playing not only an administration role, but an education role,” she said.
She claimed, in some cases, communication between the pharmacy and the facilities became an issue — saying Walgreens was calling facilities multiple times but “couldn’t get ahold of individuals.”
Meanwhile, a spokesperson for Continental Retirement Community in Austin said they were “working hard” to get their clinic on the books through this pharmacy program, but still hadn’t heard back.
Another Walgreens official pointed to a shortage of pharmacy workers and nurses in other states, such as Mississippi, as a cause for delays in the rollout, but held up Texas as an example.
“In other states, like Texas, where we don’t have any staffing challenges, we can move a lot quicker,” Roy Armstrong, a regional health care director for the pharmacy chain, said on Monday. “Mississippi has been a challenge for us long before the Covid-19 vaccine showed up. That’s the reason we’re lagging behind in Mississippi.”
A portion of the state’s long-term care facilities are not enrolled in the federal program.
35 SNFs and 19 other long-term care facilities are enrolled as vaccine providers themselves, meaning they will receive vaccine shipments directly at their facility. 108 SNFs and 1,430 other long-term care facilities are not enrolled in either of the above vaccination programs, but a spokesperson for DSHS told KXAN in December they were collaborating with other state agencies and associations to help get these facilities access.
KXAN Investigators are expecting an update from the state of Texas this week on the status of the rollout across all long-term care facilities.
So far, West Virginia’s vaccination rates are the highest in the country. The state opted out of the federal pharmacy partnership, instead relying on local pharmacies and health departments to vaccinate its nursing home residents. Recent health data revealed it had administered roughly 98% of its first doses.
Do you have a loved one in long-term care? Are you a resident of one of these facilities with concerns? If you have a story, reach out to KXAN Investigator Avery Travis at firstname.lastname@example.org or on Facebook and Twitter.