Frustrations build over COVID-19 vaccine delays in Minnesota nursing homes

Only 7,400 COVID-19 vaccine shots have been given to residents and workers at Minnesota nursing homes in the past week despite a targeted campaign that gave them first priority for vaccinations.

The slow pace has stemmed from bottlenecks in the patchwork distribution system, particularly with the large pharmacy chains that were tapped by the federal government to deliver the shots in nursing homes and assisted-living facilities. Those pharmacy chains, CVS Health and Walgreens, lacked the technicians to administer the vaccines quickly, which has resulted in unexpectedly long waits for the shots to arrive.

Across the state, some long-term care providers have turned to local pharmacies in a push to get vulnerable residents and staff inoculated as quickly as possible, industry representatives say.

State health officials acknowledged in written materials prepared for a state hearing Wednesday that smaller chains and local pharmacies "will be able to move more quickly and get on to" assisted-living facilities.

"Clearly, we're not moving fast enough as a state to deliver this vaccine to those who are most vulnerable," said Kristine Sundberg, executive director of Elder Voice Family Advocates. "If this continues, we could see people die unnecessarily."

The rollout of the vaccines is the most ambitious in modern U.S. history, and state officials said it is proceeding at a remarkably fast rate given the limited supply and complexity. Just a month ago, they noted, there was not an approved vaccine for the novel coronavirus in the United States, and nursing homes in Minnesota did not begin vaccinating until Dec. 28.

"We look forward to expanding this pace and getting more vaccines to more people in the weeks ahead," said Scott Smith, a spokesman for the state Department of Health.

Still, some lawmakers and elder care advocates maintain that more planning should have been done and expressed fear the state's vaccination effort could begin to mirror the chaotic rollout of COVID-19 testing early in the pandemic. They are also questioning why certain groups, including some inmates in Minnesota's prisons, are receiving shots of the vaccine ahead of frail and elderly residents in long-term care facilities, which have been the site of nearly two-thirds of the state's COVID-19 fatalities.

State Sen. Karin Housley, the Republican chairwoman of the Senate Aging and Long-Term Care Policy committee, called the pace of the vaccine rollout in long-term care facilities "unconscionably slow."

"The pace needs to speed up, and our seniors need to be at the very top of the list," she said. "Explain to me how a senior in Florida can get a vaccine right now, or an inmate in a Minnesota prison can get one right now, but a senior in a long-term care facility … [is] still on a waiting list for a vaccine here."

Minnesota health officials, following federal recommendations, placed nursing home residents in the highest priority group for receiving the first doses of COVID-19 vaccines because they are among the most medically vulnerable to complications from the coronavirus. Front-line health care workers, including clinicians in hospital COVID-19 units, as well as emergency medical personnel, are also considered to be high priority because of their repeated exposure to infected patients.

Other states have broken from the federal recommendations. Florida has prioritized senior citizens 65 and older for initial doses.

The federal government reached an agreement with the large pharmacy chains to administer the vaccines, but the teams have been slow to reach some long-term care facilities, say industry representatives. In some cases, teams from CVS and Walgreens were scheduling visits to assisted-living facilities as far out as late February and early March — beyond what facilities were willing to accept, said Patti Cullen, president and CEO of Care Providers of Minnesota, a long-term care industry group. To speed up the process, many facilities have turned to local pharmacies, she said.

At the Senate hearing Wednesday, state health officials emphasized that the plan to distribute vaccines to a broader population of seniors and others is dependent on allocations from the federal government, which are out of the state's control. Both state and federal health officials this week said that the pace of inoculations should increase now that providers have been trained in the handling of somewhat complex vaccines.

"The variable we have no control over is what is the [vaccine] volume," said Health Commissioner Jan Malcolm. "At this point, we're getting only 65,000 doses a week. At that pace, it's going to take us quite a long time to get all the way through" the senior population.

Added Kris Ehresmann, infectious disease director for the state Health Department, "The really happy news for us right now is that everyone wants to receive the vaccine. But it's also stressful, because we can't make as much vaccine available as there is interest."

State health officials said a small number of inmates who live in long-term care units in Minnesota's prisons were vaccinated, in accordance with federal guidelines to inoculate those most at risk of serious COVID-19 complications. The Department of Health has allocated about 400 doses to the state's highest-risk inmates.