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Helping Senior Care Operators Maximize COVID-19 Vaccine Participation

Helping Senior Care Operators Maximize COVID-19 Vaccine Participation

December 30, 2020

The distribution of the COVID Vaccines from Pfizer and Moderna is excellent news for nursing homes and senior living communities whose residents and staff have been disproportionately impacted by the coronavirus. Reaching high vaccination rates is crucial for communities to mitigate COVID-19 spread and create a sense of security for residents and family in the new year. However, achieving high vaccination rates presents a number of, but not insurmountable hurdles. Below, we explain the challenges and offer some solutions.

In addition to logistic obstacles in the administration of the vaccine, facility leaders must also convince staff, residents, and their family members on the safety, efficacy, and necessity of vaccination. A recent Wall Street Journal article suggests that as many as 72% of nursing assistants at nursing facilities may not agree to take the vaccine. Many individuals feel they have insufficient information about the vaccine to feel comfortable taking it. In addition, collecting insurance information and consent forms from residents and staff presents additional hurdles for vaccine participation.

In this article we share additional information about the Pfizer and Moderna vaccines, and answer some frequently asked questions our team has fielded from residents and staff in communities across the country. Tembo Health can support operators in their efforts to educate residents and staff to help achieve maximal vaccine participation and to automate the consent process with our digital HIPAA-compliant platform.

How to Overcome Vaccine Hurdles

Educate staff, residents, and their families about the vaccine: A number of surveys have suggested that staff, residents, and their family members may be reluctant to take the vaccine due to a lack of information or question regarding the safety, efficacy, and necessity of vaccination.

As communication preferences vary, we suggest that you offer a mix of written and verbal resources. Here are a few:

  • Flyers from authorities like the CDC, vaccine manufacturers (Pfizer, Moderna) - or even our comprehensive FAQ overview below may help.
  • Hotlines for further information. You can have a member of your medical staff field calls or, if you need assistance, Tembo is here to help.

Automate the consent process: Pharmacies delivering the vaccine are required to collect a signed consent form along with front and back images of the insurance cards for each patient. To minimize errors and the logistics of having patients or family members sign on site or via mail, we suggest using online consent forms.

Tembo Health provides such services through our digital platform, which includes the ability to send secure email links, sign consent forms, provide health history and take pictures of insurance cards.

Manage side effects: Side effects, or the appearance of, can be concerning for vaccine recipients. Having processes in place to answer questions can assuage concerns. Tembo Health has offered clients its team of board-certified emergency medicine physicians to help address symptoms 24/7.

Schedule vaccinations strategically: Given some individuals experience 1-2 days of full-body symptoms, Tembo Health recommends the following considerations when scheduling vaccinations to avoid staffing issues.

  1. Schedule staff vaccination clinics on a Friday to allow them the weekend to recover if they experience symptoms.
  2. Stagger staff vaccinations to avoid staffing issues from staff recovering from potential side effects.
  3. Schedule resident vaccinations on Mondays or Tuesdays to allow them the benefit from the full staffing during the week.

Tembo Health physicians receiving their vaccines.

Vaccine FAQ - Questions from residents and staff across the country

Is the vaccine safe?

All information from Pfizer, Moderna, and the CDC indicate this vaccine is safe. The vaccine underwent rigorous testing through 3 phases of clinical trials - “no corners were cut in evaluation of these vaccines” per the FDA. The process was expedited because researchers had already built the tools needed for an mRNA vaccine from research of other Coronaviruses and mRNA technology for cancer.

What is an mRNA vaccine? Will the vaccine give me the virus?

The vaccines that are being distributed by Pfizer and Moderna are mRNA vaccines. While this is a new form of vaccination, mRNA vaccines have been in study for a decade. mRNA vaccines do not carry the virus itself (live or dead), and do not carry any risk of causing the viral disease to a vaccinated person. The mRNA vaccine provides the body with the building blocks of one viral protein which the body recognizes as foreign. The mRNA vaccine itself then disintegrates, leaving the immune system with only the memory of the viral protein. Should that individual ever be exposed to the actual live virus, the body can quickly recognize and eliminate it.

What are the benefits of mRNA vaccines?

mRNA vaccines have several benefits compared to other types of vaccines. No part of the mRNA vaccine is an infectious element. Additionally, the development and manufacturing process can be standardized and scaled, making vaccine development faster than traditional methods.

Are the Pfizer and Moderna vaccines effective?

The research data indicates that the vaccines are 95% efficacious. Specifically, the Pfizer/BIONTECH data studied 43,661 people who were randomized to either receive the mRNA vaccine or a placebo. Of these 43,661 individuals, only 170 contracted COVID-19, only 8 of which had received the vaccine. Similarly, Moderna studied approximately 30,000 patients who either received the mRNA vaccine or a placebo. Of these 30,000 patients, 95 contracted the virus, but only 5 of these patients had received the vaccination. Thus, both vaccines appear to be very efficacious at preventing COVID-19 in individuals. An effective and large-scale vaccine program will therefore help save lives. We strongly recommend taking the vaccine.

Will the vaccine prevent someone from getting the virus?

No COVID-19 vaccine will be 100% effective in preventing the virus, but the risk of contracting the virus is significantly reduced with vaccination. Additionally, by receiving the vaccine you will help to reduce the risk of COVID-19 spread in your community. If enough individuals obtain the vaccination, spread of the virus becomes increasingly rare and the virus can be virtually eliminated.

What are the side effects to the vaccine?

There are reports that some individuals experience mild-to-moderate side effects lasting 1-2 days, usually following administration of the second dose of the vaccine. Long term studies have not been performed and long term effects, if any, are not fully known; however, side effects of vaccines are generally limited to the days after initial administration. The CDC and FDA continue to monitor the safety of these vaccines.

Redness and inflammation at the injection site: The vaccine works by making the body produce one small, inactivated protein (the ‘spike protein’) of the virus. The body’s immune system creates a defense against this protein, which is what provides protection against future exposure, and the creation of this defensive mechanism can create short-lived inflammation. This inflammation can manifest as pain or tenderness at the site of injection. Redness and swelling are rare, but may also occur.

Other symptoms: Some individuals have more generalized symptoms, including fever, headache, muscle aches, and fatigue, to varying degrees. These symptoms are generally mild and resolve in 1-2 days.

Should I be concerned about preexisting conditions and allergies before taking the vaccine?

The CDC recommends that patients who have previously had a severe allergic reaction to any other vaccine or injectable therapy be observed as a precaution when receiving the COVID-19 vaccine, but are not excluded from receiving it. This concern stems from 2 patients in the UK that developed an allergic reaction after receiving the vaccine. Severe allergic reactions to food, medicine, environmental allergies, latex allergy, etc. are not a contraindication or a reason to take extra precautions when receiving the vaccination according to the FDA. People with many pre-existing conditions were studied in the Pfizer trial and did well.  

How is the vaccine administered?

Both the Pfizer and Moderna vaccines are administered via injection divided into two doses, with the second dose of the Pfizer vaccine administered 21 days after the first, and Moderna’s at 28 days after the first. The first shot primes the immune system, helping it recognize the virus, and the second shot strengthens the immune response. It is crucial to receive both doses to ensure efficacy and it is important to get the same vaccine for both doses, as the Pfizer and Moderna vaccines are not interchangeable.

Are there any differences between the Pfizer and Moderna vaccine?

Both vaccines were developed independently and differ in how they are stored, although they use the same mechanism and have similar dosing regimens - both showing similar efficacy, having a similar safety profile.  

Can I still pass along the virus if I have been vaccinated?

Because some vaccinated individuals may still become infected with COVID-19, it is possible that even after vaccination, you may be able to contract and expose others to the virus. It is also possible that those who developed immunity may still be able to pass the virus to others, even while immune themselves. Therefore, it remains important to wear masks and maintain social distancing measures.

Should I take the vaccine if I have already contracted the virus?

Yes, as data from the clinical trials show that the vaccine is likely safe and efficacious in persons with prior COVID-19 infection.

If I receive the vaccine how will that impact future COVID testing?

Once vaccinated, the results of COVID-19 viral tests (nucleic acid amplification or antigen tests) will not be affected.  

Are there any issues if I received monoclonal antibodies as a COVID treatment previously?

There has been no data to study the safety and efficacy of the vaccination in patients who have received convalescent plasma or monoclonal antibody therapy. The CDC recommends that any patient who has received monoclonal antibody treatment wait 90 days to be vaccinated as a precaution, as you are unlikely to contract COVID during that time.

Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Sources

  1. Learn About the New mRNA COVID-19 Vaccines (CDC)
  2. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine (NEJM)
  3. Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States (CDC)
  4. Vaccines and Related Biological Products Advisory Committee Meeting
  5. December 17, 2020 (FDA)
  6. Vaccines and Related Biological Products Advisory Committee Meeting
  7. December 10, 2020 (FDA)
  8. Nursing Homes Grapple With Staff Hesitant to Get the Covid-19 Vaccine (WSJ)

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