'Simply not enough': Officials respond to percentage of eligible CA nursing home staff boosted

SAN FRANCISCO (KGO) -- With the clock ticking, eligible healthcare workers have until Feb. 1 to receive their COVID-19 booster shot, according to a California health order.

Yet, an ABC7 News I-TEAM analysis of data from the CDC and the U.S. Centers for Medicare & Medicaid Services found many healthcare workers and residents at skilled nursing facilities are not boosted.

The self-reported data found that for California, as of Jan. 9, 36% of eligible staff members and 53% of eligible residents have received a booster. About 1,120 facilities reported data to the federal government.

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"People are not understanding that the booster is powerful," said UCSF Professor Dr. Peter Chin-Hong. "The acceptable percentage is 100%."

In the Bay Area, the percentage of residents boosted as of Jan. 9 ranges from 43% to 76% and the percentage of staff boosted as of Jan. 9 ranges from 31% to 64%.

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"I'm horrified. Those numbers are horrifically low and why? Why? They don't need to be," said Debbie Toth, President and CEO of Choice in Aging, which has provided mobile vaccination and booster clinics to Contra Costa County skilled nursing facilities.

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"I don't understand why we aren't prioritizing where we know we have the most vulnerable people in the most vulnerable setting," said Toth.

The federal government previously partnered with pharmacies to provide vaccinations at long-term care facilities, but that partnership doesn't exist for booster shots.

"It makes no sense that there's no plan in place at the federal level," said Toth.

Without federal help, individual counties and facilities have to make their own arrangements.

"They really rely on mobile units coming to that facility," said Dr. Marin County Public Health Officer Matt Willis.

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Dr. Willis says the county has documented a higher percentage of staff and residents boosted than the federal data suggests but admits overall, the percentages are disappointing.

"Clearly there's a lot of progress to make," he said. "These rates just simply aren't high enough."

Other counties like Alameda also questioned the federal data, pointing out that not all skilled nursing facilities are self-reporting and that some may be inaccurately calculating their percentages.

Contra Costa, San Francisco, Solano and Napa counties told us they're providing mobile vaccination teams to long-term care facilities as needed and expect the percentage of those boosted will be higher by Feb. 1.

"I don't think that there is a viable excuse not to do something to save lives right now," said Toth.

The San Francisco Department of Public Health provided the following statement:

SFDPH coordinates closely with nursing homes and long-term care facilities, including supporting the implementation of state and local guidelines and mandates for vaccination of residents or staff. We have also coordinated directly with a number of long term care facilities to offer additional booster events for patients and staff through our mobile teams (50 events completed since December alone). To our knowledge, to date, many are making great progress in achieving high levels of booster rates among residents, patients and staff and we anticipate they will be able to meet the state requirements in a timely fashion.

Contra Costa Health Services (CCHS) provided the following statement:

Contra Costa Health Services and its partners are working hard to ensure that everyone who is eligible for a COVID-19 booster can get one, particularly those who are especially vulnerable to serious illness if they become infected. Residents living in care facilities are the top priority of our mobile clinic program. CCHS has focused booster efforts in long-term care facilities by outreaching to facilities, and by linking them to booster teams. Booster teams, including the CCHS mobile vaccine team, pharmacy partners, healthcare partners, and non-profit partners, work with facilities to set-up mobile vaccine clinics on site to provide no-cost vaccinations to residents and staff. Since Dec. 2, 2021, the CCHS mobile vaccination team alone has made or scheduled 95 visits to care facilities in our county. In addition to continued outreach efforts for booster clinics, CCHS has also had regular communication with long-term care facilities in the county and a well-established process for site managers to request visits from our clinics. CCHS supports these facilities with infection control guidance, vaccination and testing clinics, but does not license or regulate them. CCHS does not specifically track booster rates in long-term care facilities, but our countywide booster rate for eligible residents (12 and older) is 46.7%. CCHS encourages SNFs to vaccinate their own staffs and patients whenever possible, but to not hesitate to request assistance if they need it.

Solano County provided the following statement:

Solano County is in line with the other 8 Bay Area counties in reference to booster shot uptake within our long term care facilities. As this data was collected up to January 2nd, we expect the numbers to be slightly higher, especially for staff who must be boosted by February 1st to work in a residential care facility for the elderly. Since January 2nd, our team has been out to over 20 long term care facilities and hosted over 10 pop-up clinics for community members to get their booster shot. With the current surge of COVID-19 cases within the community, we are urging people to get vaccinated and receive their booster shot, if eligible. Everyone ages 12 or older should get a booster dose for additional protection against COVID-19 and its variants. Community members can check our website for a list of pop-up clinics to get vaccinated.

Alameda County provided the following statement:

We will note that, the data as it was presented to us doesn't accurately reflect the booster dose rates in the 67 Skilled Nursing Facilities (SNFs) and 530 other Long Term Care Facilities (LTCFs) in Alameda County. In addition to the many SNFs that are not self-reporting their data (reflected as zeros in the data sent), other SNFs are inaccurately using the resident total census and total staff numbers as the denominator when calculating the booster dose rates instead of booster eligible residents and booster eligible staff. These two factors are contributing to booster rates appearing lower than they are in Alameda County. We recommend reviewing data available here https://www.cdc.gov/nhsn/covid19/ltc-vaccination-dashboard.html, however, that data won't reflect the 530 other LTCFs in Alameda County. Their data is collected through a voluntary monthly survey collected by California Department of Social Services. Staff for both SNFs and other LTCFs are required to receive their booster dose by 2/1/22 if they are eligible. Data reported accurately from 39 SNFs through January 2, 2022, show that 78 percent of skilled nursing facility residents in Alameda County and 58 percent of staff have received a booster dose. These rates exceed California's SNFs overall performance. Throughout the pandemic Long Term Care Facilities (LTCFs) have remained the highest priority for COVID-19 outbreak response. Residents of these facilities have increased risk of severe illness, hospitalization, and death. A dedicated team of public health nurses and staff provide rapid response to exposures and cases in these settings and guidance to protect vulnerable residents while limiting further spread of COVID. Shortly after vaccines became available, Alameda County prioritized resources and organized a delivery system to get workers and residents vaccinated at facilities that the federal pharmacy program didn't reach. The federal government did not extend the Federal Pharmacy Partnership Program for boosters. As a result, facilities had to make their own arrangements for their residents and staff. Alameda County has filled in the gaps for facilities that couldn't, including small facilities. The Alameda County Health Care Services Agency filled the critical gap when large pharmacies required 25 doses or more to hold a booster clinic at a Long Term Care Facility. We have received requests for booster clinics from more than 190 SNFs and other LTCFs. Thanks to vaccinating partner providers, more than 170 booster clinics have administered over 3400 doses since mid-October and clinics continue to be scheduled every week. These clinics also provide flu shots. Alameda County shares evidence-based ways to increase booster rates with SNFs with lower rates. Federal data reflect that vaccination and booster provide strong protection for SNF residents and staff against hospitalization and death due to COVID. Everyone eligible is strongly encouraged to get their dose.

Napa County provided the following statement:

There is a growing recognition of the importance of getting boosted, as studies continue to find boosters offer significant protection against serious illness and hospitalization, particularly for vulnerable populations. Our team has done outreach to all nursing homes and long-term care facilities in Napa County to identify their needs for mobile booster clinics. When we get a request, our mobile vaccination team responds quickly to make mobile booster clinics available to residents and staff on site (often within days). There has been steady interest from our nursing homes and long-term care facilities in those opportunities. On December 22, The State Health Officer issued an order that requires healthcare workers eligible for booster doses to receive their boosters no later than February 1, 2022. We expect this order will result in an increase of booster rates among eligible groups. As healthcare facilities across the country face staffing shortages, it is possible that some workers have not had availability in their schedules to access booster doses. Additionally, the federal government has not partnered with pharmacies to provide booster shots to long-term care facilities, as they did for the initial vaccination series through the Pharmacy Partnership for Long-Term Care. That program created a relatively seamless process for long-term care facilities to receive vaccination support from a pharmacy partner enrolled in the Federal Retail Pharmacy Program. Not having that program readily available for the booster campaign has resulted in the need for long-term care facilities to take the initiative in requesting and scheduling booster support. We continue to work closely with healthcare partners and community-based organizations to make vaccination opportunities convenient, free, and accessible to all who need.