Health advocates urge Illinois to involve more pharmacies to help give COVID-19 vaccines at assisted living sites

Big chain pharmacies have administered the first round of vaccinations at skilled nursing homes in Illinois, but will take about two more weeks to serve assisted living sites — a delay that may prove fatal for some residents, public health advocates warn.

While a federal program depends on CVS and Walgreens drugstore chains to inject the vaccines, other states have found a way to speed up the process by involving other pharmacies that are already working with assisted living facilities in their communities, nursing home experts said. Some health advocates say Illinois should do likewise.

Gov. J.B. Pritzker’s administration indicated that the state is relying on the big chains to finish the first round of shots at assisted living sites by Feb. 15.

Pritzker said at a news conference Thursday that he had recently spoken with leaders from CVS and Walgreens about concerns regarding the pace of vaccinations at nursing homes and other long-term care facilities.

The federal program has allocated nearly 500,000 doses to long-term care facilities in the state. While there is a lag time of up to 72 hours in reporting, only about 131,000 were reported to have been administered as of Thursday, the Illinois Department of Public Health reported.

Despite the large percentage of allocated doses that have not been reported used, Pritzker said the pharmacies are working hard, and he believes the program is “on a good trajectory at this point.”

“The state is doing everything that we can to facilitate that, to help them along in the process,” Pritzker said after touring a vaccination site staffed by Illinois National Guard members at Morton East High School in Cicero.

Illinois Senate Republicans say otherwise. They wrote a letter to the Democratic governor, asking to maximize the rollout of the vaccine. They cited statistics showing that Illinois ranked 47th in overall vaccine distribution, stating, “Illinois has failed its residents.”

Across the country, much of the blame for delays has been placed on the lag in inoculating long-term care residents.

Other states have taken steps to speed up vaccinations for long-term care residents, who are most at risk of dying from the virus.

West Virginia opted out of the federal program, and instead used local pharmacies to finish the first round of injections at long-term care facilities by Dec. 30.

Wisconsin officials also plan to divert doses from the federal program to independent pharmacies and local health departments, to speed up the slow rollout of vaccines at assisted living facilities, Wisconsin Public Radio reported.

Florida also announced it would expedite vaccinations at assisted living facilities by transferring the responsibility from CVS and Walgreens and contracting instead with a local health provider to do the job.

Some health advocates believe that more could be done in Illinois. They say time is of the essence as immunizations shift from skilled nursing homes, which typically provide medical care, to assisted living facilities, which often are more focused on helping with daily living activities such as bathing, dressing and cooking. Some long-term care facilities also include independent living units, where residents are also expected to be immunized.

Patricia Merryweather-Arges, executive director of Project Patient Care, a nonprofit public health policy group, said that the COVID-19 vaccines could be administered by the pharmacy each nursing home is already working with to get medications and other immunizations, including the big chains.

“Had the local pharmacies that serve the nursing homes each day been allowed to immunize the nursing home residents, they would be done by now,” she said.

There are about 2,000 non-hospital pharmacies statewide, with Walgreen or CVS accounting for almost half of them. And there are about 12,000 pharmacists and 36,000 pharmacy technicians in Illinois ready to help if the state would only involve them, said Garth Reynolds, executive director of the Illinois Pharmacists Association.

Many of the pharmacists have signed up with the state ICARE registry to give shots to the public, but are awaiting state approval, Reynolds said.

“We are ready, willing and able,” Reynolds said. “We just got to be told when and where we need to be, and we’ll be there.”

Syracuse University law professor Nina Kohn, who specializes in elder law, said any delay in vaccinations could result in more deaths.

“These delays are lethal,” she said. “The devastation we’re seeing in nursing homes is not inevitable. There’s so much that can be done to stop the unnecessary deaths we’re seeing.”

In addition to involving local pharmacies, she said, states or the federal government could limit nursing home workers to only one facility, to prevent their spreading the virus in multiple buildings.

She warned that assisted living facilities may have very vulnerable patients but not be as well equipped to handle vaccinations as skilled nursing facilities.

“Early indications are that using local pharmacies can help, because you are bringing additional resources to bear on the problem,” she said.

Dr. Michael Wasserman was a member of the National Academies task force last year that recommended that residents of long-term care facilities be the first to get vaccinated. He is the immediate past president of the California Association of Long Term Care Medicine.

People who work in long-term care knew the federal vaccination system wouldn’t work well, he said, because it was built around the big pharmacy chains, rather than the nursing homes.

Part of the delay, he said, was due to CVS and Walgreens having to hire and train pharmacists to give the vaccinations. In addition, he said, many nursing home workers, many of whom are low-income Black and Latino women, are reluctant to get the shot.

Instead, Wasserman said, the vaccination program should have used trusted local pharmacies that nursing homes nationwide already use to get their medications and immunizations for flu and pneumonia. Such a shift could still speed up the process significantly, he said.

“The federal plan was misguided and poorly planned,” Wasserman said. “Tens of thousands of older adults have unnecessarily died because of delays in the vaccine rollout to the people who needed it the most.”

CVS did not immediately respond to questions about the program. Walgreens is making “good progress,” spokesman Phil Caruso said, having given nearly 70,000 first doses at long-term care facilities statewide, including at more than half of assisted living facilities that selected the chain.

Since starting the program Dec. 28, Caruso said, Walgreens has remained on track to finish the job.

“We share the state’s desire to vaccinate as many vulnerable populations in as safe, efficient and timely manner as possible,” he said.

The governor’s press secretary, Jordan Abudayyeh, said Illinois is offering staff and scheduling assistance to finish the vaccinations quickly.

“The state is in close communication with both pharmacy partners and is working with them to ensure they have the resources needed to schedule and administer vaccinations at the rest of the long-term care facilities,” she said. “The state of Illinois is working alongside our partners to start vaccinations sooner than they were previously scheduled through the PPP programs, with the goal of expediting this process as much as possible.”