CVS and Walgreens vaccine rollout plagued with miscommunication and paperwork

  • FILE - This Friday, Oct. 21, 2016, file photo shows a CVS drugstore and pharmacy location in Philadelphia. On Monday, Jan. 15, 2018, CVS said it will stop significant touchups of images used in its advertising for beauty products. (AP Photo/Matt Rourke, File) Matt Rourke

Monitor staff
Published: 1/21/2021 3:23:44 PM

As the pandemic continues its deadly creep into the long-term care facilities, the state reported 46 ongoing COVID-19 outbreaks at nursing homes last week.

Hundreds of deaths – 718 and counting – have been traced back to these facilities since the start of the pandemic. In the last seven days alone, 54 people associated with long-term care facilities in New Hampshire have died from COVID-19. Meanwhile, CVS and Walgreens, which have been contracted by the federal government to manage the vaccinations of nursing homes, have administered vaccines markedly slower than hospitals in the state.

Hospitals have administered about 94% of vaccines that have been received from the state, yet CVS and Walgreens collectively have administered a little less than half of their vaccines, despite having about 5,000 fewer delivered doses than hospitals, as of Jan. 14.

Brendan Williams, the president of the New Hampshire Health Care Association, said the explanation is bureaucratic drag – miscommunications and arduous paperwork have been a constant through the process.

Early in the distribution process, Williams said state officials had to remind CVS multiple times that residents in the assisted-living section of nursing homes were also supposed to be vaccinated.

Nursing home administrators, already swamped with under-staffing and COVID-19 outbreaks, often had to badger pharmacy representatives for appointment dates.

“The difference is the efficiency you acquire when you cut out an intermediary,” Williams said. “The pharmacies, CVS in particular, have required a great deal of cajoling.”

Perry Plummer, who leads the state’s vaccine distribution, said working with the pharmacy chains has been difficult because there isn’t a direct line of communication. Because CVS and Walgreens are contracted with the federal government and not the state of New Hampshire, information must go through the CDC and then back to health officials in New Hampshire.

Assisted-living facilities – where residents who need lower levels of medical care mostly live on their own – seem to be most affected by the lag, Williams said. Though the two pharmacies are responsible for vaccinating a combined 158 such facilities, only 72 have been completed. Plummer said he expects all assisted-living facilities to get vaccines by the first week in February.

“There’s no question assisted-living facilities didn’t get ramped up as quickly as we would have hoped,” Plummer said. “There was some miscommunication and misunderstanding.”

CVS and Walgreens have been criticized nationally for their slow rollout of the vaccines. Nursing home administrators in several states have said the pharmacy chains have done more harm than good in helping distribute vaccines. A Mississippi health official publicly criticized the chains, after only 5% of the committed 90,000 vaccine doses committed had actually been administered.

Not every state has done it this way. West Virginia has become a national example of nursing home vaccine distribution done well, in large part because state officials decided to opt-out of the CVS-Walgreens partnership. Instead, they partnered with small, local pharmacies that their nursing homes already had relationships with.

In early January, they finished administering first doses to every long-term care facility in the state. Many states, including New Hampshire, cannot boast the same even weeks later.

Williams said there are a multitude of different distribution strategies that might have gone smoother – perhaps nursing homes, which already employ registered nurses, could have administered the shots directly. But weeks into the effort, it’s too late to turn back now.

New Hampshire is in no way the worst-off state when it comes to long-term care vaccination rollout. In Illinois, for example, CVS completed vaccinations at just one of 647 assisted living facilities. In Maryland, CVS has vaccinated one of 1,625.

“That’s just criminal,” Williams said. “Days matter in this pandemic, and lives are hanging in the balance.”

Williams fears what this rocky rollout signifies for the rest of New Hampshire’s vaccine plan. Vaccinating nursing homes and hospitals was supposed to be the easy part – getting shots to a relatively small, highly concentrated group of people is far simpler than reaching hundreds of thousands Granite Staters scattered across the state.

“If this is really that hard, I just don’t understand how its’ going to work with the general public,” he said. “It just seems like a monumental task for these deep-pocketed pharmacies.”

Several nursing home administrators have said their vaccination process has gone smoothly. Craig Labore, an administrator at Grafton County Nursing Home, said vaccines were administered carefully and efficiently. He was careful to point out that his facility partnered with Walgreens and that many of his colleagues who have been paired with CVS have had a more difficult time. Williams said those who have had challenges are unlikely to go public with their complaints and “bite the hand that barely feeds them.”

A spokesperson for CVS said its vaccination efforts are still on schedule as agreed in the federal partnership, according to public statement. Walgreens also said they’re on track to finish administering the first round of vaccines by Jan. 25.

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