Millions of Kentuckians to be eligible for COVID boosters; nursing homes first in line

Millions of Kentuckians to be eligible for COVID boosters; nursing homes first in line

David R. Lutman/Special to Courier journal

Kentuckians vaccinated for COVID-19 could soon be eligible for a booster shot, starting in September, with approval by the U.S. Food and Drug Administration.

That group of more than 2 million people would join more than 27,000 nursing home and senior living residents already eligible for a booster shot in Kentucky because they are considered to have low immunity.

The Biden administration on Wednesday announced a plan — subject to final approval by the FDA — to offer everyone who's had two doses of the Pfizer-BioNTech or Moderna vaccines a third "booster" shot, starting Sept. 20.

The vaccine would be available to individuals at least eight months after their last shot.

Also on Wednesday, President Biden said nursing homes will be required to have staff vaccinated for COVID-19 or risk losing federal Medicare and Medicaid funds that cover the majority of residents who live in most facilities.

"We're still in a pandemic of the unvaccinated," Biden said, adding that people who live in the facilities deserve to be protected from COVID-19 infection.

Kentucky has about 60% of its nursing home workers vaccinated, according to the U.S. Centers for Disease Control and Prevention, and officials have said they have struggled to persuade some workers to take the COVID-19 vaccine.

Rates of vaccinated residents are higher, at more than 80%.

A tight labor marker and the potential loss of workers who refuse vaccines have prevented many nursing home administrators from joining the increasing number of employers making COVID-19 vaccines a condition of employment.

"I'm afraid there's a huge potential for creating a mass exodus from long-term care to those other health care entities that are not required under conditions of participation to be vaccinated," said Tim Veno, president of Leading Age Kentucky, which represents nursing home and other providers.

The administration of Gov. Andy Beshear said Wednesday it was still waiting on final action by the FDA on booster shots for the general population and didn't provide details of how a new mass vaccination effort would work.

About 2.4 million people in Kentucky have now been vaccinated, most with the Pfizer or Moderna version. Fewer have the Johnson & Johnson one-shot vaccine, introduced in March, and federal officials said they are still studying whether to recommend a booster for it.

But efforts to offer the booster shot to nursing home and other senior living residents are already underway, Dr. Steven Stack, state public health commissioner, said Tuesday.

Veno said he is working with state public health officials on details of how to get the third shot to residents who began getting their first doses in December.

"I have a lot of members planning on setting up a clinic," he said. "They're ready to go.

Mary Lynn Spalding, CEO of Christian Care Communities, home to about 4,000 residents at facilities around Kentucky, said her organization is trying to arrange dates now for vaccine clinics.

"Our residents are very excited to get the vaccine," she said. "Everyone's really anxious to get the booster shots."

Last week, the FDA approved booster shots for people with suppressed immunity, such as those with organ transplants or undergoing cancer treatment, and Kentucky public health officials said Tuesday they decided to include nursing home residents in that group.

"Because of their medically frail condition …  and the environment they live in, a congregate setting, we have determined that all of these individuals are going to be offered a third shot," Stack said, speaking at news conference Tuesday.

Stack said nursing home residents were hit hardest by COVID-19, accounting for two-thirds of the deaths before the vaccine became available in December 2020.

Veno said concern also is growing about "breakthrough" infections among vaccinated residents and staff who test positive for COVID-19.

"I'm hearing of more and more breakthrough cases," he said. "I'm happy to report they are asymptomatic or the illness is relatively mild and they don't require hospitalization."

While the recent developments involving booster shots took many by surprise, Dr. Mark Burns, an infectious diseases specialist with the University of Louisville, said he had been expecting decisions about them soon.

That's because of growing concern about the rapidly spreading delta variant of COVID-19 and evidence that immunity of the Pfizer and Moderna drugs has waned over time.

"The bottom line," Burns said, "is that people are going to need boosters."

Burns said he believes the new, more contagious delta strain of COVID-19 has heightened concern among federal health officials — as well as concerns that even more dangerous variants may develop as the virus spreads.

"This delta variant is a very bad one," Burns said. "We want to make sure our antibody levels are high enough to be effective against these variants."

The best defense against delta or future variants is for more people to get vaccinated, he said. In Kentucky, about 54% of people have received at least one dose of vaccine.

"You still have people who are unvaccinated," he said. "As long as this virus continues to spread, it's going to mutate."

And Burns said he thinks the state can handle another round of mass vaccinations for boosters should the FDA approve them for everyone already vaccinated, based on previous and ongoing efforts.

"It's just a matter of getting it planned and rolling it out," he said. "I don't think it's going to be a problem."

Meanwhile, people already eligible can seek a booster vaccine at any pharmacy, doctor's office or other site that offers them, Stack said. They only have to attest they have a condition that lowers immunity and won't have to provide proof, he said.

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