In a concerning development, less than 4 in 10 nursing home residents have received the latest COVID-19 vaccine, despite the devastation caused by the disease within these facilities since 2020. The Biden administration and the care industry agree that they share responsibility for the low vaccination rates, but the blame game between the two parties continues.

Xavier Becerra, the Secretary of Health and Human Services, has held two meetings with representatives from nursing homes since December 21 to emphasize the importance of offering vaccines to the residents. However, nursing homes argue that the federal government needs to increase the funding provided to administer the vaccines, while also urging Becerra to do a better job persuading people to get vaccinated.

Katie Smith Sloan, president of industry group LeadingAge, expressed her concerns to Becerra, calling on him to directly appeal to residents and their family members. Sloan provided a to-do list to improve vaccination efforts, including allowing nursing homes to make smaller vaccine orders to match declining demand, involving hospitals in the vaccination campaign, increasing Medicare reimbursements for vaccine administration, and developing an effective messaging strategy.

During the second meeting, Becerra reiterated the federal rules requiring nursing homes to offer vaccines but did not offer any new aid. Despite the demands put forth by nursing homes, a senior administration official, speaking anonymously, expressed skepticism that checking off every box on the to-do list would significantly increase vaccination rates.

The vulnerability of nursing home residents to COVID-19 due to their age and underlying conditions makes the low vaccination rates even more concerning. Initially, when the first COVID-19 shots arrived in nursing homes in late 2020, almost every resident chose to be vaccinated, providing a sense of relief given the high death toll at that time.

However, the success of the initial vaccination campaign has diminished over time. Interest in vaccination has reportedly declined due to concerns over the inability of the vaccines to fully halt transmission, as well as disagreements over who needs an annual shot, despite expert consensus that elderly individuals should receive it.

In September 2023, the administration shifted the responsibility of buying and managing distribution of the vaccines to insurers, pharmacies, doctors' offices, and other private healthcare organizations. This decision, coupled with the end of the public health emergency, has likely contributed to the decline in vaccination rates among nursing home residents.

As of now, only 38 percent of nursing home residents have received the latest COVID-19 shot, a significant drop from the initial vaccination campaign. There is a wide variation in vaccination rates among states, with North and South Dakota reporting over 60 percent of nursing home residents vaccinated, while only 20.1 percent of Arizona nursing home residents have received the vaccine.

Tragically, COVID-19 continues to claim lives in nursing homes, with nearly 600 residents dying in the first two weeks of 2024. While government and industry leaders acknowledge that there may be other factors at play, they believe that providers in states with higher vaccination rates can serve as examples for others to do better.

Dr. Jeremy Cauwels, overseeing the Good Samaritan Society, a long-term care provider based in South Dakota, emphasized the importance of trust in increasing vaccination rates. He cited the strong relationships between patients and healthcare providers as a powerful tool in overcoming vaccine skepticism. Some facilities within Sanford-owned facilities have achieved vaccination rates of over 90 percent.

While some nursing homes have made efforts to vaccinate their residents effectively, with more than half of LeadingAge facilities reporting high vaccination rates, industry experts have noticed a decrease in the administration's efforts to persuade Americans to get vaccinated compared to earlier in the pandemic.

Centers for Disease Control and Prevention (CDC) Director Mandy Cohen expressed the agency's commitment to the vaccination of nursing home residents, underscoring the risks they face. The CDC, along with federal agencies, state and local health departments, and healthcare partners, has been working to address access issues and encourage vaccine uptake.

Despite these efforts, some individuals within the administration believe that the shift from a government-run distribution system to one managed by the private sector should result in a reduced role for the government in promoting vaccination. The belief is that messaging from manufacturers and private entities may be more effective, as the administration's hard sell approach might reinforce vaccine skepticism in certain communities.

As COVID-19 vaccination rates among nursing home residents remain low, it is clear that further action is needed to protect these vulnerable individuals. It is crucial for the Biden administration, nursing homes, and the healthcare industry to work together to address the challenges and develop effective strategies to overcome vaccine hesitancy, ensure adequate funding for vaccination efforts, and restore public trust in the vaccination process.