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Jabbar Fazeli is a geriatrician in southern Maine.
Despite the expected post-holiday surge in COVID cases, and the emerging new virus variants, we are all hopeful that the virus will be vanquished through immunization in the coming months.
Based on the current pace, long-term care facilities in Maine should be done vaccinating their staff and residents in the next couple of months. There are no official figures on how many healthcare staff are refusing the vaccine, but anecdotally, the number being vaccinated are nowhere near 100 percent. The Maine Medical Directors Association is now surveying long-term care facilities for vaccination data.
While the resident vaccination rate is high, that is not enough to protect these elderly residents since their immune response is known to be weaker with all vaccines. Staff vaccination provides the primary cocoon of protection for the long-term care residents, but it’s still not on target — more education and measures are needed to improve staff vaccination rate.
Another important group that also needs to be vaccinated as a priority are the family caregivers. Just like staff, family members are more susceptible to community transmission of the virus and need to be vaccinated if they are to interact with long-term care residents.
Most long-term care residents haven’t seen their families face to face in the same room for almost a year, and while the state and federal guidelines allow some visits, there is no easy path to safely achieving this goal without practical plans to vaccinate family members.
An unvaccinated and untested family member poses a risk to the facility they enter and the residents they visit. Facilities cannot, by law, require vaccination of family members, so it falls on policy makers to remedy this gap in long-term care vaccination.
The logistics of vaccinating family members might be considered daunting, but if there is an official prioritization of family caregivers for vaccinations, facilities, pharmacies, and families can handle most of the logistics on their own. In the case of our facilities, we would issue a document signed by the medical director stating the name of the resident and their one or two family members designated as essential for purposes of visitation. The families can bring these facility-issued documents to their CVS or Walgreens and schedule a vaccination appointment.
Many of our long-term care residents cannot wait until the summer for their families to get vaccinated with the rest of the lower risk population, and some won’t be around to see that happen.
By the numbers, we need 12,000 vaccines to cover two family members per nursing home resident in Maine. This should be doable in the coming weeks or months. The numbers for assisted living and independent living is higher but still manageable if there is a will to do this.
Long-term care facilities in Maine worked hard, despite the shortages and challenges, to keep their residents safe and alive. To the residents, however, it’s not enough to be alive, they also need to live, and for that they need their families.
Let’s ask our leadership to save a few vaccines for this cause.
