Medicare plans to press reports on vaccinations

Nursing-home filings seen as way to boost inoculations

Centers for Disease Control and Prevention Director Dr. Rochelle Walensky testifies during a Senate Health, Education, Labor, and Pensions hearing to examine an update from Federal officials on efforts to combat COVID-19, Tuesday, May 11, 2021 on Capitol Hill in Washington. (Jim Lo Scalzo/Pool via AP)
Centers for Disease Control and Prevention Director Dr. Rochelle Walensky testifies during a Senate Health, Education, Labor, and Pensions hearing to examine an update from Federal officials on efforts to combat COVID-19, Tuesday, May 11, 2021 on Capitol Hill in Washington. (Jim Lo Scalzo/Pool via AP)

WASHINGTON -- Medicare will require nursing homes to report covid-19 vaccination rates for residents and staff members, the government said Tuesday. Officials hope to nudge facilities to keep giving shots as the worst ravages of the pandemic ease but the danger of a rebound still lurks.

"We're hoping to drive increased vaccination rates among residents and staff, as well as transparency for residents and their families," Dr. Lee Fleisher, chief medical officer at the Centers for Medicare and Medicaid Services, told The Associated Press.

Medicare's move to sustain the pace of vaccinations comes as an initial effort to get shots to nursing homes across the country has wound down. That partnership between the government and retail pharmacy giants CVS and Walgreens is being succeeded by an ongoing collaboration with specialized long-term-care pharmacies that cater to the needs of the nursing home industry. Assisted living facilities and other care centers serving older people can also participate.

A smooth transition will be critical because the coronavirus is far from eradicated, even as new residents are being admitted to long-term-care facilities and staffing ebbs and flows.

People living in long-term-care facilities have borne a heavy toll from the pandemic. They represent about 1% of the U.S. population but accounted for roughly 1 in 3 deaths, according to previous estimates from the Covid Tracking Project.

"This is an important development that is months overdue," said David Grabowski, a Harvard health policy professor who has tracked the industry's struggles with the outbreak. "Many of us argued that this information should have been published starting in December when the federal long-term-care vaccination effort began."

[Video not showing up above? Click here to watch » https://www.youtube.com/watch?v=BUG1XRVyIZ4]

Nursing homes will now be required to submit weekly vaccination numbers for residents and staff members to the Centers for Disease Control and Prevention. That requirement will take effect within two weeks. Medicare officials say it may take two to four more weeks after that for the data to start flowing. The plan is to post facility-level information on the internet so residents and families can easily access the details from Medicare's "Compare Care" website.

"Residents of nursing homes and their families have every right to this basic information," said Sen. Bob Casey, D-Pa., part of a bipartisan group urging the change.

Fleisher said the agency will also gain greater insight into levels of vaccination across the entire industry. That would let health officials direct vaccines and support services to nursing homes lagging behind.

Academic researchers believe that the virus most likely entered nursing homes through staffers who were infected in their communities and became unwitting carriers. Many aides in the low-wage industry work shifts in different facilities.

Medicare's new rule also requires nursing homes and facilities serving people with intellectual disabilities to offer shots and factual education about vaccination to residents, staff members and clients.

Nursing homes are now required to report covid-19 cases and deaths but not vaccinations. A relatively small number of facilities provide the data voluntarily to the government.

"Publicizing this information will hopefully encourage facilities and policymakers to continue efforts to vaccinate staff and residents," Grabowski said. "Many staff were initially hesitant about the vaccine, and new staff and residents also need to be vaccinated. There is still a lot of work left to do."

Cases and deaths plummeted after the government launched a concerted effort to vaccinate residents and staff members. The CDC reports that nearly 2.9 million nursing home residents and staff members are fully vaccinated. Nursing homes and other long-term-care facilities have opened up to family visits again after spending a year in lockdown.

Nursing homes are already required to report rates of flu vaccinations. But until the new requirements were issued Tuesday, there was no similar requirement for covid-19 vaccines even though disease from the coronavirus is far more lethal.

The main nursing home industry trade group, the American Health Care Association, says it supports public reporting of vaccination data but that it shouldn't just apply to them. Hospitals, home health agencies and other providers should also be required to post their numbers. Results should not be used to "judge" nursing homes with low vaccination rates, the group said, but to help them improve.

UBER, LYFT RIDES

Also Tuesday, the Biden administration announced that ride-hailing companies Uber and Lyft plan to offer free rides to coronavirus vaccination sites under a program expected to launch soon.

People will be able to use the companies' apps to choose a vaccination location and follow simple directions to redeem their ride, the White House said in a statement. The partnership is scheduled to begin in the next two weeks and last through July 4.

"By helping get a free ride to a vaccination site, Lyft and Uber are eliminating a potential barrier and driving America closer to the president's goal of getting 70% of the U.S. adult population with at least one shot by July 4th," the White House said.

While demand for Uber and Lyft trips has plummeted during the pandemic, the companies said rides have picked up in recent weeks, leading to a shortage of drivers. The vaccination effort could reintroduce passengers to the services they shied away from at the height of the crisis.

The Biden administration also reported that 1 million Americans had signed up for health insurance under the Patient Protection and Affordable Care Act during a special enrollment period for those needing coverage during the coronavirus pandemic.

President Joe Biden reopened the HealthCare.gov insurance markets in February for a special six-month sign-up opportunity that will go through Aug. 15. His coronavirus relief package also boosted taxpayer subsidies, making the coverage a much better deal for new and current customers.

Biden said the U.S. had made "enormous progress" in expanding access to health insurance through this special enrollment period.

However, the 1 million figure announced Tuesday by the White House also includes people who would have otherwise qualified for a sign-up opportunity, even without Biden's special enrollment period.

Meanwhile, CDC Director Rochelle Walensky urged during a Senate hearing Tuesday that parents get their children vaccinated.

The Food and Drug Administration cleared the Pfizer-BioNTech coronavirus vaccine for emergency use in children as young as 12 on Monday, expanding access to the vaccine before next school year. Walensky said she knew some parents wanted to wait and see how the administration of shots to children goes, but she urged children to ask for the vaccine if their parents are hesitant.

"I would encourage all parents to get their children vaccinated. I know many parents are enthusiastic and have been texting me," Walensky told the Senate Health, Education, Labor and Pensions Committee. "Some parents want to be first, but I'm also encouraging children to ask for the vaccine. I have a 16-year-old myself, and I can tell you he wanted to get the vaccine. He wants his life back. These kids want to go back to school."

RELUCTANCE WANES

Separately, a poll by The Associated Press-NORC Center for Public Affairs Research found that fewer Americans are reluctant to get covid-19 vaccinations than were just a few months ago.

Just 11% of people who remain unvaccinated say they definitely will get the shot, while 34% say they definitely won't, according to the poll.

More than 150 million people -- about 58% of all adults -- have received at least one dose, according to the CDC.

As that number grows, reluctance is inching down. Overall, the AP-NORC poll found about 1 in 5 American adults say they probably or definitely won't get vaccinated, compared with about a third in January, when the shots were just rolling out.

Kizzmekia Corbett, an immunologist with the National Institutes of Health, is one of many health experts who have been working to address concerns of Americans reluctant to get the shots.

Corbett, who helped lead development of the Moderna shot, said she spends hours giving plain-spoken answers to questions from Americans -- especially Black Americans -- to counter misinformation about the three vaccines used in the U.S.

Black Americans are becoming more open to the shots, with 26% now saying they definitely or probably won't get vaccinated compared with 41% in January. That's similar to the 22% of Hispanic Americans and white Americans the poll found unlikely to get vaccinated. Among Asian Americans, just 9% say they definitely or probably won't get the shots.

Holdouts are from all over American society -- fueling experts' advice that people need to hear about the vaccine from trusted sources, whether that's scientists like Corbett or their own doctors. Adults under 45, rural Americans and Republicans are especially likely to say they will avoid vaccination, the poll found. But again, attitudes are changing: 32% of Republicans now say they probably or definitely won't get vaccinated, down from 44% in January.

About three-fourths of those who say they are unlikely to get vaccinated have little to no confidence that the vaccines were properly tested, and 55% are concerned about side effects, the poll found. Even among those who say they will probably get vaccinated but have not done so yet, concerns about proper testing are elevated compared with people who have received their shots already.

In forums hosted by colleges, Black pastors, doctors and even basketball great Kareem Abdul-Jabbar, Corbett says the best way to overcome distrust is to put the science in understandable terms for strangers just like she does for family members.

The vaccines' speedy development "is historic and it is brag-worthy," said Corbett, whose National Institutes of Health team was able to customize a shot that matched the new virus after spending six years developing vaccines against other dangerous coronaviruses such as MERS.

But "really, we should have started the conversations very early about what went into it," she said, so the public understood that no steps were skipped.

The AP-NORC poll of 1,842 adults was conducted April 29-May 3 using a sample drawn from NORC's probability-based AmeriSpeak Panel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 3.2 percentage points.

Information for this article was contributed by Ricardo Alonso-Zaldivar, Lauran Neergaard, Hannah Fingerhut and staff members of The Associated Press; and by Jennifer Hassan, Yasmeen Abutaleb, Marisa Iati and Faiz Siddiqui of The Washington Post.

Upcoming Events