Thousands of Vaccines From Nursing Homes Boost Supply in States

Dozens of U.S. states are releasing thousands of Covid-19 vaccines left over from a federal initiative for nursing homes, increasing supply for other eligible people like essential workers and seniors.

Illinois will use about 97,000 doses earmarked for nursing homes to vaccinate people 65 and older, teachers and other members eligible under phase 1B. Thirty-two states and cities are transferring extra doses from the federal program, Kristen Nordlund, a spokeswoman for the Centers for Disease Control and Prevention, said in an email Thursday.

Illinois made the decision “to make sure that we can get as many vaccines into the arms of as many people as possible,” Governor J.B. Pritzker said Wednesday. Already, 195,000 doses have been administered in the state’s long-term care facilities, according to data from the CDC.

The extra doses come from a federal program where Walgreens Boots Alliance Inc. and CVS Health Corp. are immunizing residents and workers at nursing homes and assisted-living facilities. Walgreens and CVS have found themselves with extra doses because federal officials overestimated the number of residents and more staff than expected declined to be vaccinated.

Governors, including Pritzker, have widely criticized the federal program for moving too slowly. The revelation that the pharmacies received far too many doses that could be used elsewhere only added to their frustration.

The CDC, which is overseeing the program, allocated doses based on twice the number of beds in a facility. The formula was intended to cover all residents and employees, assuming a ratio of one employee per bed. In reality, those calculations were too high.

“What we need for the program is definitely going to be less than what they anticipated,” said Rina Shah, Walgreens’s vice president of pharmacy operations.

Supply Estimates

In the first weeks of the program, the CDC required states to allocate “ample vaccine supply” to avoid any interruptions or delays in those on-site vaccination efforts, said Nordlund. In some instances, pharmacies wound up with too much supply because of vaccine hesitancy, active coronavirus outbreaks, extra doses in vials and lower-than-expected occupancy, particularly during the holidays, she said.

Occupancy in senior housing is currently at record lows, according to the National Investment Center for Seniors Housing & Care. Only 38% of staff at more than 11,000 nursing homes got at least one dose in the early weeks of the program, according to data released this week by the CDC.

“When you combine all factors together, the actual utilization has been far lower than allocation,” said Chris Cox, CVS’s senior vice president for pharmacy.

Walgreens monitored clinics for the first few weeks to determine if the extra doses were isolated incidents or part of a trend. Once Walgreens identified a discrepancy, it informed the federal government and states, Shah said.

CVS projected how many doses it would need for the remaining clinics, factoring in a roughly 30% increase in the number of residents and staff choosing to be vaccinated during the second of three scheduled on-site clinics, Cox said.

Many states are now either pausing new shipments to the pharmacies or are redirecting the extra doses, he said. Some states like Ohio are asking CVS to immunize people in its drugstores. Others are giving the doses to different providers.

Mass Clinics

Illinois will send the extra 97,000 shots to Walgreens and CVS stores so their pharmacists can immunize people in phase 1B, the state said Wednesday. Arizona and Nevada used some of their extra doses to host mass-vaccination clinics, Shah said.

Idaho made a little over 33,100 shots available for the long-term care program, said Sarah Leeds, Idaho’s immunization program manager. So far, 14,261 doses have been administered, according to CDC data.

This week, Idaho transferred about 12,600 doses, enough to fully vaccinate 6,300 people -- from CVS to other vaccine providers in the state’s seven public-health districts, said state Department of Health and Welfare spokeswoman Niki Forbing-Orr.

The federal program was designed to ease some of the burden on states, Leeds said.

“In a lot of ways it did,” she said. “But I would say it maybe has been offset by having to go back and look at data or the pace at which the vaccines are being administered.”

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