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Miscommunication and logistics keep some older NC residents waiting on COVID vaccines

NC retirement communities claim CDC removed them from vaccine program 'without notification.'

Brian Gordon
USA TODAY NETWORK
Barbara Fischer talking to her daughter Amy Fischer over the computer.

For months, Marcia Goldstein of Waynesville thought her 94-year old mother, Maxine Goldstein, would get a COVID-19 vaccine at Bella Vista Gracious Retirement Living, her retirement community in Asheville.

Bella Vista’s management did too.

But within the past week, both said they were surprised to learn Bella Vista wouldn’t receive any vaccines.  

“I got desperate, I got frustrated, I got scared for my mother,” Marcia said upon hearing the news. “She’s not a spring chicken.”

Marcia and Maxine had been told Bella Vista was part of the CDC Pharmacy Partnership Program for Long-term Care, which has contracted CVS and Walgreens to administer vaccines in long-term care facilities across most states, including North Carolina.  

Bella Vista is managed by Hawthorn Senior Living, a Washington state-based company which has facilities in 20 states, including nine in North Carolina. According to company spokesperson Adam Bryan, Hawthorn enrolled more than 6,000 residents in the CDC program on Oct. 27.

Bryan said the CDC confirmed these enrollments and told Hawthorn that the company would be notified if they were any issues.

According to Bryan, Hawthorn next heard from the CDC about these vaccinations on Jan. 15, when the company was informed their facilities weren’t eligible for the federal vaccination program.

“Many retirement communities that initially were led to believe they were accepted into the program were removed without notification by the CDC,” Bryan said.

Three days later, Hawthorn informed Bella Vista residents.

“Without notifying us, we were taken off the list,” the letter read.

In an email to the USA Today Network, CDC spokesperson Kate Frusich said that Bella Vista “is an independent living facility” which makes it ineligible for the program.

“The eligibility criteria was designed to ensure the partnership program serves those at highest risk of infection and severe illness from COVID-19 who need onsite vaccination services,” Frusich said.

With vaccine supplies limited around Western North Carolina, Marcia fears an outbreak could ravage the Bella Vista community, where she said many residents need additional assistance. 

Marcia Goldstein with her mother Maxine Goldstein

“All residents are senior citizens,” Marcia said. “Some of them don’t even know what day it is, much less how to schedule a COVID-19 vaccination and arrange transport.”

With no doses coming to Bella Vista, Marcia called several area county health departments over the next few days searching for a vaccine. On Thursday, she found a potential opening and drove Maxine 30 minutes to a vaccination event held on former fairgrounds in Haywood County.

“It’s the best news ever.” Marcia said moments before her mother got her first dose. “I just feel bad because I have one mother, which is fine, but there are a hundred-something other people in that building who don’t have a daughter who lives in a nearby county to help with this.”

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Frustration mounts

When CVS and Walgreens began administering COVID-19 shots in long-term care facilities in late December, and many North Carolinians assumed their loved ones living in these facilities would soon get vaccinated.  

Long-term care residents - those in nursing homes and assisted-living centers - were near (and remain near) the top of the state’s vaccination prioritization list. Many are older and more vulnerable to the virus. Since the pandemic began, long-term care residents have accounted for 45% of the 8,200 coronavirus deaths in North Carolina, according to the state’s COVID-19 data.

Yet as weeks passed, and the state expanded vaccine eligibly to anyone 65 and older, relatives of long-term care residents - and the residents themselves - have grown frustrated as many facilities haven’t received any doses.

“People were very hopeful that it was going to be fast-tracked and done very quickly and that has not been the case,” said Lauren Zingraff, executive director of the Raleigh-based nonprofit Friends of Residents in Long Term Care.

While the state manages vaccinations for the general population, the federal government contracted CVS and Walgreens to administer vaccines in North Carolina's long-term care facilities. Through a partnership with the U.S. Centers for Disease Control and Prevention (CDC), the two pharmacies began administering does on Dec. 28.

As of Tuesday, CVS finished administering first doses in 630 of the 899 facilities it had been contracted to cover in North Carolina, according to CVS spokesperson Joe Goode. As of Jan. Monday, Walgreens had completed giving first doses in 176 of its 183 assigned facilities, according to a company database.

“We remain on track to achieve our vaccine goals in North Carolina consistent with the timelines established by the program,” Goode said in an email.

Walgreens spokesperson Erin Loverher said in an email, “It will take time to cover all facilities, but we have a plan in place.”

Long-term care facilities have faced many of the same issues that have also limited the broader vaccine distribution effort, said Julie Swann, a systems engineer at N.C. State University who advised the federal government’s response to the 2009 swine flu pandemic.

“A new program was set up quickly, and no one really worked through all of the operation details to make it happen smoothly,” she said.

Swann named staffing shortages and cumbersome paperwork among the factors slowing down CVS and Walgreens. She noted gaining consent from patients and their families adds more time to the process.

“One thing that should be clear is that there is not just one operational problem to be fixed,” Swann said, noting complaints with long-term care vaccinations have been prevalent nationwide.

One state that hasn’t received as many complaints is West Virginia. The state was an outlier by not entering the federal partnership with CVS and Walgreens. Instead, it created its own network of local pharmacies to administer doses and has already covered its entire long-term care population.

Swann said that with sufficient advanced planning, a similar West Virginia-model could’ve succeeded in North Carolina.

More:Doorstep lessons: How one woman tries to erase COVID vaccine doubts in WNC's Black communities

Vaccines came too late for some

Family members of long-term care residents expressed feeling a mounting sense of worry and confusion during this past month as they waited for vaccines to arrive to facilities.  

Amy Nugent Haase, a veterinarian in Union County, weighed taking her mother, Dorothy Nugent, 83, away from her senior living facility last week to get a vaccine.

“I was expecting (my mother’s vaccine) a few weeks ago when Mecklenburg (County) began to vaccinate 75-plus in Bojangles' Coliseum," she said. “It seemed a long wait after holiday cases were rising.”

Amy Nugent Haase with her mother Dorothy Nugent

Haase opted against booking her mother a vaccine after considering the risk Dorothy, who has mild dementia, faced by going out in public. With vaccine supplies limited, getting a shot wasn’t guaranteed anyway.   

This week, CVS staff came to Dorothy’s facility, Waltonwood Providence in Charlotte, to give first doses of the Moderna vaccine.

Yet residents in other facilities are still waiting.

In late December, Amy Fischer of Orange County learned her 83-year-old mother’s facility, Brookdale Meadowmont in Chapel Hill, wouldn’t get vaccines until Jan. 26.

“I was incredulous,” she said. “My expectation was they were going to do it really quickly, like a commando operation.”

Seeking answers, Fischer emailed her state senator, Gov. Roy Cooper, and state health secretary Dr. Mandy Cohen. She learned long-term care vaccinations were being handled by the federal partnership with CVS and Walgreens.

“My biggest frustration is that there is no accountability,” Fischer said. “There’s no one on the state or local level who they’re answering to.”

Brookdale Meadowmont had a reported coronavirus outbreak in mid-December, and Fischer feared the delay in vaccinations could be costly. Her fears were realized on Jan. 4 when she was informed her mother, Barbara Fischer, had contracted COVID-19.

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Brian Gordon is a statewide reporter with the USA Today Network in North Carolina. Reach him at bgordon@gannett.com or on Twitter @briansamuel92.