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COVID-19 continues to menace nursing homes across the U.S. In a new report, the Centers for Disease Control and Prevention revealed that just 4 out of 10 nursing home residents got their updated COVID shot since last fall. Sarah Boden looks into why the vaccination rate is so low for these vulnerable Americans.
SARAH BODEN, BYLINE: Mollee Loveland works in a nursing home about 30 miles outside Pittsburgh. She's taking a small break now. She had her daughter, Maya, in May.
(SOUNDBITE OF BABY COOING)
MOLLEE LOVELAND: She got really long legs. She's probably 8 pounds now, but she's still so tiny.
BODEN: Loveland heads back to work soon, but she's nervous about catching COVID at the nursing home and making her baby sick. And there are signals that the U.S. might be headed for another summer surge of COVID, just like last year. Loveland says summer COVID is particularly rough on her patients.
LOVELAND: It seems like it's more amplified with the breathing issues because of how humid it is, how hot it is, how muggy it is, especially having a temperature during summer months. I feel like summer COVID is worse than winter COVID.
BODEN: And winter COVID was already hard on U.S. nursing homes this year. The CDC found when COVID peaked in January, the hospitalization rate for nursing home residents was eight times higher than for all people age 70 and older.
Dr. Rajeev Kumar is president of the medical society for clinicians who provide long-term care. He says part of the problem is that the federal government is no longer picking up the tab for administering the vaccine. While the shots remain free to patients, clinicians must now bill each person's insurance company separately.
RAJEEV KUMAR: It was a lot smoother for pharmacies to say, hey, we administered - I don't know - 150 vaccines today, and we'll get paid for 150 administrations. Now, they have to get individual bills, and it's a little bit more tedious.
BODEN: That makes vaccinating everyone in a nursing home a lot more complicated. And he says there's more skepticism of the vaccine, compared to when it first rolled out. Loveland says she sees that skepticism in her patients at work.
LOVELAND: It's the Facebook rabbit hole. A lot of my patients now are on social media as well, that a lot of people's personal opinions on Facebook affect how the patients think.
BODEN: But there are ways to combat bad information. Just look at North and South Dakota, where more than 60% of nursing home residents in those states have been vaccinated since the fall. Sanford Health is a major medical system there and operates dozens of nursing homes across both states. Dr. Jeremy Cauwels is Sanford's chief medical officer.
JEREMY CAUWELS: For us, the right thing to do was to say, number one, use the power of the bigger organization to make sure we have the vaccine we need.
BODEN: In some Sanford nursing homes, the number of residents who have been vaccinated since October top 60 or even 70%. Cauwels says to achieve this, Sanford leveraged the fact that many of its nursing home patients have primary care clinicians also employed by the health system. They can help persuade the patients to get vaccinated.
CAUWELS: You really can restore some of that hope and faith in medicine in general by being consistent, by being caring and by being thoughtful for the folks that are sitting in front of you that day.
BODEN: Talking directly to patients helps. But critics say that's the bare minimum of what nursing homes should be doing.
RICHARD MOLLOT: Trust has been broken over and over and over again.
BODEN: Richard Mollot leads the Long Term Care Community Coalition, a watchdog group that monitors nursing homes. He says the larger issue is that too many nursing homes consistently ignore resident concerns, serve low-quality food and deliver substandard, if not dangerous, care. All of these problems have gotten worse since COVID caused extreme stress across the industry. Many workers quit during the pandemic, and research shows nursing homes have not fully recovered from this exodus.
MOLLOT: And that has resulted in much lower care, much more disrespectful interactions between residents and staff and would lead to that lack of trust.
BODEN: For Mollot, that's what's actually driving the low vaccination rate. And he says that's inexcusable because nursing home residents are so vulnerable to the virus.
Mollee Loveland's maternity leave ends soon, and she's headed back to the bedside. She says the bosses at her job often ignore patient concerns.
LOVELAND: I feel like if the facilities did more with the patients, then they would get more respect from the patients.
BODEN: So when management tells patients it's time to get the updated COVID shot, Loveland says they're not inclined to listen.
For NPR News, I'm Sarah Boden in Pittsburgh.
GONYEA: This story comes from NPR's partnership with KFF Health News.
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