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The Centers for Disease Control and Prevention has proposed guidelines for prioritizing who receives future COVID-19 vaccinations, highlighting nursing home employees in particular.

In a Wednesday presentation, the agency’s Advisory Committee on Immunization Practices laid out scenarios for vaccine delivery targeting groups at high risk from severe disease. These include 17 million to 20 million U.S. healthcare personnel along with essential workers, people with high-risk medical conditions, and the estimated 53 million U.S. adults aged 65 years and older — about three million of whom live in long-term care facilities, the group reported.

These groups overlap, with nursing home workers standing out as both at risk themselves and as potential virus carriers among vulnerable older residents.

The proposed guidelines include “all paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials,” along with those not directly involved in patient care, ACIP said. In skilled nursing facilities, this includes nurses and nursing assistants, who comprise the largest percentage of the industry’s workforce, along with personal care aides, medical and health services managers, cleaning personnel, cooks and physical therapists, the organization noted.

ACIP foresees some challenges in vaccine delivery to these settings, in part due to the need for social distancing. “Workers at long-term care facilities are a priority among healthcare personnel, and achieving high coverage is important and may be resource intensive,” the group concluded. 

ACIP expects to vote on the prioritization in a September session, and the organization ended its August meeting with the following groups in priority “tier 1”:

  • Those most essential in sustaining the ongoing COVID-19 response
  • Those at greatest risk of severe illness and death, and their caregivers
  • Those most essential to maintaining core societal functions

Meanwhile, the National Academy of Medicine is inviting public comment on a draft study that will propose equitable allocation of potential COVID vaccines. Comments will be taken starting Sept. 1 via the National Academies’ website

“Input from the public, especially communities highly impacted by COVID-19, is essential to produce a final report that is objective, balanced, and inclusive,” the organization stated.

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