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A large swath of nursing homes in the United States are poised to receive Covid-19 vaccines beginning Monday, as the country pushes to inoculate some of its most vulnerable citizens and free them from months of confinement.
Nursing homes have felt the brunt of Covid-19’s severity in the United States. At least a third of the country’s more than 305,000 deaths have been reported among residents and employees of nursing homes and other long-term care facilities for older adults, while more than 787,000 staff members and residents have become infected. Most homes have been closed to visitors since the early days of the pandemic, leaving residents feeling lonely and isolated.
Vaccinations started in the United States last week, with health-care workers at the front of the line. The effort has expanded to long-term care facilities as conditions in them have deteriorated anew, with nearly 20,000 cases and an estimated 5,000 deaths reported per week, according to the American Health Care Association and National Center for Assisted Living.
Some states, including West Virginia, Connecticut, Delaware and Florida, began administering vaccines at long-term care facilities last week. The homes are expected to remain locked down until residents’ relatives have been vaccinated.
At The Cedars, a retirement community in Portland, Maine, pharmacists from Walgreens are expected to arrive at 8:30 a.m. Monday to administer vaccines to residents and staff members. “There will be much celebration in the air,” said Katharine O’Neill, the director of operations and communications.
In New York, the state health facilities association — which includes 425 skilled nursing homes and assisted living facilities — has been working with the state and federal governments for about two months to plan how the vaccine will be administered, said Stephen Hanse, the president and chief executive of the association.
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Answers to Your Vaccine Questions
With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:
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- If I live in the U.S., when can I get the vaccine? While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
- When can I return to normal life after being vaccinated? Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
- If I’ve been vaccinated, do I still need to wear a mask? Yes, but not forever. Here’s why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to keep the vaccinated person from getting ill. But what’s not clear is whether it’s possible for the virus to bloom in the nose — and be sneezed or breathed out to infect others — even as antibodies elsewhere in the body have mobilized to prevent the vaccinated person from getting sick. The vaccine clinical trials were designed to determine whether vaccinated people are protected from illness — not to find out whether they could still spread the coronavirus. Based on studies of flu vaccine and even patients infected with Covid-19, researchers have reason to be hopeful that vaccinated people won’t spread the virus, but more research is needed. In the meantime, everyone — even vaccinated people — will need to think of themselves as possible silent spreaders and keep wearing a mask. Read more here.
- Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection into your arm won’t feel different than any other vaccine, but the rate of short-lived side effects does appear higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. The side effects, which can resemble the symptoms of Covid-19, last about a day and appear more likely after the second dose. Early reports from vaccine trials suggest some people might need to take a day off from work because they feel lousy after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headaches, chills and muscle pain. While these experiences aren’t pleasant, they are a good sign that your own immune system is mounting a potent response to the vaccine that will provide long-lasting immunity.
- Will mRNA vaccines change my genes? No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.
Most homes will get the vaccine through CVS Pharmacy or Walgreens, part of a deal struck with the federal government, and residents will probably be vaccinated in their rooms, while staff will receive the doses in separate spaces, Mr. Hanse said.
There will be vaccination celebrations, probably mixed in with holiday festivities. Morale is higher than it has been throughout the pandemic, Mr. Hanse said, because the vaccines give residents hope that they will soon be able to see their loved ones in person after many months of solitude. “One of the things that’s really in play here. too, especially in New York, was the inability for family and loved ones to visit with their family,” he said.
In Fairborn, Ohio, at the Wright Rehabilitation and Healthcare Center, the first doses of the vaccine are scheduled to arrive in the first week of January, Greg Nijak, the executive director of the facility, said.
Preparations have centered on securing vaccine consent forms and disseminating information about the safety of the vaccine. “
Elsewhere, there is trepidation. At the Martha T. Berry Medical Care Facility outside Detroit, a recent survey found that less than half of the staff wanted to take the vaccine. “Our staff is mostly skeptical,” Kevin Evans, the executive director of the facility, said in an email.
The facility has started an information campaign for residents and staff members. Despite the apprehension among employees, residents are eager for the vaccines’ arrival, which the facility is planning to celebrate.
“Though we have multiple FaceTime and Skype and window visits,” Mr. Evans said, “it is not the same as a hug from a son, daughter, or grandchild.”
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