Home health workers are a top priority to get COVID-19 vaccines, but don’t know when or where

As photos of the first hospital workers getting COVID-19 vaccinations proliferate and nursing home residents and employees prepare to roll up their sleeves any day now, another top priority group — home care providers — wonder when they’ll get their shots.

“It’s still very much up in the air,” said Dave Totaro, chief government affairs officer for Bayada Home Health Care, which operates in 23 states. About half of the New Jersey-based company’s 36,000 employees are in New Jersey or Pennsylvania.

“We don’t know not only when but where,” he added. “We don’t even know how we’re going to be notified.”

Most states have placed home care nurses and aides in their top priority group, known as 1a, along with other high-risk medical workers and those who work or live in nursing homes. Hospitals and nursing homes are relatively easy places to vaccinate large groups. That’s a plus with the first vaccine approved, one made by Pfizer-BioNTech that requires special ultracold freezers and is shipped in 975-dose trays. A second vaccine made by Moderna that does not require as much special handling is also on track for emergency authorization later this week.

Vaccinating home care workers, who are tied to smaller offices and spend most of their time in homes spread throughout communities, presents tougher logistical challenges — challenges that states are apparently still working through.

While New Jersey would not release details of its home health plans, Stephanie Kulak, corporate clinical director for Preferred Home Health Care Nursing Services, said New Jersey’s plan is “fairly well organized” while Pennsylvania’s is not. Her agency has about 4,000 employees that work with clients in Pennsylvania, New Jersey, and Delaware.

Kulak said she has been told New Jersey plans to vaccinate home health workers through PODs, or points of dispensing. Agencies will have the option of getting the vaccines themselves and giving the shots, having pharmacies come to them to vaccinate workers or sending workers to pharmacies. Her agency plans to have pharmacies give the shots at agency offices. She said she’s been told vaccines could be available within two weeks.

Nancy Fitterer, president and CEO of the Home Care and Hospice Association of New Jersey, said home care agencies are likely to get the Moderna vaccine because of the more flexible handling requirements.

Laurie Conbeer, director of nursing for Phoenixville-based Personal Home Care, said there has been a frustrating lack of details in Pennsylvania. “We have no clear path to the vaccine at this point,” she said.

Bryant Greene, who owns six Always Best Care offices in Pennsylvania and Delaware, also wants more information. “We’re a part of phase 1a, but when?” he asked. “Where do we go stand in line?”

Teri Henning, CEO of the Pennsylvania Homecare Association, said she talks with the state Department of Health every day about the logistics of vaccinating the state’s more than 183,000 home care workers. She hopes to have information this week. “We are getting a lot of questions from members and care providers,” she said.

A Health Department spokesperson said the state is considering agency locations and how much vaccine will be allotted to nearby communities. “The timeline of when this happens is dependent upon our vaccine allocations moving forward and remains fluid,” said Rachel Kostelac.

James Garrow, a spokesperson for the Philadelphia Department of Public Health, which will have its own distribution system, said home care workers who are employed by hospitals will get their vaccine through their hospitals. Those who work at unaffiliated agencies will be able to get shots through pharmacies, urgent care centers, and health department clinics. The earliest this could happen is next week, he said.

Nina O’Connor, a physician who heads Penn Medicine’s palliative care program, said staff of Penn’s home care program have been included in the system’s top priority group and are scheduling their shots now.

Totaro, of Bayada, said there has been no national vaccine distribution plan and states only learned last week how many doses would be in their first shipments. “Given the hand they were dealt, Pennsylvania and New Jersey are doing about as well as they can,” he said.

There is some concern that agency workers might not want to be among the first to get the new vaccines, which were developed at record speed. To address worries, some agencies are teaching staff how the vaccines work and how they were tested. Fitterer said she has heard that as many as 80% of staff members in some agencies and as few as 40% in others want the vaccines.

Totaro said attitudes at Bayada changed drastically after photos and film of hospital workers getting shots became widely available. A week ago, about 80% of workers were concerned about getting the shots. By Wednesday, though, about 71% said they’d get them.

Kulak said almost everybody in some offices in North Jersey, where the virus hit early and hard, wants the vaccine. “They’ve seen patients that have been affected by this and they’re living in it,” she said. “They want it to end.” People at the company’s Bala Cynwyd office are similarly enthusiastic. “Every employee there is just like, how soon can we get this?”

Greene, who has a little less than 1,000 employees, said his nurses are eager to get the vaccine, while nursing assistants have more mixed feelings. He’s getting more comfortable with the vaccine as he sees hospitals using it, but has some concerns himself even though he has risk factors for serious COVID-19: He’s Black, male, and has Type 2 diabetes. He would probably get it if he worked directly with patients. He doesn’t plan to pressure employees to be vaccinated.

“I’m eager to introduce them to it as a resource,” he said. “I am not eager to make them pushed to feel they have to.”

Totaro said he has not heard of anyone who is requiring the vaccine.

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While workers will still have to wear masks and other protective gear, the vaccines will likely reduce stress for both workers and clients, agency leaders said. They lost a lot of business early in the pandemic as families feared having any outsiders in their homes. Since then, many have learned they can’t take care of their loved ones alone. “The burden’s too high,” Kulak said.

Totaro isn’t grumbling about the current timeline for vaccination. “We’ve waited a long time,” he said. “We’re willing to wait a little longer to make sure it’s being done efficiently and accurately.”