By the end of December, West Virginia had given all roughly 28,000 staff and residents of nursing homes and other long-term care facilities in the state the first dose of the coronavirus vaccine.
It was a remarkable achievement, especially given that only about 429,000 doses have been administered to long-term care facilities nationwide, according to the Centers for Disease Control and Prevention.
The key was Gov. Jim Justice’s decision not to use the federal Pharmacy Partnership for Long-Term Care Program. Rather, he let state and local agencies work with private healthcare providers to administer the vaccine.
“As we looked at the federal program and the makeup of our pharmacies in West Virginia, it became that the federal program might not be the best avenue for our state to tackle long-term care facilities,” said Krista Capehart, director of professional regulatory affairs for the West Virginia Board of Pharmacy, one of the agencies responsible for coordinating the effort.
Under the federal program, vaccines are distributed via two large chain pharmacies, CVS and Walgreens. According to Matt Walker, director of the West Virginia Independent Pharmacy Association, it made more sense for West Virginia to rely more on independent pharmacies.
“West Virginia is a small, rural state, and we don’t have a city with more than 50,000 people,” Walker said. “But what we do have is many small communities with small pharmacies that are trusted in those communities.”
About 45% of the pharmacies in West Virginia are independently owned, according to Capehart.
The West Virginia Board of Pharmacy opened the state distribution plan to all pharmacies, including CVS and Walgreens, although only Walgreens participated. In late November, the Board of Pharmacy sent surveys to all pharmacies asking if they would be willing to participate in vaccinating long-term care facilities. The ones that responded “yes” received a follow-up survey asking if they had adequate staff and the equipment to store vaccines that needed to be refrigerated.
It would seem that coordinating with a few large chain pharmacies would have been easier than coordinating with multiple independent ones. But independent pharmacies had one key advantage.
“We have a lot of freedoms that the corporate chains don’t,” said Clark Parker, the pharmacist in charge at the Bypass Pharmacy in South Charleston. “We don’t have to go through 47 different people to get permission to vaccinate a long-term care facility. We just have to follow state regulations.”
Being more nimble than large chain pharmacies allowed some pharmacies to seek out nursing homes actively.
“I reached out to some of the facilities in my area and asked if they had partnered with another pharmacy,” said John Lambert, a pharmacist and owner of Lambert Drug Store in Romney. “Most said no and said they were looking for a partner. I asked if they wanted me as their partner, and they were excited to have us partner with them.”
Many long-term care facilities were able to partner with pharmacies they had long-term relationships with. In the case of facilities that didn’t have such relationships or had one with a CVS, which did not participate in the program, the Board of Pharmacy would assign facilities to pharmacies that had agreed to participate.
Once the long-term care facilities had partnered with a pharmacy, they then had to inform the state how many people in their facility needed to be vaccinated.
“After that, we just needed to schedule a date and make sure the residents and staff showed up,” said Marty Wright, CEO of the West Virginia Health Care Association, a trade association for long-term care facilities in the state. “Most of the burden fell on the pharmacies.”
Once the National Guard delivered the vaccines to the pharmacies, it usually took only a few days to get the staff and residents vaccinated. Both Lambert Drug Store and Bypass Pharmacy completed their vaccinations at long-term care facilities in about five days.
“It was pretty impressive,” Clark said of the campaign. “I’ve got to give the National Guard credit along with the Board of Pharmacy, local health departments, and the coordinators in the nursing homes. I’m usually a skeptic of any mass mobilization, but they have all done an incredible job.”
