Megan McCormick, Community Health Worker for Aging and Disability

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The Aging and Disability Resource Center (ADRC) of Jackson County developed “Healthy Measures," a promotional campaign to interact face-to-face with clients and engage them in their own self-protection by improving vaccine confidence and expanding access to vaccines. The campaign, conducted between October and December 2022, included two components:​

1. Connecting people with medical professionals from Jackson County Public Health who partnered with the ADRC to answer questions and share information on available vaccines. People were also connected to the Elder Benefit Specialists who provided information on insurance coverage for vaccines.​
2. Dissemination of tote bags with items such as a cold pack, a thermometer, a pulse oximeter, a COVID-19 at-home test, facemasks, and hand sanitizer. These tote bags were distributed in the community during events like the senior carnival and the 'Bingo Bash,' as well as at congregate meal sites and during home deliveries.  
   

Care Providers of Minnesota

Patti Cullen, President and CEO

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Care Providers of Minnesota, a non-profit membership association made up of nursing homes, senior housing, and assisted living home care, attributes the association's vaccination successes to their three-bucket approach:

Efficiency:

• Ensuring vaccines are available and ready at the time a resident is admitted or when staff is onboarded or inquires about vaccines. Partnerships with the Minnesota Department of Health (MDH), the Regional Health Care Coalition, and the Quality Improvement Organizations (QIO) help facilitate vaccine access​. ​
  
• Minnesota Vaccine connector for direct scheduling at vaccination sites.
  
• Encouragement for hospitals to vaccinate prior to transfer/discharge.

Coordination of Efforts:

• ​MDH website provides resources that facilities can use/adapt for planning and messaging:
  
• ​​​https://www.health.state.mn.us/diseases/coronavirus/hcp/ltc.html#NaN
• https://www.health.state.mn.us/diseases/coronavirus/vaccine/index.html
  
• Minnesota's Regional Health Care Coalitions coordinate strategies and removing barriers at the local level. 
  
• ​​Regular communication between MDH, QIOs, and Care Providers of Minnesota to target assistance to lower-performing facilities.
  

​​Communications: 

• MDH dedicated email/phone line for vaccine access issues and MDH LTC webinars.
  
• Regional Health Care Coalition meetings/contacts.
  
• QIO outreach particularly for assistance in data entry in the National Healthcare Safety Network (NHSN).
  
• Streamline and coordinate messaging to/from LTC facilities based on inquiries from the White House/Centers for Medicare and Medicaid Services/CDC, particularly for lower-performing facilities.
  

​​Addressing the barriers to success: the working partnership between MDH, Regional Health Care Coalitions and Care Providers of Minnesota enabled the following efforts:

​Barrier – vaccine access in communities/populations with lower vaccine coverage.

• ​​Action: set up vaccination events/pop-up clinics focused on cultural, faith-based and disability communities using trusted messengers to drive demand and participation.
  

​​​​Barrier – staff turnover in LTC facilities and poor vaccine data quality in NHSN.

• Action: linked assistance to provide staff training to improve data quality.
  

Barrier – confusing information on the timing of bivalent vaccine after COVID and/or last booster.

• Action: developed clear messages LTC facilities can use to inform staff/residents.
  

Barrier - family resistance to allowing their loved one to receive the vaccine.

• ​Action: developed concise informational one-pagers, and advertisements, as well as trusted messengers, to share current information with both the public and LTC resident families​.
  

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The Ohio Department of Aging established the Ohio COVID-19 Vaccine Maintenance Program, a state-supported collaboration that matched nursing homes and assisted living facilities with a pharmacy. This allowed facilities to select the vaccine provider of their choice, maximize flexibility, and schedule clinics when it is convenient for them. Options include three plans:

• Pharmacy administered - the pharmacy stores the vaccine, delivers the vaccine, administers the vaccine, and reports the data.
  
• Joint administration - the pharmacy stores and delivers the vaccine, but the facility administers a vaccine, while the pharmacy may do the reporting.
  
• Facility administered - the facility stores the vaccine, administers the vaccine, and reports the vaccine data.
  

As of December 2022, the program included over 1,300 LTC facilities and 37 pharmacies which delivered nearly 176,000 doses and held 27,000 clinics.

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North Dakota Health and Human Services Immunization Unit

Jenny Galbraith, Immunization Manager

The North Dakota Health and Human Services (ND HHS) Immunization Unit leveraged its partnerships to fully understand the vaccination capabilities of all of the State’s LTC facilities. Four strategies that proved to be successful in improving the State’s LTC facilites COVID-19 vaccination rates:​​

• Coordinated the connection of a local pharmacy vaccination provider with each LTC facility. Prior to each vaccination campaign effort (initial series, booster, bivalent booster), the Immunizations Unit called each facility to confirm they had a primary and backup vaccinator available as soon as recommendations are announced. In addition, a two-week goal was established to generate a sense of urgency at the onset of each campaign effort.
  
• Established a strong partnership between the ND HHS Immunization Unit and the ND LTC Association. The Immunization Unit maintained this partnership throughout the COVID-19 pandemic to ensure open communication and coordination of all response efforts, including case reporting, testing, isolation/quarantine efforts, vaccination, and treatment.
• Established a reporting system (prior to the rollout of the NHSN module) to capture vaccine coverage among LTC staff and residents. This reporting tool allows for visibility (and comparison against the immunization information systems) of poor data quality vs. low vaccine coverage, facilitating a more targeted technical assistance to each facility.  The Immunization Unit, in turn, actively engaged facilities on a regular basis.
  
• Established a partnership with the ND State University to provide communications and education support to facilities requiring technical assistance. This partnership essentially expanded the capacity of the Immunization Unit and allowed for in-person (in-facility) technical assistance as needed. 
  

Additional Resources

• ​Promoting Bivalent Vaccinations for Older Adults: Long-Term Care Provider Perspectives (Archived Webinar)​
  
• Easy to Read COVID-19 Materials
• Possible Side Effects After Getting a COVID-19 Vaccine
  
• Sample Letter to Long-term Care Facility Residents
• COVID-19 Vaccines for Long-term Care Residents
• COVID-19 Update: Clinical Guidance and Patient Education for Bivalent COVID-19 Vaccines
• Why Long-Term Care Residents Should Get the COVID-19 Bivalent Booster
  

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