In researching the link between social and mental health among long-term care (LTC) residents, The Journal of Post-Acute and Long-Term Medicine (JAMDA) identified 12 ways to maintain social connections during COVID-19. The full research is available on their site.

[Click for PDF version]

We hope these strategies might help families, and staff build and maintain social connection for LTC residents during this challenging time. For additional COVID-19 resources, see our COVID-19 Partner Resources library.

Throughout January, the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) co-hosted a series of fireside chats on COVID-19 vaccine safety. Below are highlights from these sessions.

What is the difference between the two COVID-19 vaccines?
The major difference is the cold storage requirement (minus 75 degrees Celsius) of the Pfizer vaccine and its expiration after five days of refrigeration. There are minor differences in dosage and timing – with Moderna's administered as two 100-microgram doses given 28 days apart and Pfizer's administered as two 30-microgram doses given 21 days apart. 

Do the COVID-19 vaccines contain the virus?
No, the virus acts like an avatar. It makes the virus seem as if it is already in the body.

How can we be sure the COVID-19 vaccines are safe?
Multiple U.S. partners are working together to ensure the safety of these vaccines, imploring measures to include expedited clinical trials and extensive vaccine safety monitoring. Learn more via the CDC.gov website, Ensuring the Safety of COVID-19 Vaccines in the United States.

Can the COVID-19 vaccines cause infertility?
No.

Will the COVID-19 vaccines alter my DNA?
No.

Were the COVID-19 vaccines tested on individuals of different races?
Black, Hispanic, Asian, and American Indian representatives were included in trials. According to Newsday.com, they were represented as follows:

* Black (13% U.S. population): 10% U.S. Pfizer participants; 10% Moderna participants
* Hispanic (<19% U.S. population): 13% U.S. Pfizer participants; 20% Moderna participants
* Asian (6% U.S. population): About 6% Pfizer participants; 4% Moderna participants
* American Indian: Pfizer participation similar to U.S. population; Moderna information not provided.

Source: Minority numbers up in clinical trials (December 7, 2020)

If you have had COVID-19 do you still need to be vaccinated? 
Yes, studies are in the works to determine how long you might be immune to the virus.

Does the vaccine contain any fetal cells?
No.

If you already tested positive is there a timeline for getting vaccinated? 
No, but it is recommended you get vaccinated.

How long do you need to be monitored after getting the shot? 
For most people, 15 minutes. If you've had allergic reactions in the past, wait 30 minutes.

Should you continue to wear a mask after both shots?
Yes, you could be a carrier. But, if you are exposed after both shots, you shouldn't have to quarantine.

Does the vaccine contain aspirin in it?
No, nor does it have aluminum or preservatives.

How often will people need to get vaccinated? 
It is too early to tell.

Why are children not receiving the vaccinations? 
The vaccines were fully-trialed on those age 18 and up. Trials began in October in children as young as 12, but trials are expected to continue for several more months.

How can we answer general concerns about staff getting vaccinated?
We are seeing more staff getting vaccinated after they see others receive it with no issues. The CDC developed a toolkit to help facilities address myths and get all healthcare workers vaccinated. 

How can we address safety concerns based on vaccine reactions?
The CDC has no safety concerns based on current vaccine reactions. There is a smartphone app (V-Safe) to text with the CDC after you've received your first and second dose.  

How can we address concerns about the speed of COVID-19 vaccine development?
The technology used to develop the vaccine has been around for 10 years. It was developed for another virus and continues to reduce the timeframes for other vaccine development. Both Pfizer and Moderna trials had at least 30K participants.

When will COVID-19 vaccination distribution improve?
In mid-February, the CDC will begin working with 21 different pharmacy chains/groups to dispense the vaccine.  

Will the states be taking some COVID-19 vaccines back from facilities?
The CDC has tried to provide the correct quantities for each facility. If there are extra doses after all staff and residents are vaccinated, the state may take the overage to use elsewhere.

What can you tell us about the development of new COVID-19 vaccines?
Two new vaccines are close to approval. The AstraZeneca vaccine has a very high efficacy rate. Johnson & Johnson's one-dose vaccine is still in the trial phase with hopes of test completion by mid-February. 

Do people need a second dose of the existing vaccines?
There is not enough data at this time to determine if the second dose is needed.

How can we address timing concerns about getting the second dose within recommended timeframes?
The CDC says you can get the second dose up to 42 days after the first dose. 

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This concluded the series of sessions, but you may find these additional resources helpful:

• 8 Things to Know about the U.S. COVID-19 Vaccination Program

• AMDA COVID-19 Vaccine Q&A Summary

Over the past several months, we've searched and summarized those resources that might be of most help to our friends in senior care. In case you missed them, here they are. And note, most of them have a colorful infographic, checklist or flyer for you to email/print/share with staff, residents and families. Just click the image at the top of each blog.

• 4 Common COVID-19 Myths Debunked
• 5 Leader Strategies to Increase Staff Engagement Despite Fatigue
• 5 Tech Tactics SNFs Are Using to Combat COVID-19
• 7 Focus Areas from the Coronavirus Commission on Nursing Homes
• 7 Steps to Prep Your Facility for the COVID-19 Vaccine
• 8 Tips to Help Staff Cope with Crisis
• 8 Ways to Mitigate COVID Costs in Senior Care
• 12 Low-Cost Ways to Reduce Pandemic Loneliness
• Best Practices for Mitigating COVID Costs in Senior Care
• CDC Interim Infection Prevention Recommendations
• CMS COVID-19 – Summary of Nursing Home Visitation Memo
• CMS COVID-19 Alert – Managing Residents' Safety Over Holidays
• CMS COVID-19 Toolkit – Highlights from Cohorting/Housing Section
• CMS COVID-19 Toolkit – Highlights from Comms and Visitors Section
• CMS COVID-19 Toolkit – Highlights from Infection Control Section
• CMS COVID-19 Toolkit – Highlights from Staffing Section

In addition, McKnight's Long-Term Care News did an excellent job highlight the 7 top long-term care stories of 2020. Included in this article are summaries of each of these:

• ‘Shocking’ therapy cuts slated for 2021
• Unprecedented federal action bans most nursing home visitors 
• CMS paves way for resuming visits at nursing homes
• Nurse aide training, certification requirements waived
• Readmission resident-screening rules changed
• Feds distribute point-of-care COVID-19 tests to all nursing homes
• COVID-centered, infection control training for nursing homes unveiled

This week, AMDA, also known as The Society for Post-Acute and Long-Term Care (PALTC) Medicine has released a COVID-19 vaccine education toolkit to help answer questions from staff, residents and family members. We've used it to create a COVID-19 Vaccine Q&A Flyer with top questions for you to distribute, or hang around your community.

Flyers/posters are just one of many suggested ideas for boosting staff/residents' confidence in the vaccine and the questions are just seven of the many presented in the AMDA toolkit. 

Among questions were these popular ones:

• Can the vaccine give me COVID-19? No, these vaccines do NOT contain COVID-19. They also cannot change your DNA.
  
  
• When will I be protected? You'll be protected 1-2 weeks after the second dose. You must receive 2 doses of the SAME vaccine, 3-4 weeks apart.
  
  
• How long will I be protected? It is uncertain now, but as time passes, experts will know more. You may need to receive them on a regular basis (like the flu shot).
  
  
• What are the possible side effects? You can expect short-term discomfort: fatigue, headache, muscle pain, chills, fever and pain at the injection site. Side effects typically last 24-48 hours and may be worse after the second dose.
  
  
• What if I've already had COVID-19? Even if you've had COVID-19, it is important to get vaccinated for longer/better protection.
  
  
• Will I still need to wear a mask? Yes! A large number of people will need vaccination before transmission drops enough to stop using masks.
  
  
• Why should I get vaccinated? Protect yourself/your family. Keep your residents safe. Help stop spread in the community. Set an example for others, including residents, families, co-workers, and the community.

For more questions, please see Questions and Answers about the COVID-19 Vaccine for PALTC Staff, Patients, Residents and Family Members

For more creative ideas for improving resident/staff confidence in the vaccine, see Strategies for Improving Staff and Resident Confidence in the COVID-19 Vaccine

And, don't forget to download, distribute and hang our flyer, Answers to Your Covid-19 Vaccine Questions.

This week, AHCA/NCAL released an 8-minute video with their Chief Medical Officer Dr. David Gifford and Dr. Shari Ling, Deputy Medical Director at CMS. The two discussed common myths among senior care communities and corrected them. 

Below is a summary of their discussion. Also available is an at-a-glance summary to share with your staff, residents and their families.

Myth #1: Testing Negative After Exposure Means You're All Clear
False. If you know you've been exposed to COVID-19, an immediate test does not mean you're clear. You should wait 5-7 days post-exposure to test and isolate for 14 days.

Myth #2: It's OK to Unmask Outside of Your Senior Care Community
False. Many people are getting infected outside of the facility – most often at family gatherings or restaurants. Further, more than 50% of COVID cases are asymptomatic.

Myth #3: You Only Need to Mask-Up Around Residents
False. Beyond residents, your mask protects you, coworkers and anyone you contact outside of the community. Masks should be worn in all areas of the facility, including break rooms, and out in public.

Myth #4: It's Rude to Alert Other Staff of Improper PPE Use
False. Don't be afraid to tell coworkers if masks have slipped and thank others for helping you. It happens, so we all need to band together and help each other be safe.

Want more? See this article: How to Dispel a Dozen Covid-19 Myths for Patients.

We've reached another critical stage in this pandemic. It's time to snap back to attention and increase safety measures during the holidays. We hope these resources will help.