For many families, there’s a turning point: This week, health workers from CFS and Walgreens, under contract from the federal government, will fan out to nursing homes across the country to vaccinate residents against the coronavirus. The shots will not only help protect the elderly and sick in the country – and the staff who care for them – but they also raise the prospect of ending the devastating isolation that many residents have felt for months.
Family members hope that they will soon return to regular visits to parents and grandparents, aunts, uncles and other loved ones. We spoke to experts about some frequently asked questions.
Will the restrictions on visits be lifted soon?
Probably not in a big way. Restrictions vary by state, and the federal government’s guidelines on what it considers safe now stand up. They already allow visits under certain conditions. The Centers for Medicare & Medicaid Services, or CMS, advised in September to allow outside visits with residents and also inside visits, if the facility has been free of cases for 14 days.
Some medical experts have said those guidelines are too lax and that visits should be severely restricted, even banned. However, some of these experts now say that the vaccine changes the comparison somewhat.
“Once all residents have been vaccinated, it opens the door to relaxation of restrictions,” said Dr. Michael Wasserman, the immediate former president of the California Association of Long Term Care Medicine, a geriatrician and former director of nursing home chains.
To facilitate visits, Dr. Wasserman recommends that all nursing home residents be vaccinated (unless they have a condition or allergy that would discourage vaccination on medical grounds); all staff must be vaccinated; the nursing home must have the ability to ensure that visitors test negative for the coronavirus and that penalties are imposed for wearing a mask in public settings.
Is the vaccine safe and effective for elderly and vulnerable nursing home residents?
The clinical trials of the Pfizer and Moderna vaccine included people over 65 and the results showed that it is safe and works in both older and younger people.
“This vaccine has been tested and clinically tested to ensure it meets the highest safety standards. It’s also safe to get it if you already had the virus, ”says a campaign to encourage people to take the photos by the American Health Care Association and the National Center for Assisted Living, a combined trade group that provides nursing homes and counseling represents living communities.
The lead administrator for CMS, Seema Verma, bolstered admission confidence for elderly patients, including those with health problems, in a statement last week: “I urge states to prioritize nursing homes and vulnerable seniors in the distribution of the vaccine. “
This point is echoed by Dr. Sabine von Preyss-Friedman, chief medical officer of Avalon Health Care Group, which operates nursing homes, who said the new vaccines appear “safe and effective.”
As the distribution of a coronavirus vaccine begins in the US, here are answers to some questions you may be wondering about:
- If I live in the US, when can I get the vaccine? While the exact order of vaccine recipients may vary by state, medical providers and residents of long-term care facilities are likely to come first. If you want to know how this decision comes about, this article will help you.
- When can I return to normal life after being vaccinated? Life will only return to normal if society as a whole is given adequate protection against the corona virus. Once countries have approved a vaccine, they can vaccinate at most a few percent of their citizens in the first few months. The unvaccinated majority will still remain vulnerable to becoming infected. A growing number of coronavirus vaccines offer robust protection against illness. But it is also possible for people to spread the virus without even knowing they are infected because they experience only mild symptoms or no symptoms at all. Scientists do not yet know whether the vaccines also block the transmission of the coronavirus. So for now, even vaccinated people will have to wear masks, avoid crowds indoors, and so on. Once enough people have been vaccinated, it will be very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society reach that goal, life could begin to approach almost normal by the fall of 2021.
- If I have been vaccinated, do I still need to wear a mask? Yes, but not forever. This is why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to make antibodies. This appears to be sufficient protection to prevent the vaccinated person from becoming ill. But what’s not clear is whether it’s possible for the virus to bloom in the nose – and sneeze or be exhaled to infect others – even if antibodies have been mobilized elsewhere in the body to keep the vaccinated person from getting sick. The clinical trials of the vaccine were designed to determine whether vaccinated people are protected from disease – not to find out if they can still spread the coronavirus. Based on studies of flu vaccines and even patients infected with Covid-19, researchers have reason to hope vaccinated people will not spread the virus, but more research is needed. In the meantime, everyone – even vaccinated people – will have to see themselves as potential silent diffusers and keep wearing a mask. Read more here.
- Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is given as an injection into the arm, like other typical vaccines. The injection in your arm will feel no different from any other vaccine, but the number of short-term side effects will seem higher than with 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 may resemble the symptoms of Covid-19, last about a day and are more common after the second dose. Early reports from vaccine studies suggest that some people may need to take a day off from work because they feel bad 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 headache, chills, and muscle pain. While these experiences are not pleasant, they are a good sign that your own immune system is developing a powerful response to the vaccine that will provide long-lasting immunity.
- Will mRNA Vaccines Change My Genes? No. Moderna and Pfizer vaccines use a genetic molecule to boost 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 with a cell, allowing the molecule to slip in. The cell uses the mRNA to make coronavirus proteins that can stimulate the immune system. Each of our cells can contain hundreds of thousands of mRNA molecules at any given time, which they produce to make proteins themselves. Once those proteins are made, our cells shred the mRNA with special enzymes. The mRNA molecules that our cells make can only survive for a few minutes. The mRNA in vaccines is designed to resist the cell’s enzymes for a little longer, so that the cells can make extra virus proteins and elicit a stronger immune response. But the mRNA can take up to a few days to be destroyed.
If restrictions are relaxed, should I visit right away?
The Pfizer and Moderna vaccines both require two injections: the first injection and a booster three or four weeks later. Dr. von Preyss-Friedman recommends waiting at least two weeks after the second shot to pay a visit.
“You hope these vaccines work, but these are older patients,” she said. “You want to be wrong on the side of protection.”
She said that ideally the visitor would also be vaccinated. Since shots won’t be widely available for the first few months, it may be best to wait until you get your vaccine. Until then, she feels that nursing homes should consider visits on a case-by-case basis.
Should visitors still wear a mask?
Absolutely, medical experts said. This is especially true if they have not been vaccinated, but even after they have been vaccinated “until rates drop in the community,” said Dr. Joshua Uy, a geriatrician and associate professor at the University of Pennsylvania Medical School and Renaissance medical director. . Healthcare & Rehabilitation Center, a nursing home in Philadelphia.
Dr. Uy said he hopes the federal government will provide adequate personal protective equipment so that all visitors and residents can be approved for such visits.
What is being done to encourage nursing home residents to get vaccinated?
The Nursing Home and Assisted Living Trade Group has started a program to help nursing homes and other health care facilities explain to residents the essential need to receive the vaccine. The campaign, #getvaccinated, notes, “The older population has a much higher risk of becoming very ill, hospitalized or dying from Covid-19. The vaccine has been shown to provide great protection against serious diseases due to Covid-19. “
But the people they love most may have more effective persuasion. Families can help, said Dr. Uy, by encouraging their parents and grandparents in nursing homes to get vaccinated.
“The vaccine,” he said, “will be our way out.”