Staggering COVID-19 vaccination of health care personnel to protect health care quality and improve patient safety
By: Dr. Anthony Salandy
Date: 3rd December 2020
Imagine managing a hospital medical unit with a staff of 50 and scheduling them to receive the first dose of a COVID-19 vaccine on a Monday and Tuesday of a particular week. Subsequently, approximately 80% of your staff get vaccinated on those two days. And, by Thursday and Friday of that same week, 25% of your scheduled staff call out sick due to systemic reactions to the COVID-19 vaccine. Maybe, a greater percent call out sick after receiving the 2nd dose a few weeks later.
Now envision that scenario occurring across hospital units (e.g., Oncology, Med-Surg, Pediatrics, ICU) and departments (e.g., food services, environmental engineering, waste management). Moreover, picture it occurring in long-term care facilities (LTCFs) and rural ambulatory care/provider office settings – who are already experiencing limited staffing due to the COVID pandemic.
Shortage in skilled health care personnel can disrupt capacity, and severely impact quality of care and patient safety. This situation could play out if these operational considerations are not addressed in Phase 1a of the COVID-19 vaccination program. The Center for Disease Control and Prevention (CDC) and state health departments should be very clear on operational guidance for COVID-19 vaccine administration at the local level.
COVID-19 vaccine recipients in Phase 1a will include paid and unpaid persons serving in health care settings who have the potential for direct and indirect exposure to patients or infectious materials. Also, included are residents of long-term care facilities (defined as adults who reside in facilities that provide a variety of services including medical and personal care, to persons who are unable to live independently).
To avert potential capacity and quality care issues, The Institute for COVID-19 Vaccination Advocacy encourages operational planners of the COVID-19 vaccination program carefully deliberate the following:
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Stagger COVID-19 vaccination of health care personnel within similar hospital units and departments or positions across the entire hospital, LTCF/ambulatory care facility/doctors’ offices. Careful planning should be given to health care personnel embedded in COVID-19 and related units at medical facilities.
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Schedule and plan for potential absenteeism due to health care personnel systemic reaction to the vaccine. This would require careful planning by practice/unit supervisors and managers. For instance, obtaining data on willingness to get vaccinated would be an important data point for planning purposes. In addition, leadership should communicate with staff about the reasons for staggering vaccination times. Also, institutional guidance on vaccination mandates, exemptions, and refusal should be considered. Closely working with Human Resources will be critical.
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LTCF administrators should work closely with pharmacies in the Long-Term Care Program (Partnership Program) to schedule onsite vaccination visits for staff and residents. Pharmacies in the Partnership Program will administer the vaccines to (1) “residents in all LTCFs, including skilled nursing facilities (SNF), nursing homes, assisted living facilities, residential care homes, and adult family homes” and (2) any LTCF staff members who had not already received a COVID-19 vaccine. Pharmacies will make multi vaccination visits. Thus, LTCF leadership should discuss their staff COVID-19 vaccination strategy with pharmacies to maximize onsite vaccination visits.
Anthony Salandy, Ph.D., M.S.
Dr. Salandy is Founder and Executive Director of the Institute for COVID-19 Vaccination Advocacy (ICVA). ICVA aims to increase knowledge of the COVID-19 vaccination program, decrease COVID-19 vaccine hesitancy, and improve COVID-19 vaccination coverage around the globe.