March 8, 2021
The Centers for Disease Control and Prevention (CDC) has released new public health guidance for individuals who are fully vaccinated. CDC is now recommending that in non-health care settings, fully vaccinated people can:
  • Visit with other fully vaccinated people indoors without wearing masks or physical distancing;
  • Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing; and
  • Refrain from quarantine and testing following a known exposure if asymptomatic.
  • CDC defines “fully vaccinated people” as individuals who: (1) received either two doses of the Pfizer or Moderna vaccine, or the single dose of the Johnson & Johnson vaccine; and (2) two weeks have passed from the date of their final vaccination.

CDC indicates that fully vaccinated people should continue to take basic precautions such as wearing masks in public, avoiding medium to large size gatherings and testing if symptomatic. More information and complete guidance are available on the CDC website

While the new guidance does not directly apply to long term care settings, it does apply to staff outside of work. Providers can use this new guidance to encourage staff to become vaccinated. Positive messages about the value of the vaccine are shown to be a top strategy in encouraging staff uptake. 

Please note that CMS has NOT issued changes to any of their nursing home visitation or quarantine guidance, so existing guidelines remain in effect. Also, some states have specific guidance on visitation and quarantine in long term care that must continue to be followed.  

AHCA/NCAL will continue to advocate to CDC and CMS on updating restrictions on visitation and other guidance in LTC settings given the evidence on vaccine effectiveness continues to grow.
WHCA continues to actively press government entities for clear guidance, accessibility, and a plan moving forward for our long term care facilities to have ready access to COVID-19 vaccine for staff and residents. With the completion of Phase 1 of the Federal Pharmacy Partnership vaccination plan, at this time facilities (skilled nursing and assisted living) will need to take steps to secure access to vaccine for new residents, staff, and those who did not get vaccinated initially.

In absence of further direction from Washington State to secure access to COVID-19 vaccine, follow the steps below.

The first step is to determine which long term care pharmacies in your area are offering COVID-19 vaccine. WHCA is working with the Department of Health (DOH) to receive a list of LTC pharmacies with provider agreements. Once DOH releases the list, WHCA will forward the information.
  • To offer vaccine, the pharmacy must have signed a provider agreement in Washington AND be enrolled in the state immunization registry (IIS). Make sure to verify this.
  • If they are unable to offer vaccine, call around to other LTC pharmacies.
  • The American Society of Consultant Pharmacists has developed a pharmacy locator for COVID-19 access that providers can use to help identify a pharmacy. This locator only includes pharmacies registered with the federal program, so there may be additional LTC pharmacies signed up in your state.

Second, determine how you will receive and administer COVID-19 vaccine in your center.
  • Once you identify a LTC pharmacy with access to COVID-19 vaccine, you will need to determine how you will receive and administer the vaccine to your residents and staff.
  • There are three potential models for this:
  1. The pharmacy brings vaccine to your center and administers it to residents and staff. In this scenario, the long term care pharmacy retains all responsibilities for wastage, transportation, storage, and reporting.
  2. The pharmacy offers a subcontract model where they subcontract facility staff to administer the vaccine on their behalf. In this scenario, the LTC pharmacy retains all responsibilities for wastage, transportation, storage, and reporting.
  3. The pharmacy offers a distribution agreement where they order and deliver doses of the vaccine to the long term care facility, but then hands off responsibility to the facility. In this scenario, the long term care facility is responsible for wastage and reporting, but may not be responsible for storage.

What if you cannot find a long term care pharmacy to deliver vaccine? If your facility cannot locate a long term care pharmacy with vaccine, you should:
  1. Reach out to your local LHJ (Local Health Departments: Washington State Department of Health). For Seattle/King County, email both Maureen Linehan and Julie West regarding your need for resident and staff vaccine resources.
  2. Long term care facility staff remain Tier 1A and can go to the Washington Department of Health website to find vaccination distribution sites closest to your area. They may also use the DOH - Vaccine Phase Finder Tool to confirm eligibility.
  3. If a facility is still unable able to secure vaccine for residents and staff, please email Kathy Bay at DOH.
WHCA continues to post resources and information as it becomes available on our website. If you have questions or need additional information, please call the WHCA office at (800) 562-6170.