Delays in new vaccine rollout at some nursing homes, pharmacies, doctors' offices

Two weeks after the federal government approved the new COVID-19 vaccines, many nursing homes, pharmacies and doctors’ offices are still waiting for their arrival.

Frustrated Long Islanders found their vaccine appointments canceled for lack of supply, and some pharmacies have been unable to obtain doses from wholesalers.

That’s in addition to problems some people have faced in trying to get insurance coverage for the vaccine — without copays, as required by law — although experts and groups representing insurers say those issues are largely resolved.

Experts worry the problems may cause some people to not get the vaccine, which federal health officials said offers strong protection against infection for about three months and against severe disease for months longer.

“When you create these barriers and challenges and hurdles and hoops for people to jump through just so they can have access to vaccinations, we might steer people away from wanting to be vaccinated,” said Selena Gilles, a nurse practitioner and associate dean of the undergraduate program at the NYU Rory Meyers College of Nursing in Manhattan.

Some Long Islanders have had no problem obtaining the vaccine.

But Daniel Longo, managing director of Precision LTC Pharmacy in Farmingdale, which supplies about 80 nursing homes and other long-term-care facilities, said he has been frustrated by his inability to obtain it for his clients, despite strong interest.

“So many people want it, for all the patients and for the staff,” he said.

When the first COVID-19 vaccines were released in late 2020, the state and federal governments prioritized nursing home residents and other people at high risk of severe COVID-19, and they received shots first.

That’s not happening today. Richard Mollot, executive director of the Manhattan-based Long Term Care Community Coalition, which works to improve the lives of long-term-care residents, said it should.

“Both the state and federal government should be much more active in ensuring there is meaningful access for residents and staff,” he said.

Nursing-home residents are at especially high-risk because of their health conditions and because they are regularly in close contact with others, he said.

 The U.S. Department of Health and Human Services said in a statement that, with the government no longer buying vaccines and relying on the private market, “long-term care facilities will use their existing partnerships with pharmacies and health departments to provide COVID-19 vaccines in the same way that they provide other vaccinations.”

State health department spokeswoman Danielle De Souza said in an email that “the federal government has reassured states that an ample supply of vaccine is available,” but that, with vaccine distribution now commercialized, “the state is not involved in the distribution of doses.”

Nursing homes getting vaccine later this week

Northwell Health’s Orzac Center for Rehabilitation in Valley Stream and Stern Family Center for Rehabilitation in Manhasset are not expected to obtain the vaccine until later this week or next week, said Lisa Mulloy, Northwell’s chief pharmacy officer. Northwell-affiliated doctors’ offices also are expected to receive the vaccine within the next week, she said.

Longo said after he unsuccessfully tried multiple times to order vaccines from pharmaceutical distributors Cardinal Health and McKesson, he finally was able to order directly through Moderna. A small order is scheduled to arrive Thursday, and he plans to order more, he said.

McKesson said in a statement that “ramp-up was required across the supply chain that may have had [an] impact on delivery dates for select customers. We are working diligently to turn COVID-19 inventory as quickly as it is received and are growing our fulfillment of orders daily.”

Cardinal said it was fulfilling all orders for Pfizer-BioNTech vaccines and is “experiencing a short delay in shipping Moderna product” — although after Cardinal sent its statement, Longo said he still was unable to order through them for either vaccine.

Pfizer and Moderna said in statements they have ample supply of vaccines, have shipped millions of doses and are shipping millions more.

Suffolk County offers the vaccine at its traveling immunization sites for uninsured people, through a federal program that provides those vaccines for free, and began receiving doses on Thursday, said health department spokeswoman Grace Kelly-McGovern.

Elizabeth Nolan, 39, of Babylon, said she had an appointment scheduled for Sunday at a CVS, but it was canceled because there wasn’t enough vaccine. She rescheduled for Friday.

“I teach high school and my students are dropping like flies from COVID,” she said. “I cannot tell you how many of them are sick. So I want to get it as soon as I can.”

COVID-19 case and hospitalization rates have been rising for weeks, although they are still below the levels of early autumn last year. 

CVS and Walgreens said in statements that some appointments were rescheduled due to delays in receiving vaccines.

Jennifer Kates, a senior vice president at the San Francisco-based health-policy nonprofit KFF, whose own vaccination appointment for Tuesday in Washington, D.C., was canceled for lack of supply, said it’s unclear what is the root of the problem.

“There’s a mismatch somewhere,” she said. “It’s hard to know if it’s on the ordering side or on the shipping-speed side, or what. But it’s a process that has not been worked out completely.”

Rachael Piltch-Loeb, an assistant professor at the CUNY Graduate School of Public Health in Manhattan and an expert on emergency preparedness, said the shift to a private-market approach to vaccine distribution likely is contributing to supply issues.

“It is hard for companies to know exactly how much to order and which sites to distribute” to, she said.

Financial risk for pharmacies

Nidhin Mohan, owner of New Island Pharmacy in Deer Park, said he is not offering the vaccine in part because of lack of strong demand from customers, and the insurance confusion, and because his wholesaler will not accept returns of unused vaccines, which are available in packs of 10 at $1,300 per pack. There was no financial risk when the government supplied the vaccines, he said.

Nolan faced even more problems trying to get her children vaccinated. She tried in vain for days to find vaccines, including at Walgreens and CVS pharmacies miles away, for her daughter, Lillian, 8. But until Monday night, when she found an appointment at a CVS, nothing was available.

Walgreens said in a statement that vaccines for children 3 to 11, which are of a different dosage than for older children and adults, will be available starting Friday.

Nolan also plans to get a vaccination for her 2-year-old son, Lachlan. CVS said vaccinations for children up to 18 months old would begin “in the coming weeks.”

Uptake for the COVID-19 booster shots was especially low for children. Fewer than 3% of children 5 to 11 years old on Long Island, and only about 5% of kids under 5 and between 12 and 17 years old, have received the boosters, according to state Department of Health data. About 40% of Long Islanders 75 and older received boosters.

Nolan said she first tried to get her children vaccinated at her pediatrician, RBK Pediatrics, which has offices in Bay Shore and Commack.

RBK office manager Kathy Lavigna said an informal survey of parents showed low interest in the new vaccine for children.

“We don’t think we’re going to have the demand,” she said. “Most of them are saying my child got the other two, and they’re fine.”

By David Olson

david.olson@newsday.com@DavidOlson11

David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.