Grant Thorsett in 2011 (Courtesy/Steve Thorsett)
Grant Thorsett should have been near the front of the line to receive a Covid vaccine in Oregon.
Instead, he and some other residents of the Dallas Retirement Village’s Health Center were told they were ineligible because they’d recently been exposed to Covid - and had to wait another two weeks for a shot.
Thorsett, 80, has lived at the skilled nursing facility in Dallas for about six months, recovering from a traumatic brain injury, his son Steve Thorsett, who is also president of Willamette University, said.
Dallas Retirement Village was scheduled for vaccinations on Dec. 29, about three weeks after a Covid outbreak began at the nursing facility. But the CVS pharmacist administering vaccines screened out residents who had been exposed to the virus but weren’t showing symptoms, including Thorsett - a decision the state’s long-term care ombudsman said was in error and unnecessarily delayed protecting some of the Oregonians most vulnerable to Covid.
“I find that egregious that those residents basically got skipped because of what I’m considering an administrative failure at CVS,” said Fred Steele, Oregon’s long-term care ombudsman.
“We were frustrated that we weren’t told in advance it was going to be a problem and that we only found out after the clinic was essentially over and it was too late to do anything about it,” Steve Thorsett said.
Steele and state and county health officials said they’re not aware of other long-term care facility residents in Oregon being denied a vaccine because of a recent Covid exposure. But the incident shows how communication challenges between federal, state and local entities and a lack of clarity over guidelines can delay priority vaccinations.
Long-term care facilities have been the site of many of Oregon’s worst Covid outbreaks and account for a disproportionate share of deaths from the virus.
Residents are typically older and have other medical conditions, both factors that make them vulnerable to severe cases of Covid.
Because of those risks, long-term care facility residents and employees have been prioritized for vaccination. In most states, including Oregon, that’s happening through a federal partnership with the Centers for Disease Control and Prevention, who have contracted with private pharmacies including CVS and Walgreens to vaccinate residents and employees.
CDC guidelines say residents at long-term care facilities may be vaccinated even if they’ve been exposed to Covid, noting that it’s common for exposure to the virus to be repeat and ongoing in those settings.
In response to questions from Salem Reporter, Dallas Retirement Village administrators said CVS determined eligibility.
“Vaccines for our venue have been distributed to the pharmacies, not to us. Therefore, we must adhere to their rules,” facility administrators said in a statement. “Our sole focus is preventing the spread of COVID-19 in our community, and we are working with local and state health authorities to procure enough vaccines for residents and staff as quickly as possible.”
CVS spokeswoman Monica Prinzing said the pharmacy chain vaccinated 71 people and skipped about a dozen during their visit to Dallas in December. She said CVS schedules three clinics at each facility they vaccinate at, spaced several weeks apart, so residents who miss the first one can still get both doses of the vaccine.
“For long-term care patients who have been exposed to COVID-19 and are currently in quarantine but don’t know if they are COVID-19 positive, the decision to vaccinate will depend on the clinical assessment made by the CVS pharmacist onsite and facility administrator. The patient’s primary care physician may also be consulted as needed. Clinical factors such as whether the patient is experiencing symptoms, their answers provided on the COVID-19 screening questionnaire, and other clinical indications will be considered,” Prinzing said in a statement.
Ultimately, Thorsett and other residents were vaccinated Jan. 11 after Steele and the Polk County Public Health Department worked with Oregon Health Authority to set up a make-up clinic, nearly two weeks after residents were initially skipped.
In an interview Friday, Jacqui Umstead, Polk County’s public health administrator, said she’s had trouble getting timely information from the state about the status of vaccination efforts in long-term care facilities, and was still awaiting clarity on whether the county was allowed to coordinate vaccination at facilities that were missed. By Monday, the county and state had set up the clinic.
Umstead said last week she wasn’t sure if the issue was on the state or federal level, but said she wants to be able to track vaccination so the county can step in if long-term care facilities are missed in the federal rollout.
“There hasn’t been as much communication as we need to make sure we’re covering that population,” she said. “They’re just as overwhelmed as everyone else is and I understand that but again, this is still our priority population.”
In response to questions from Salem Reporter about the cause of the delay and the state’s role in ensuring long-term care facility residents get vaccinated, Elisa Williams, a spokeswoman for the Department of Human Services, said the department and OHA learned of the incident in December and had to review guidelines with the CDC to understand what action they could take.
Williams said Monday the state agencies determined the county would be able to vaccinate residents who were skipped, though she did not say when that determination was made.
“The goal is to vaccinate everyone who is eligible as quickly as possible. We’re not aware of any systemic problems involving vaccines being denied. OHA has communicated with all pharmacy partners that the expectation is to follow CDC guidelines,” Williams wrote in an email. She said the state is also sharing information with local public health agencies about long-term care facilities not yet scheduled for vaccination.
Steele said his office wants to ensure vaccines are delivered more quickly to long-term care facilities, and that guidelines are consistently followed, and oversights corrected.
“It shouldn’t have taken two weeks. I would like to see a process that’s a little more nimble,” he said.
Steve Thorsett said he was grateful to Steele’s office and the county for ensuring his father was protected. Before retiring, his father taught biology at Willamette and served as the university’s pre-med advisor for students pursuing a medical career.
As Grant Thorsett has recovered from his brain injury, Steve Thorsett said his father has been eager to explain the science behind the Covid vaccines to his relatives.
“He explained in very great detail exactly how they worked,” Thorsett said. “These vaccines are very much at the heart of what he does professionally.”
Have a question or tip about Covid vaccine rollout in the Salem area? Contact reporter Rachel Alexander: email@example.com or 503-575-1241.
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