Meeting the needs of Ohio’s
Long-term Care Professionals since 1946

Find a Care Provider
|  Follow OHCA on Facebook Follow OHCA on Twitter Follow OHCA on Instagram Follow OHCA on Linkedin


December 15, 2020

CDC Guidance on Working After Vaccination. The Centers for Disease Control and Prevention (CDC) issued important guidance entitled, "Post Vaccine Considerations for Healthcare Personnel," describing how to handle employees who exhibit symptoms after being vaccinated that could either be side effects of the vaccine or symptoms of COVID-19. Many OHCA members have expressed concern that if these employees have to be excluded from work, it could have a devastating impact on facility staffing. CDC clarified that it is not a black-and-white situation, but should be evaluated based on which symptoms the individual exhibits. Basically, CDC draws the line between symptoms that could be either COVID-19 or vaccine-related and those that are not connected with the vaccine. Fever could be either COVID-19 or vaccine-related. The guidelines generally calls for exclusion from work based on fever of 100 degrees or more, but add:

In facilities where critical staffing shortages are anticipated or occurring, HCP with fever and systemic signs and symptoms limited only to those observed following vaccination could be considered for work if they feel well enough and are willing. These HCP should be re-evaluated, and viral testing for SARS-CoV-2 considered, if fever does not resolve within 2 days.

The guidance also contains vaccination scheduling recommendations that may or may not work in the Pharmacy Partnership for Long-Term Care, along with a number of other considerations.

We recommend all members participating in the Partnership review the CDC guidance carefully and develop policies that implement the guidance before their scheduled vaccination date.

Governor Outlines Next Steps in Vaccine Distribution. We are checking on whether a number of members are included in the Pharmacy Partnership for Long-Term Care, based on their request. A follow-up question is how anyone who is not in the Pharmacy Partnership is to get vaccinations, as they do not relinquish their Phase 1A status by being excluded from the list. Following today's press conference, his second in two days, Governor Mike DeWine's office released a summary of his comments that partly addresses this issue, under the subtitle, "Local Health Department Vaccination Guidance":

Next week, local health departments in Ohio that registered as providers are expected to begin receiving vaccines. Today, Governor DeWine outlined guidance on individuals who should be prioritized by health departments during Phase 1A.

Local health departments should coordinate the vaccinations of congregate care residents and staff, such as those at nursing homes and assisted living facilities, who are not enrolled in the federal long-term care pharmacy programs or are not registered as providers themselves. This includes people with developmental disabilities and those with mental health disorders, including substance use disorders, who live in group homes, residential facilities, or centers, as well as staff.

In addition, local health departments should prioritize vaccinating other healthcare providers who are not being vaccinated by hospitals and health systems and are not enrolled as providers themselves. These providers could include:

  • Home health workers
  • Hospice workers
  • Emergency medical services responders
  • Primary care practitioners
  • Free-standing emergency department, urgent care, pharmacy, and dialysis center providers not vaccinated by hospitals or healthcare systems
  • Dental providers
  • Public health employees who are at risk of exposure or transmission, such as vaccinators
  • Mobile unit practitioners
  • Federally-qualified health center providers
  • High-risk ancillary health care staff members

CMS County Positivity Still Very High. Ohio's latest county-level positivity table, as determined by the Centers for Medicare and Medicaid Services (CMS) for SNF testing and visitation, shows all but one county with test positivity of greater than 10%, many in the 20s and 30s. Nonetheless, in terms of the color chart, this week's data have Ohio with 21 yellow counties because of CMS's decision in September not to classify counties with greater than 10% positivity as red if they conducted relatively few tests in the measurement period. It also is worth noting that CMS only counts polymerase chain reaction (PCR) tests, not antigen tests.

AMDA Vaccine Education Slides. You may find these slides from the American Medical Directors Association (AMDA) useful for education on the COVID-19 vaccine. They were designed specifically for use with long-term care facility staff and residents. We think they are a particularly good example of educational materials, albeit best suited for an in-person or virtual town hall meeting.