In this July 27, 2020, file photo, a nurse prepares a shot that is part of a possible COVID-19 vaccine in Binghamton, New York. Credit: Hans Pennink / AP

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Jabbar Fazeli is a geriatrician in southern Maine.

When New York was going through its COVID-19 peak, long-term care facilities were months away from becoming a priority in terms of testing availability and personal protective equipment distribution.

With a COVID-19 vaccine on the horizon, it remains to be seen if staff and residents in long-term care will be considered a top priority, ahead of other priorities, in terms of actual planning and distribution.

I hope I am preaching to the choir when I say that protecting the elderly in nursing homes and assisted living facilities is essential in reducing mortality from the second wave of COVID-19. Prioritizing this segment of the population is not just a moral responsibility, but is also practically beneficial in controlling the pandemic. The fewer outbreaks in these facilities, the more availability of hospital resources for the general public. Outbreaks in facilities drain precious resources in the battle against the virus.

Vaccination plans for the elderly in long-term care facilities does not start and end with vaccinating all the residents. Most of these residents have numerous co-morbidities and are unlikely to have as positive of a response to a vaccine as the staff who care for them. Controlling COVID-19 in long-term care facilities has always centered around controlling the infection among staff, and this remains true when it comes to vaccination.

Vaccinating staff in long-term care facilities should be the very first step in this process as they are more likely than the residents to mount a response to the vaccination and stop the infection from reaching the residents. The secondary step of vaccinating elderly residents will provide additional protection, but is unlikely to exceed the protection gained from vaccinating staff and caregivers.

Planners should be aware that some staff may opt not to vaccinate if given a choice. That is due to the concerns about the safety of the vaccine given the accelerated development timetable.

In addition to a possible state mandate for vaccination of health care workers to protect patients, it is equally important to address some of the staff concerns that are mostly caused by disinformation around vaccination in general and the COVID-19 vaccine in particular.

One basic piece of information is that while safety is being monitored throughout the vaccine trial process, the safety of vaccines is established during phase one of a vaccine trial. Phase two is to establish the right dosage, and phase three is to determine whether a vaccine actually works in triggering an immune response and to protect from future infection.

There is no hiding the fact that the process is indeed being rushed at phase three of the trials and some trials have combined phase two and three to save time. This, however, doesn’t compromise the safety elements.

The main issue with this speedy process is that the vaccines may not be as effective as expected. We should also note that there is no greed factor here, because the companies producing the vaccines are already paid in advance for the millions of vaccines already produced in the hope that they might work. Rolling out a defective product would only damage the reputation of a company without any financial gain. One would also expect that the many scientists and U.S. universities involved in monitoring and reviewing the trial data would keep the public informed of any issues.

Like the flu vaccine, the COVID-19 vaccine is designed to trick the immune system into thinking that the body is infected with the virus, and while most will only feel muscle discomfort at the injection site, some might develop mild symptoms mimicking a viral infection. Sooner or later some will claim that the vaccine gave them COVID-19, just like some now say that flu shots give them the flu. This myth, and others, need to be addressed head on through a vaccination campaign in facilities and around the state.

In order to ensure that everyone is doing their part, the state needs to mandate insurance carriers to cover vaccines as well as COVID-19 test screening of health care workers, which is not yet universally covered.

Finally, it is important to remind ourselves that out of the million-plus COVID-19 deaths in the world in the past 10 months, not a single death was caused by a vaccine.