Maine’s independent pharmacies are playing a growing role in administering coronavirus vaccines to the residents of long-term care facilities, after a bumpy start to a Trump adminstration program that enlisted two large pharmacy chains — CVS and Walgreens — to do that same work across the country.
The goal of the partnership with CVS and Walgreens was to make vaccinations easy and efficient for those most vulnerable to the disease. But after it got off to a slow start in Maine, the state CDC even made the decision to divert doses from the two chains to local pharmacies so they could be administered more quickly.
When Portland’s Shalom House, which operates group homes for people with mental illness, found out that CVS would be its partner to administer the COVID-19 vaccine to its clients and staff, clinical director Abby Spadone was thrilled. But her excitement quickly faded.
“It was a bit overwhelming and confusing,” she says. “We ended up over a couple of days receiving multiple emails from CVS. I think I had 70, 71 emails from them.”
Seventy-one emails, Spadone says, to set up clinics at more than a dozen sites. And she says some of the sites appeared to be double-booked for vaccinations, while others had no dates.
“I couldn’t get a hold of anyone at CVS to really figure out what the details were for the individual clinics,” she says.
So when Shalom House was contacted recently by Maine-based Bedard Pharmacy to let them know they had received approval to administer the vaccine, Shalom House switched. Spadone says Bedard, which had worked with Shalom House before, responds to her emails within minutes. Their clinics are now scheduled for the first week of February.
CVS, Spadone says, had been scheduling into March.
“It just — it feels like we can just finally take a sigh of relief and know that there’s going to be a vaccine on the way,” she says.
The vaccines that Bedard Pharmacy will administer are among 500 doses that the Maine CDC transferred from CVS.
The agency has also diverted doses from Walgreens. In mid-January, CDC Director Nirav Shah announced about two-thousand doses would be transferred from Walgreens to hospitals because there was no plan to administer them.
A few days later, Shah said he was redirecting an additional 975 doses from Walgreens to an independent Maine pharmacy in Bangor.
“That pharmacy is ready to go into nursing homes and long term care facilities to start vaccinating folks,” Shah says. “We’re going to continue doing that. We’re not messing around with this. We’ve got doses waiting to be administered, and people waiting to receive them. If we see a mismatch there, we are going to continue moving things around in that fashion.”
“These assignments, I would say, were kind of in our wheelhouse. We were ready for this,” says John Hebert, a pharmacist and owner of Bangor Drug — the pharmacy that received the diverted doses from Walgreens — and Hebert’s Rexall Pharmacy in Van Buren.
Hebert says he has a competitive advantage because he already services long-term care facilities and understands how they work. And he approaches these COVID-19 vaccine clinics as a true partnership, which allows them to move quickly.
“We learned early on that instead of showing up to these places with, you know, three vaccinators, two intake personnel, we could show up with maybe one vaccinator because we were receiving so much help from the facilities themselves,” Hebert says. “That’s allowed us to put three teams in the field instead of one.”
Word has gotten around at how efficient Bangor Drug is — so much so that some facilities, such as the Gardiner Health Care nursing home in Houlton, have asked to be reassigned to them.
Within four days of partnering with Bangor Drug, director of nursing Anne Jones says Gardiner Health Care held a clinic, and she says Hebert’s personal familiarity with Aroostook County may have convinced some skeptical residents and staff to accept the vaccine.
“Certainly helped to encourage people or make people feel more comfortable with getting the vaccine,” Jones says. “We did have several people that had said ‘no’ originally, did end up stepping up and getting the vaccine. So I do think that played a lot into it.”
The role of independent pharmacies in Maine vaccinating long-term care facilities against COVID-19 has grown. The state CDC’s first allocation was 1,200 doses to five independent pharmacies. Since then, a total of 20 pharmacies have participated, receiving a total of 11,000 doses. That’s still less than half the 27,000 doses that have gone to CVS and Walgreens.
“It got vaccine out more quickly than what we were looking at with only the two large pharmacies doing the entire job, basically,” says Rick Erb of the Maine Health Care Association, a trade group for long-term care facilities.
A spokesperson for CVS says the company is on schedule with vaccine clinics based on the parameters of the program. According to data CVS posts online, all 38 Maine nursing homes it’s partnered with have received their first doses, and about 90 percent of the 170 other long term care facilities it’s working with have also received a first dose
Walgreens doesn’t provide state-level data, but a spokesperson says nationally, the chain completed administering first doses at nursing homes this week. Clinics at other facilities have been scheduled in more than 70 percent of jurisdictions.
Even critics of CVS and Walgreens’ performance acknowledge that vaccinating long-term care facilities is a massive undertaking. That’s why Hebert says involving a mix of pharmacies is the best approach.
“Trying to do it without the chains is probably not a good idea either,” he says. “I think you try to involve as many people who are qualified that want to be involved, and I think that is how you do it quickly.”
He credits the Maine CDC with getting doses on the ground to places that can administer them quickly. If they weren’t as responsive, he says, his pharmacy team would be sitting idle after finishing their initial assignments, waiting for the next phase of the vaccination rollout.