While the carnage among the elderly from COVID is well known, I suspect it’s far less known that around one in six all of COVID deaths, not just the elderly occurred in those in nursing homes. That’s why it’s distressing, to say the least, to see such abysmal nursing home vaccination rates–only 38% nationwide:

(data from here)

As you can imagine, like most policy failures, there are multiple assholes involved (boldface mine):

Xavier Becerra, the secretary of Health and Human Services, has held two meetings with representatives of the facilities since Dec. 21 to remind them that they must offer residents the shots. But nursing homes say the federal government needs to pay them more to administer the jabs — and Becerra needs to do a better job persuading people to get vaccinated.

“Americans look to you as the highest public health official in the land; it would speak volumes if, in addition to other actions, you appealed directly to residents and their family members,” Katie Smith Sloan, president of industry group LeadingAge, wrote in a Dec. 22 letter to Becerra…

Sloan gave Becerra a to-do list to help the homes: allow them to make small vaccine orders that fit slackening demand, enlist hospitals in the vaccination campaign, permit the industry to bill Medicare more for administering the shots, and come up with a message that works…

“We’ve chased down all these to-do items for three years running — I don’t think they’ve had the impact,” one senior administration official, granted anonymity to discuss the administration’s response, said of the nursing homes’ demands. The person said the agency would examine the latest requests and continue to work with the industry, but was skeptical it would radically change the outcome even if the administration acceded to them…

There’s no clear answer why, but two shifts have likely contributed, according to industry and government leaders.

First, interest in vaccination has declined as they proved unable to halt transmission, as have disagreements over who needs an annual shot — even as there’s consensus among experts that elderly people do.

Second, the administration stopped buying and managing distribution of the shots starting with the rollout of the updated vaccine last September.

The move coincided with the administration’s decision to end the public health emergency, which justified the move to shift responsibility to insurers, pharmacies, doctors’ offices and the other private health care organizations that manage other vaccinations.

For nursing homes, that means they have to source the shots and manage how they’re given, creating logistical and reimbursement challenges…

“There was some thought that maybe it might be better if the messaging came from the manufacturers and from private entities,” the senior official said, believing that the hard sell from the administration was merely reinforcing vaccine skepticism in some communities.

This is such a clusterfuck. It is affecting the most vulnerable Americans, and this should be a major public health priority. Utter policy failure.