Coronavirus (Covid-19) and vaccines: Are chain pharmacies prepared for the onslaught?

Filed Under: Costs, Patients, Providers

When your turn comes, where can you go to get a Covid-19 vaccine? As states and the federal government prepare to vaccinate millions of people this spring, major pharmacy chains and grocery stores like CVS, Walmart, Kroger and Walgreens have emerged as some of the central locations officials say will be distribution points for the vaccine.

But some pharmacy workers said that they’re worried that their employers may not be ready for the job ahead.

PHARMACY CHAINS AND GROCERY STORES ARE CRUCIAL TO VACCINE ROLLOUT

In October, the Department of Health and Human Services announced that CVS and Walgreens pharmacies would partner with the federal government to administer vaccines to residents of long-term care facilities (LTC). In early January, both chains said they would complete vaccinations at LTC facilities by the end of the month, and expect to administer between 20 to 25 million vaccines in the coming months to the general population.

Vaccinations may be a saving grace for big drugstore chains. CNBC reported in early January that vaccinations could mean customers would flock in-person to drugstores, delivering sales on other items. Companies like Walgreens and CVS have struggled to compete with retail giants like Walmart, which has opened up its own health clinics in-store, and online retailers.

“They, as an industry, have all been trying to figure out ‘What do we need to do to pivot our strategy, so that we don’t become the next RadioShack?’” Brian Tanquilut, a healthcare services research analyst for financial services company Jefferies, told CNBC.

Problems in the vaccination rollout schedule have pushed officials to look for other avenues for distribution. The government announced in November that it would enlist regional chain groceries like Wal-Mart and Publix to help with upcoming mass vaccinations in the spring. In early January, the Wall Street Journal reported that many of those regional supermarkets had been tapped by federal and state governments earlier than expected to provide vaccinations for frontline workers at their pharmacies.

“We’re getting calls just because of the need,” Colleen Lindholz, president of Kroger’s health-care business, told the Journal. Lindholz also said that the company was exploring ways to potentially hold events to vaccinate hundreds of people at a time.

AT KROGER, SCHEDULING HEADACHES ALREADY

On the ground, however, pharmacists say that big chains are not prepared for the coming onslaught of vaccine needs. (All pharmacists interviewed for this piece spoke on the condition of anonymity for fear of professional repercussions.)

A pharmacist who works at a Kroger location in Texas said in an interview that the state’s decision to publicly list where all vaccine doses go means that she spent hours fielding calls from people looking to get their first dose at the store’s pharmacy.

“Starting last week, I couldn’t get anything done at all,” she said. “All we did was answer phones for two or three hours.”

On top of the calls, the pharmacist said, a computer system that Kroger set up to handle scheduling for medical staff and front-line workers was faulty and overscheduled appointments, sending multiple people to her pharmacy for the same appointment slot and vaccine dose.

“I spent a lot of time putting out fires, trying to apologize and explain and figure out what the problem was,” she said. “Meanwhile, we’re supposed to be filling 300 prescriptions a day. None of that was getting done.”

Through this hassle, she said, Kroger’s corporate arm has made no indications that she or any other pharmacists will get staffing help. The Texas pharmacist is not surprised: she said she has had a job open for a pharmacy technician at her location for months, but the pay is simply too low to entice any applicants. (Pharmacy technicians undergo less education than pharmacists and cannot medically advise patients on certain medications; they can prepare medications and administer drugs under a pharmacists’ supervision.)

And the pharmacist said she is dreading having to handle the larger rollout in the coming months, especially in helping people with low computer literacy or who have no access to the internet trying to make appointments.

“Kroger has not communicated to us what the plan is for scheduling going forward….It’s dangerous,” she said. “You’re supposed to be filling prescriptions accurately.” (We reached out to Kroger for comment and will update the story if they return a comment.)

AT CVS, PHARMACISTS SAY THEY CAN’T GET VACCINATED

The Kroger pharmacist in Texas is married to another pharmacist who works at a CVS in a Target. The Texas pharmacist said that CVS has informed her husband that he will also not be getting additional help with the vaccine rollout.

“He’s by himself a lot of the time,” she said. “He’ll be starting to get the vaccine in the next week or two…with no intention of giving him more tech help.”

CVS has repeatedly cut tech hours at her husband’s location, she said, and has issues enticing pharmacist technicians to apply for its positions – especially given that pay usually starts at $13/hour.

“He works inside at Target, so a person could just go apply and work at Target for $15,” she said. “Why would anyone want to work for less?”

Another pharmacist in Virginia wrote in a Reddit message that her job at CVS pays hourly, with no health insurance.

“I do not think the pharmacy is prepared” to vaccinate people this spring, the Virginia pharmacist wrote. “This company has this great habit of making decisions at the 11th hour- now they’re saying they want every store to have 2 technicians who can immunize- many stores only have 1-2 technicians on staff, and some of those techs are brand new.”

The Virginia pharmacist said she has not yet been trained to administer the coronavirus vaccine because she declined the company’s offer of $4 extra per hour to administer the vaccine in long-term care facilities. “I felt that the risk to my health was too great, for too little benefit in return,” she wrote.

This pharmacist said that while she is considered a frontline healthcare worker at the highest need tier, CVS has made no arrangements to vaccinate her.

“Our district manager tells us we won’t be getting the shot until the vaccine reaches stores (you know, for customers, the only people the company cares about) and that could be months from now,” she wrote. “So I’m a frontline healthcare worker, who can’t even get the vaccine right now because everyone keeps passing the buck. I won’t be triaged to get it any sooner than random people off the street. I thought that maybe just once, the company I work for would show that they think of their employees as healthcare workers, as human beings. But no, we get no sort of priority over customers. So I have to work on the frontlines, around all these people, with no control over who can come into stores, and I don’t get the vaccine until the bulk of people can. This is wrong, period. All employees should be getting the vaccine right now.”

Another CVS pharmacist at a small town in the Midwest echoed these concerns.

“The roll out of the vaccine has been totally uncoordinated,” she wrote. “We are not ready. They are starting to train technicians to do vaccinations, but it isn’t going to fix the problem. We are not ready for this. In a small town everyone thinks we can get them a shot if they ask or put them on a list. I haven’t even gotten my vaccination because my company only gives us the leftovers, which also means it’s not guaranteed they will have one for you in 3 weeks.”

The Midwest pharmacist cautioned customers about the onslaught of demand ahead.

“People need to be patient with their pharmacy staff,” she wrote. “We aren’t getting information any faster than anyone and they are prioritizing everyone before their own staff at this point. We are doing what we can. I want to help people, but there’s only so much anyone can do with no extra help and being the only pharmacist on staff 12 hours a day. “

In response to these employees’ allegations, a representative from CVS wrote:

As we announced in October, we’ve hired 10,000 pharmacy technicians and other health care workers to support our COVID-19 response efforts, including vaccinations. We are also hiring pharmacists in certain geographies based on concentrations of long-term care facilities that selected CVS Pharmacy as a COVID-19 vaccination partner.

When COVID-19 vaccines are available in our stores, we’ll have 90,000 health care workers, including pharmacists, pharmacy technicians and nurse practitioners, prepared to play a critical role in the vaccination process. We’ll continue to adjust our hiring levels to meet demand, which has been the case since the start of the pandemic, but the bottom line is we have the necessary staff in place. 

The health care workers who comprise our vaccination teams visiting long-term care facilities are eligible to be vaccinated if allowed under state guidelines and subject to available vaccine supply. In any case, our vaccination teams are equipped with appropriate personal protective equipment for their safety and that of vaccine recipients.  We’ve also awarded three rounds of appreciation bonuses to our front-line employees and other colleagues since the start of the pandemic.

Regarding staffing levels in our pharmacies, we make adjustments in each store and for each store’s shift based on customer traffic, prescription volume and other factors. Those adjustments can result in a location getting either more or less hours in their staffing schedules. The fact is that we’ve increased labor hours in our pharmacies overall to support vaccinations, beginning with flu shots last fall.  

AT WALMART, A PHARMACIST WORRIES ABOUT STAFFING

Another pharmacist based in Texas who works part-time at Walmart as a “floater” – rotating between different store locations – wrote that the company has been “pretty good to its people during Covid.” However, she also said that the company has been looking for ways to make more cuts to its staff.

In the summer of 2019, Walmart laid off 3 percent of its pharmacy staff around the country. While reduced hours and reduced customer flow kept the spring and summer of 2020 relatively easy, the Texas pharmacist said, she’s uneasy about what the coming onslaught of vaccines could mean for her workload.

“They’ve been slowly trimming technician hours over the last couple of months…and they say that techs will not administer the Covid vax, unlike other chains,” she wrote.

In response to the pharmacist’s claims, a representative from Walmart told Clear Health Costs:

We have not been trimming hours. The past year has been an exceptionally busy time for pharmacy staff, and we recognize the work they are doing and will do to promote health and wellness, including supporting COVID vaccinations in their communities. Whether or not a certified pharmacy technician can administer vaccines is a decision made by state pharmacy boards. In Texas, certified pharmacy technicians can administer the COVID-19 vaccines, and we are excited for them to support our COVID response.

In January, the pharmacist wrote, Walmart announced pharmacy bonuses and temporary pay raises for pharmacy staff in preparation for the vaccine rollout.

Those initiatives, the pharmacist wrote, “actually scare me.”

“Can I refuse the $1,500 bribe, I mean bonus, and not be part of the sh*tshow that they think it’s gonna be, to give that much?” she wrote.