Higher Nursing Home Staff Vaccination Rates Linked to Fewer COVID-19 Cases, Deaths

While recent court injunctions have suspended the Centers for Medicare & Medicaid Services (CMS) COVID-19 vaccine mandate for the time being, new evidence shows that nursing home staff vaccination rates may have ramifications on the resident population they serve.

In fact, nursing homes with the lowest staff vaccination rates had more than two times the resident COVID-19 cases and nearly three times the resident COVID-19 deaths compared with nursing homes with the highest staff vaccination rates.

This disparity is true even when controlling for resident vaccination rates and the county each nursing home is located in.

These most recent findings, published on Wednesday in the New England Journal of Medicine,  illustrate that being at increased risk for COVID and bringing it into skilled nursing facilities has real implications on the health and well being of the residents that live there.

“We estimate that if all facilities had staff vaccination rates in the highest category during this period, 4,775 resident COVID-19 cases and 703 resident deaths could have been prevented,” David Grabowski said in an email to Skilled Nursing News. “In other words, our study strongly suggests that staff vaccination protects nursing home residents.” 

Grabowski, a professor of health care policy at Harvard Medical School, is one of four researchers associated with the study.

Facilities have taken a multi-pronged approach to keeping COVID-19 out of their buildings, which has included masks, PPE and testing, but the national data collected from nursing homes by CMS between June 13 and August 22 shows staff vaccination compliance may be key.

“I think the findings were stark,” Brian McGarry, one of the study’s authors and a professor at the University of Rochester told SNN. “We found that in the presence of high community spread, i.e. when there’s a lot of COVID circulating in the community, that those facilities that had low staff vaccination rates had substantially higher resident case rates, and probably not surprising, higher staff case rates.”

He felt the data indicated that staff vaccination rates have “carryover effects” and may impact the number COVID resident deaths a facility experiences.

“Sometimes this comes up in the debate around vaccine mandates that the residents are protected, but why should I as a staff member have to be vaccinated, it’s my choice,” McGarry explained. “I think what our results show is that it’s not just about the staff getting COVID.”

In counties with the highest prevalence of COVID-19, facilities with low staff vaccination rates were associated with 1.56 additional COVID-19 cases per 100 beds among residents,1.50 additional cases per 100 beds among staff, and 0.19 additional COVID-19–related deaths of residents per 100 beds relative to facilities in the same county that were in the highest quartile of staff vaccination, the data showed.

When high community prevalence of COVID-19 was found, nursing homes with low staff vaccination coverage had higher numbers of cases and deaths than those with high staff vaccination coverage.

McGarry praised skilled nursing facilities that implemented vaccine mandates themselves and felt the best thing for the industry and the individuals that live in nursing homes is to see the vaccination mandate move forward.

“I think this really bolsters the case for doing a mandate and it’s frustrating that, at least at the federal level, that’s on hold for the time being,” he added. “Time is of the essence here to get staff vaccinated to get those vaccination rates up as high as possible so that we can keep residents safe and protect them throughout these winter months when viral infections are usually at their peak.”