Though many nursing home providers and industry advocates pushed for test-out options when the COVID-19 vaccination mandate for health care workers was first announced, data from Mississippi shows a minimal increase when such an exemption was instituted.

Staff vaccination rates increased from 43% before the state enacted a test-out mandate to 51.3% over three months later, for an increase of 8.3.%, a study published in the American Journal of Public Health shows.

While the state had statistically greater gains than most states comparatively, Mississippi’s staff vaccination rate remained below the national average and was similar to surrounding states without mandates. For comparison, the national average increase was 5.6% during the 13 weeks the study was conducted.

The study used National Healthcare Safety Network and Kaiser Family Foundation data to analyze trends over time in statewide vaccination rates between June 1, 2021 and Aug. 29, 2021 at 1,210 facilities in Alabama, Louisiana, Mississippi, Tennessee and Arkansas.

Mississippi had no statewide nursing home staff COVID-19 vaccination mandate while the study was conducted, but facilities were subject to staff testing one or two times per week. While Arkansas achieved the highest vaccination rate increase of the states analyzed, none of them achieved high staff vaccination rates in accordance with the goals and standards set by the Centers for Disease Control and Prevention (CDC), according to the study.

The vaccinate test-out policy implemented in Mississippi may have been associated with an increase in staff vaccination rates but the increase was “modest” at best, one of the authors Maggie Syme, project director at Hebrew SeniorLife, wrote.

“If you allow people a test-out option in a mandate, you’re probably not going to be happy with the results,” she told Skilled Nursing News. “I think it’s a soft option. It may fulfill some directive to act, but it doesn’t seem to be a very effective route if you actually want employees to increase their vaccination rates significantly.”

Recent substantial gains in staff vaccination have been made following the enactment of CMS’s COVID-19 vaccine regulation requiring nursing home facilities to obtain 100% staff vaccination rates, with only medical or religious exemptions still in place.

While 51.3% was an improvement for Mississippi back in 2021, it’s still a far cry from the 85.9% national staff vaccination rate the sector is currently reporting, according to CMS data, or the 83.12% rate the state now has.

Syme felt the marginal gains may be attributable to giving nursing home staff an opt-out strategy who didn’t want the vaccine.

“We haven’t talked directly to any operators about this but similarly I would expect that if you looked at this at the chain level, a similar policy would be less effective than a hard mandate,” she added. “I think we’re starting to see that the test-out option really just isn’t an effective route.”