22 States Petition CMS to End Mandate As 76% of SNF Staff Behind on Vaccines

Roughly 76% of nursing home staff and more than 60% of residents have yet to receive the new Covid-19 bivalent booster, as providers brace for the threat of a tripledemic.

That’s according to an AARP analysis of federal data as of mid-October. Some states are further behind than others. Arizona, for example, has only 15.2% of staff and 22% of residents considered up to date on their vaccinations. North Dakota, on the other hand, has 60.9% of residents but only 18.5% of staff that are up to date, according to the analysis.

California led the way in staff vaccinations with 54% of workers considered current on their boosters.


While 75% of the staff in most nursing homes have received their primary vaccinations, only 1 in 10 nursing homes had 75% of their staff up to date on their boosters, according to the report.

“These up-to-date vaccination rates are far, far too low,” said Ari Houser, AARP senior methods advisor and coauthor of the report. “It’s much lower than we would like to see going into the late fall and winter.”

While AARP has tracked nursing home vaccinations since June 2021, this is the first analysis that includes the new omicron-specific bivalent boosters.


A study conducted by the Commonwealth Fund last month found that if vaccination continued at its current pace, the country faced a potential winter surge of Covid infections that could result in 16,000 hospitalizations and 1,200 deaths per day by March 2023.

And a CDC analysis published at the end of September showed that getting a second booster dose proved to be 74% effective at 60 days against severe Covid-related outcomes, like hospitalization or death. The second booster was 90% effective against death alone, in comparison to one booster, according to the analysis.

AARP’s analysis was published the same day that 22 states filed a petition asking the Centers for Medicare & Medicaid Services (CMS) to repeal its health care worker vaccine mandate.

The group of attorneys general, led by Montana Attorney General Austin Knudsen, filed a petition under the Administrative Procedures Act, calling on the U.S. Department of Health and Human Services and CMS to repeal its interim final rule and state surveyor guidance.

“The mandate has limited many patients’ access to needed medical care and imposed substantial costs on patients and healthcare workers without any corresponding benefits. The Biden administration should have never imposed this mandate, and CMS should now throw it in the trash bin where it belongs,” the petition states.

While the petition notes worsening staff shortages as a result of the mandate, a study released in July found that initial fears of a mass exodus of nursing home workers after the vaccine was mandated was “largely unfounded.”

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