Night-shift staff may have lower testing rates and vaccination rates compared to day-shift staff, according to a new study from Health Affairs.
The researchers also noted generational and racial disparities in testing and vaccinations.
Employees who were younger, Black, worked part time as LPNs, CNAs, CMAs, or as other direct care aides, had the lowest odds of vaccination among the samples on average, according to the study.
Overall, Black employees had lower rates of vaccination than White employees, but the racial disparities in vaccination rates were largely explained by work shifts because there was a larger concentration of Black workers on the evening and night shifts compared with the day shift. Black staff’s vaccination rate stood at 48 percent while White workers’ rate was 68 percent.
Older employees were more likely to be vaccinated when compared to their younger counterparts. Vaccination rates for employees ages 60 and older was 79%, while for employees younger than age 30, the rate was 38%, the researchers noted.
Meanwhile, full-time employees were more likely to be vaccinated than part-time employees with adjusted vaccination rates of 67 percent and 52 percent for full-time and part-time staff, respectively.
“Our results suggest that equitable access to testing and vaccination for staff across all shifts—a structural factor— was an important determinant of successful implementation during July 2020–February 2021,” authors of the study wrote.
Researchers said the findings highlight the need to coordinate resources and communication evenly across shifts when implementing large-scale processes in nursing homes and other organizations with shift-based workforces.
“It is critical that nursing homes receive support from local, state, and federal health authorities when coordinating key public health initiatives,” researchers said.
Researchers analyzed time-card data, staff demographics, and facility logs of COVID-19 immunizations and testing records from 20,503 staff members across 264 nursing homes from April 2020 to March 2021. Staffing characteristics, testing and vaccination records were also obtained from facility records.
“When we looked at specific shifts across months, testing rates were highest among the day shift and lowest among the night shift,” researchers wrote. “For example, at the peak in December 2020, day-shift employees had a mean testing rate of 40.4 tests per 100 person-days compared with night shift employees, who had a mean of 29.1 tests.”
The testing trends held true across months during the study period, even with the significant increase in testing that occurred from early fall 2020 through early winter 2021 with the increased availability of rapid antigen tests and a dramatic surge in cases during that period, researchers said.
Companies featured in this article:
