4 in 5 U.S. Nursing Homes Behind on Staff Vaccination Goal, Analysis Finds

Only 20 percent, or 1 in 5, of the nation's 15,000-plus nursing homes achieved the target as of June 20, according to AARP's analysis. Hawaii, which has hit the 75 percent staff vaccination goal in 86 percent of its facilities, reports the highest rate. California follows, with 66 percent of facilities hitting the target, then comes Vermont with 55 percent.

But in 46 states, less than half of nursing homes have reached the 75 percent staff vaccination threshold. In Kentucky, with the lowest count, only three percent of facilities have vaccinated 75 percent of staff. In Georgia, only 4 percent of facilities have hit the target, while only 5 percent did in Alabama, Florida and Idaho.

David Gifford, chief medical officer of the AHCA, which represents more than 14,000 nursing homes and other long-term care facilities across the country, has said the rates show “more work needs to be done.”

"Vaccination rates among long-term care staff continue to mirror other health care settings and general population rates, especially in certain parts of the country, because there continues to be a large amount of misinformation circulating around these safe and effective vaccines,” Gifford said in a statement last month.

A Southern slump

Staff vaccination rates are especially low in some Southern states. Alongside Florida and Louisiana, Georgia, Mississippi and Oklahoma also reported staff vaccination rates lower than 45 percent. Missouri was the only other state to report a staff vaccination rate lower than 45 percent.

Resident vaccination rates are also lower than the national average in those states, with only 68, 70 and 74 percent of nursing home residents fully vaccinated in Florida, Georgia and Oklahoma, respectively. In Tennessee, 47 percent of workers and 74 percent of residents are fully vaccinated. In South Carolina, 49 percent of workers and 74 percent of residents are fully vaccinated.

This low vaccine uptake across the board leaves nursing home residents highly vulnerable to a resurgence of the virus, experts warn.

"Staff that aren't vaccinated and protected, they remain a very direct route by which the virus can enter the building,” says Justin Lessler, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

The more unvaccinated workers there are, the higher the chances are of that occurring. And the more unprotected residents there are, the higher the chances are of infection and death. That's particularly true as the spread of the new delta variant, which is more contagious and harmful than America's dominant alpha variant, increases.

"There are going to be pockets of infection,” says Jennifer Schrack, also an associate professor in epidemiology at the Johns Hopkins Bloomberg School of Public Health. “And in the South, where vaccinations are lagging, it seems like it's going to be more of a problem than in other areas.”

Cases and deaths keep falling

After several months of stagnation, the rates of new COVID-19 cases and deaths in nursing homes have begun to fall again, AARP's analysis shows. The rate of new resident infections in the four weeks ending June 20, was about 1 out of every 600 residents, representing a decline of about half from the four-week period ending May 16. The rate of new staff cases also declined between these two periods, dropping by two-thirds to about 1 staff infection for every 400 residents.

COVID-19 deaths among residents also declined, to around 600 over the four weeks, or less than 1 out of every 1,500 residents. It represents a dramatic decline from COVID-19's winter peaks in nursing homes, where about 20,000 residents died from the virus over the four weeks from mid-December to mid-January.

A recent AARP letter to the agency commended the federal Centers for Medicare & Medicaid Services’ (CMS) new vaccine education and vaccination reporting requirements for long-term care facilities but presses for more action. That includes making the new vaccination data more consumer-friendly and sustaining rigorous COVID-19 testing.

AARP's analysis, conducted by the AARP Public Policy Institute and the Scripps Gerontology Center at Miami University in Ohio, draws primarily on data acquired from the Nursing Home COVID-19 Public File by the CMS. Most nursing homes are federally certified and are required to submit data to the government each week.

The ongoing analysis captures data only from federally certified nursing homes, not from all long-term facilities (such as assisted living, independent living, memory care and others), as some other tallies do. An updated analysis will be released next month as new federal data becomes available. Read more about the analysis.

Emily Paulin is a contributing writer who covers nursing homes, health care, and federal and state policy. Her work has also appeared in Broadsheet, an Australian lifestyle publication.

Editors note: This story, published July 15, was updated on July 19 to correct errors in CMS data for three nursing homes in Connecticut, New Jersey and Texas related to the number of staff or residents that were able to be vaccinated.