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1 in 3 Nursing Home Residents Still Haven’t Received a COVID-19 Booster, AARP Analysis Finds

While nearly 2 in 3 nursing home workers are without the extra dose, too

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More than 1 in 3 U.S. nursing home residents and nearly 2 in 3 nursing home workers had still not received a COVID-19 booster as of late February, according to an AARP analysis of federal nursing home data released Thursday. 

In some states, the booster rates were even lower. Less than half of nursing home residents were boosted in Arizona, Florida and Nevada. And less than a quarter of workers were boosted in Alabama, Arkansas, Arizona, Florida, Georgia, Indiana, Kentucky, Ohio, Oklahoma, Louisiana, Missouri, Mississippi and Tennessee.

Nationally, the analysis found that 36 percent of U.S. nursing home residents and 64 percent of nursing home workers had not received a COVID-19 booster as of Feb. 20. These figures capture all nursing home residents and staff, including the 13 percent of residents and 14 percent of staff who are yet to complete an initial series of vaccinations, plus the nearly one-quarter of residents and half of staff who are fully vaccinated but have not gotten a booster shot.

AARP called on nursing homes to require COVID-19 booster shots for residents and staff in January. “We are so fortunate to have what we need to better protect nursing home residents and staff: vaccine boosters,” says Susan C. Reinhard, coauthor of the analysis and director of the AARP Public Policy Institute. “They are plentiful and free. It is imperative to step up efforts to deliver them now.”

The COVID-19 pandemic has ravaged long-term care in the U.S. More than 200,000 American COVID-19 deaths have been residents or staff in nursing homes, assisted living facilities and other senior care facilities, according to the Kaiser Family Foundation.

Many nursing home residents and staff are unsure of the official guidance for boosters or fatigued by continually changing guidance, facility owners say. “So much misinformation continues to run rampant in our society,” wrote a spokesperson for LeadingAge, which represents more than 5,000 nonprofit aging services providers, in a recent email to AARP.

Delays in receiving consent from resident representatives, long waits for pharmacy partners to provide on-site vaccinations, and the lack of a cohesive federal campaign to bring boosters to nursing homes may also be having an effect. “In the beginning of the U.S. vaccine rollout, there was a lot of focus and effort to reach those in nursing homes,” says Jennifer Kates, senior vice president and director of global health and HIV policy at the Henry J. Kaiser Family Foundation. “We haven't seen that same push on the booster side.”

Falling cases — but not everywhere

Check the vaccination rates of your nursing home  

You can now find vaccination and booster rates of both residents and staff at any Medicare-certified nursing home and compare it with state and national averages on Medicare.gov’s Care Compare website.

  • Find a nursing home’s profile via the home page’s search function
  • Visit the “Details” section of its profile
  • Click the “View COVID-19 Vaccination Rates” button

On a more hopeful note, AARP’s analysis shows that COVID-19 cases have come down considerably since the omicron surge in mid-January. During the four weeks ending Feb. 20, there were about eight new resident cases and eight new staff cases per 100 residents nationwide, down from 13 resident cases and 21 staff cases in the previous four weeks.

States have been experiencing the surge at different times, however, and 19 states actually saw an increase in resident cases in the four-week period analyzed, compared with the previous four weeks. Five states — Alaska, Idaho, Montana, West Virginia and Wyoming — also experienced record-high cases among staff.

And while the national COVID-19 death rate among residents remained lower than at any time in 2020, before vaccines were available, the four weeks ending Feb. 20 saw the highest death rate since winter 2021 — at around 1,000 per week — according to the analysis.

Worker shortages persist

The analysis found that nursing homes nationwide continue to struggle with widespread shortages of direct care workers, which makes infection control and providing high-quality care to residents more difficult. For the four-week period analyzed, 36 percent of U.S. nursing homes reported a shortage of nurses or aides. That’s the second-highest monthly rate of such shortages since the federal government began collecting such data in the summer of 2020.

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 Centers for Medicare & Medicaid Services. Most nursing homes are federally certified and 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 care 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.

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