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60 Percent of Nursing Home Residents Are Behind on COVID Vaccines, AARP Analysis Finds

More than three-quarters of nursing home staff are also behind

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More than 700,000 U.S. nursing home residents and more than 1.5 million workers had not received the new COVID-19 bivalent booster as of mid-October, a new AARP analysis of federal data shows. The lag in boosters comes even as health officials warn of a long and difficult winter, with COVID cases predicted to surge and other respiratory viruses such as the flu coming back with a vengeance.

The analysis found 60 percent of nursing home residents and more than 3 in 4 workers (76 percent) were behind on their vaccines. Booster uptake was worse in some states, like Arizona, where 78 percent of residents were behind on their shots, and Alabama, where 89 percent of staff were not up to date.

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“These up-to-date vaccination rates are far, far too low,” said AARP’s Ari Houser, a 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.”

He noted that the worst COVID spikes of the last two years have occurred during the late fall and early winter, and cases and deaths in nursing homes have been ticking up in recent weeks, potentially signaling the beginning of another wave.

AARP has been tracking vaccination rates in nursing homes each month since June 2021. But this is the first analysis to include the new omicron-specific bivalent boosters, which the Centers for Disease Control and Prevention recommended in early September for anyone who is at least two months past their last shot. 

Residents and staff are now considered “up to date” once they’ve gotten their bivalent booster, unless they completed their primary vaccination series or had another booster within the past two months. Previous reports used different criteria because the bivalent boosters were not yet approved or widely available.

Check the vaccination rates of your nursing home

You can check the percentage of residents and staff who are up to date on their vaccines at any Medicare-certified nursing home, and compare them with state and national averages, on’s Care Compare website.

  1. Find a nursing home’s profile via the home page’s search function.​
  2. Visit the Details tab on its profile.​
  3. Click the View COVID-19 Vaccination Rates button.

Deaths and cases rising

Nursing homes and other long-term care facilities have been hit hard by the coronavirus pandemic, with residents and staff accounting for roughly a fifth of all U.S. COVID-19 deaths. Of those, more than 175,000 have been people who lived or worked in nursing homes. 

During the four weeks ending Oct. 23, more than 700 nursing home residents died from COVID-19 and 35,000 were infected, down from 900 deaths and 37,000 infections during the previous four weeks ending in mid-September. There were 27,000 COVID cases among nursing home workers during the same period, or 1 for every 41 residents, down from 1 for every 27 residents during the previous month. 

But in recent weeks, deaths and cases among both residents and staff have been trending upward. “Each of the four weeks covered by the current dashboard saw more resident cases and more deaths than the previous week,” Houser said. 

Booster uptake worse in some states

AARP’s latest analysis of federal nursing home data continued to find wide disparities among states when it came to booster uptake. Arizona’s 22 percent of up-to-date vaccinations for residents marked the lowest rate in the country, compared with a high of 63 percent in Hawaii.

California led the way in staff vaccinations, with 54 percent of workers current on their boosters. Alabama had the lowest rate, with just 11 percent of workers up to date on their shots.

While three-quarters of the staff in most U.S. nursing homes have received their primary vaccinations, only 1 in 10 nursing homes had 75 percent of their staff up to date on their boosters, according to the report. 

Sam Brooks, director of public policy at the National Consumer Voice for Quality Long-Term Care, noted during an AARP tele-town hall last week that long-term care facility staff members’ booster and flu shot uptake is among the lowest in the country for health care professionals. 

He called for more outreach to help residents and their family members understand the protection that boosters can provide. “Unless we have a concerted effort, really from the federal government and state government, to say, ‘We need to do some education around this,’ we’re going to see these dismal numbers continue,” he said.

Meanwhile, family members should be asking facilities about their vaccination rates and pressing them on their plans to keep residents safe, said Megan O’Reilly, AARP’s vice president for government affairs, during last week’s tele-town hall: “AARP has updated resources available to help you be an advocate for your loved one.”

Health officials and advocates also worry that rising cases of COVID and other respiratory illnesses will exacerbate staffing shortages, which 25 percent of nursing homes reported experiencing during the four weeks covered in the report.  

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.

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