AARP Calls for Nursing Homes to Require Boosters Amid Record COVID-19 Surges

Lagging booster rates

Nursing home residents and staff were prioritized for COVID-19 vaccines when they first became available in December 2020, but they’ve been slower to get boosters.

More than 35 percent of fully vaccinated nursing home residents hadn’t received a booster as of Jan. 16, according to CDC data. That’s in addition to the roughly 13 percent of residents who are unvaccinated or only partially vaccinated and are therefore ineligible for a booster. 

Roughly 70 percent of fully vaccinated nursing home staff, meanwhile, haven’t gotten a booster. That’s along with the roughly 14 percent of staff who are unvaccinated or only partially vaccinated.

The CDC began recommending boosters for nursing home residents in the fall, after studies showed that vaccination becomes less effective over time, especially in people 65 and older. COVID-19 cases among nursing home residents with a booster were more than 10 times lower than cases among unvaccinated residents and residents who have received only their primary series of shots, according to CDC data from the week ending Jan. 2.

“While being fully vaccinated without a booster still provides protection against severe illness and death, it is no longer adequate for nursing home residents,” AARP’s Reinhard and Houser wrote on Thursday. “A booster is necessary to remain protected.”

Booster hesitancy among staff and residents, delays in receiving consent from resident representatives, long waits for pharmacy partners to provide on-site vaccinations, and staffing shortages are all contributing to the lag in boosters, according to nursing home operators. Some facilities are also citing recent COVID-19 outbreaks; once residents or staff are infected with the virus, it’s recommended that they wait until their symptoms pass before receiving a booster.

Many staff are also confused about the official guidance or fatigued by constantly changing guidance, says Glen Lewis, executive director of the Edgewater senior living community in West Des Moines, Iowa. “That’s causing some to delay or just give up trying to keep up,” he says.

Some states lag more

Booster uptake in nursing homes varies considerably among states. In Hawaii, Iowa, Minnesota, New Hampshire, North Dakota, South Dakota and Vermont, more than 80 percent of fully vaccinated residents were boosted as of Jan. 9, according to the CDC. But in Arizona, Florida and Nevada, less than 50 percent of fully vaccinated residents have received the additional jab.

“Especially where vaccination and booster uptake are lagging, states must tackle this matter with urgency,” AARP’s Reinhard and Houser wrote in their blog post.

In Arizona, which reported the lowest booster rate among fully vaccinated residents — just 46 percent — AARP state director Dana Marie Kennedy is urging Governor Doug Ducey to take “immediate steps to help ensure that both residents and staff are fully vaccinated and receive the booster dose as soon as they are eligible.”

“Booster rates in Arizona among those who live and work in nursing homes are … far less than what is needed to prevent deadly outbreaks,” she wrote in a recent letter to the governor.

After facing months of legal challenges, the Biden administration’s COVID-19 vaccine requirement for staff of Medicare- and Medicaid-certified health care facilities, which includes most nursing homes, was allowed by the Supreme Court last week.

While the vaccine requirement was already in effect in 25 states, the ruling allows the government to enforce the requirement in all states. The requirement, which AARP “strongly supports,” covers only the initial series of vaccinations, not boosters.