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

Infection rates are skyrocketing past what they were during last winter’s peaks

The doctor talks to the older woman and explains to her the safety of the vaccine itself and its effects. Immunization against the Covid virus pandemic 19.

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AARP on Thursday called on U.S. nursing homes to require COVID-19 booster shots for their residents and staff, as infection rates among both groups hit new highs and as booster rates in nursing homes lag, particularly in certain states.

“The message from recent data is clear: Nursing home residents and staff need booster shots now,” Susan Reinhard, AARP senior vice president and director of the AARP Public Policy Institute, and Ari Houser, a senior methods adviser at the Institute, wrote in a blog post on Thursday.

Check the vaccination rates of your nursing home  

You can now find vaccination 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

New weekly data from the Centers for Disease Control and Prevention (CDC) show a rapid surge in cases among nursing home staff beginning late last month. Weekly cases among workers jumped more than 10-fold from the week ending Dec. 19 to the week ending Jan. 9, from some 6,000 to 67,000 new infections. Cases seem to have dropped slightly last week, to 58,000 new inflections, according to data released on Wednesday, but that’s still more than double the cases reported during last winter’s peaks. And that figure is likely an undercount, as data continues to be submitted.

Resident cases are surging, too. They jumped from roughly 6,000 new infections during the week ending Dec. 26 to 42,000 last week, which is likely an undercount. Those infection rates surpass those of last winter, the deadliest period on record for nursing home residents, when some 40,000 died in just two months.

More than 160,000 nursing home residents and workers nationwide have died from COVID-19, accounting for roughly a fifth of the nation’s total COVID deaths.

While the current rate of resident deaths is well below that of last winter, it is rising. Deaths have recently more than doubled, from around 500 for the week ending Jan. 2 to around 1,000 last week.

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.

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