There is a 30% difference in COVID-19 vaccination coverage between long-term care physicians and facility aides, the Centers for Disease Control and Prevention has found.
Using a sample self-reported data from 300 U.S. long-term care facilities, CDC showed that vaccination rates were highest among physicians, at 75%, while nurses and aides lagged behind at 57% and 46% respectively. Notably, rates among aides are lowest in zip codes where social vulnerability to poor health outcomes is highest, the agency reported. Aides as defined in the study included certified nursing assistants, nurse aides, medication aides and medication assistants.
The results highlight the COVID-19 transmission risks for vulnerable long-term care residents, who often are in close contact with aides. And they also underscore potential health equity concerns for low-paid and socially disadvantaged employees, CDC investigators said. Nursing home aides are more likely to be members of racial and ethnic minority groups that have a disproportionate amount of underlying health problems that raise the odds of adverse outcomes from COVID-19, reported James T. Lee, M.D., of the CDC’s COVID-19 Response Team, and colleagues.
Overall county-level data also show a pattern of low vaccination in areas with high vulnerability to comorbid illness, which may be due in part to lack of access. But the low vaccine uptake in long-term care points to vaccine hesitancy, considering the availability of on-site vaccination in these facilities, Lee wrote.
“Additional efforts are warranted to improve LTCF immunization policies and vaccination practices, build healthcare personnel confidence in COVID-19 vaccines, and encourage vaccination among persons who have been economically or socially marginalized,” Lee and colleagues wrote.
Mandating vaccinations in long-term care also may be a path forward to lowering these risks, the study’s authors proposed.
Centers for Medicare & Medicaid Services rules require facility operators to educate healthcare providers on the vaccines. CDC offers education and training resources to this end. But facility operators also may wish to consider a lesson from influenza campaigns, investigators wrote. Employer flu vaccination requirements are associated with the highest vaccination coverage rates.
Long-term care facility residents and healthcare personnel accounted for nearly one third of COVID-19–associated deaths in the United States as of March 2021. That’s about 182,000 deaths, according to the CDC.
The current study was published in the CDC’s Morbidity and Mortality Weekly Report.
