A nursing home worker smiling and helping residents

Vaccine boosters may play a key role in preventing COVID-19–associated morbidity and mortality in nursing home residents, new data across two long-term care systems reveals.

Investigators followed residents of 202 Genesis HealthCare facilities and 128 Veterans Health Association community living centers to determine the effectiveness of an mRNA vaccine booster in preventing infection, hospitalization and death.

The cohort study included 10,000 nursing home residents and 4,321 VHA center residents. Participants completed a two-dose series of an mRNA vaccine and were eligible for a booster dose between September and November, 2021. Health outcomes were followed until March 8, 2022. The study period covered times when the delta and/or omicron variants were circulating.

Fewer infected, hospitalized

When compared to their peers who did not get a booster shot, nursing home residents who did get a booster shot were significantly less likely to become infected, hospitalized or to die during the study period.

Boosted VHA center residents were also less likely to be infected or hospitalized. But there was little difference in COVID-19-associated deaths between the boosted and unboosted VHA center residents, possibly because only 18 deaths occurred during the study period in that group, the researchers said.

At the same time, although boosted VHA center residents were less likely to be hospitalized than the non-boosted, hospitalization rates were substantially higher when compared to those in the nursing homes. This result may be attributable to differences in resident comorbidity burden and the availability of hospice care, advance care planning and clinician practices regarding hospitalization, investigators wrote.

Overall, however, the vaccines were consistently effective in these two disparate cohorts, suggesting the importance of boosters in the nursing home population, the researchers concluded.

The study was published in JAMA Network Open.

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