With 44% of Nursing Home Staff Not Yet Fully Vaccinated, New Funding Initiatives to Study Vaccine Hesitancy Among LTC Workers Are Launched

COVID-19 has infected almost 1.5 million individuals in our nation’s long-term care facilities and claimed the lives of over 180,000.[1] Despite COVID’s devastating impact on our nation’s long-term care facilities, nursing home staff continue to be reluctant to get vaccinated. According to new analysis by AARP,[2] over 40% of the nursing home staff are not fully vaccinated, which means that 4 in 5 nursing homes did not meet the industry’s target goal of having 75% of staff fully vaccinated by June 30, 2021.[3] Staff vaccination rates vary widely across the nation. States with the lowest nursing home staff vaccination rates, according to AARP, include Louisiana (41.1%), Florida (41.8%), and Mississippi (42.2%), compared to states with the highest rates, such as Hawaii (83.9%), Vermont (76.6%), and California (76.3%).

This news is particularly concerning as the Centers for Disease Control and Prevention (CDC) recently classified the Delta variant of COVID-19 as a variant of concern.[4] This classification category means there is evidence of increased transmissibility and disease severity, such as hospitalizations and deaths. COVID-19 vaccines, according to the CDC, appear to offer protection against current variants.[5]

In the meantime, the Patient-Centered Outcomes Research Institute (PCORI) announced $11 million in funding for two studies aimed at finding ways to reduce COVID-19 vaccine hesitancy among long-term care staff.[6] One study, at Dartmouth College, will recruit 1,800 direct care workers and compare methods to increase confidence in the vaccines. One third of the participants will attend live webinars, another third will visit a website and engage with social media, while the final third will review COVID-19 information on CDC’s website.[7]

The second study will be spearheaded by the Kaiser Permanente Washington Health Research Institute and will be carried out in 60 long-term care facilities in both Georgia and Washington State, involving 6,000 frontline workers at those facilities.[8] This study will examine the effectiveness of different ways to disseminate vaccine information in a manner that is tailored to the language or cultural groups of the long-term care staff workers. Staff will be divided into three groups with varying levels of intervention (full, limited, or enhanced usual care). The full intervention group will work with the study team to codesign vaccine information materials focusing on reaching diverse groups and will also learn to be peer advocates for the vaccine. The second group (i.e., limited intervention) will work with the materials developed by the first group and share them with staff at their long-term care facility. Finally, the third group will receive vaccine information through the CDC and give that information to their co-workers at the facilities.

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[1] KFF. State COVID-19 Data and Policy Actions. (July 2, 2021). Available at: https://www.kff.org/coronavirus-covid-19/issue-brief/state-covid-19-data-and-policy-actions/
[2] Paulin, E. Nursing Homes Not Hitting Staff COVID Vaccine Goal. (July 15, 2021).  AARP. Available at: https://www.aarp.org/caregiving/health/info-2021/nursing-home-staff-vaccine-threshold.html
[3] Nursing Homes Set Goal To Get 75% Of Staff Vaccinated By June 30. AHCA Press Release. (Feb. 25, 2021). https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/Nursing-Homes-Set-Goal-To-Get-75-Percent-Of-Staff-Vaccinated-By-June-30.aspx
[4] Centers for Disease Control and Prevention. SARS-CoV-2 Variant Classifications and Definitions. (Updated July 13, 2021). Available at: https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-info.html#Concern
[5] Centers for Disease Control and Prevention. About Variants of the Virus that Causes COVID-19​​. (Updated June 28, 2021). Available at: https://www.cdc.gov/coronavirus/2019-ncov/variants/variant.html
[6] PCORI. PCORI approves $11 million for new studies to boost COVID-19 vaccination rates among long-term care workers. (July 12, 2021). Press Release. Available at: https://www.pcori.org/news-release/pcori-approves-11m-for-new-studies-boost-covid-19-vaccination-rates-among-long-term-care-workers?utm_campaign=PCORI+approves+$11+million+for+new+studies+to+boost+COVID-19+vaccination+rates+among+long-term+care+workers&utm_medium=bitly&utm_source=website
[7] PCORI. CONFIDENT: A Randomized Trial to Increase COVID-19 Vaccine Confidence in Long-Term Care Workers. (July 12, 2021). Available at: https://www.pcori.org/research-results/2021/confident-randomized-trial-increase-covid-19-vaccine-confidence-long-term-care
[8] PCORI. ENSPIRE Study: Engaging Staff to Improve COVID-19 Vaccination Rates at Long-Term Care Facilities. (July 12, 2021). Available at: https://www.pcori.org/research-results/2021/enspire-study-engaging-staff-improve-covid-19-vaccination-rates-long-term-care