Nursing home group cites evidence COVID-19 vaccine is already working for their residents

An organization that represents long-term care providers has released preliminary, but hopeful, data on the impact of vaccination in facilities that received top priority for COVID-19 vaccines because their residents have proved so vulnerable to the new virus.

A new analysis found that cases dropped more quickly in nursing homes where residents and staff had been vaccinated than they did in facilities in the same county that had not yet hosted vaccination events.

The comparison was made just three weeks after first shots were given, too early for recipients to have reached full immunity. Both vaccines currently being administered require two doses given three or four weeks apart. A couple of weeks after the second dose, the vaccines are 95% effective at preventing symptomatic disease, clinical trials found. After just three weeks from the first dose, studies show they are closer to 52% effective. It is still unclear how often vaccinated people might spread disease without having symptoms.

The report was released by the American Health Care Association/National Center for Assisted Living, which represents nursing home and assisted living providers. The analysis was produced by the association’s research arm, the Center for Health Policy Evaluation. The report did not include information on what percentage of staff or residents agreed to be vaccinated or infection rates in surrounding communities. Previous work has shown that community infection is the best predictor of spread in long-term care facilities. Employees typically are exposed at home and then bring the virus to work.

The analysis compared 797 nursing homes that had a first vaccination clinic between Dec. 18 and Dec. 27 with 1,709 that had not begun vaccination yet. The two groups of homes were similar in most ways, but those that had not begun vaccinating were more likely to be in urban areas and had more minority residents.

The report found that rates of new cases among residents declined by 48% three weeks after a first vaccine event compared with 21% in homes that had not given vaccines. Staff case rates fell by 33% in vaccinated homes and 18% in unvaccinated facilities.

The report did not break down results by state.

In Pennsylvania, coronavirus cases and deaths have plummeted in the general population since hitting second-wave peaks in December. Total cases per day peaked at 12,806 on Dec. 10 and fell to 2,277 on Feb. 15, a decline of 82%. Deaths have also fallen by more than 80%.

Meanwhile, long-term care cases and deaths, which include both nursing homes and personal care or assisted living, have fallen even more — around 90%. Pennsylvania prioritized shots in nursing homes first, so fewer personal care residents have had access to vaccines.

Nursing homes were devastated by the first wave of the coronavirus, accounting for close to 70% of deaths in Pennsylvania in May. During the early days, testing was not widely available, asymptomatic spread was underestimated, and protective equipment for staff was in short supply. Over the summer, deaths were low. Currently, 52% of the state’s 23,126 deaths are tied to long-term care settings.

AHCA has called for more study of how well vaccination works in the long-term care population. Vaccines often are less effective in older, sicker people than they are in clinical trial participants. Knowing more about how effective vaccines are is important as facilities wonder how much they can safely relax rules on visitation and social distancing. The organization has also asked the U.S. Centers for Disease Control and Prevention for national guidance on socialization.

“Clear communication with stakeholders can help ensure everyone understands the continued need for vigilance until we know more about the vaccines’ effectiveness,” AHCA president Mark Parkinson said in a letter to CDC Director Rochelle Walensky.