First-Dose COVID-19 Vaccination Coverage Among Skilled Nursing Facility Residents and Staff

Gharpure, et al. (2021) report that residents and staff of long-term care facilities (LTCFs) have been prioritized by the Advisory Committee on Immunization Practices for vaccination in the initial COVID-19 vaccine allocation phase in the U.S. Residents and staff of LTCFs, who live and work in congregate settings, are at increased risk for infection with SARS-CoV-2,2 and residents, given their advanced age and/or underlying chronic medical conditions, are at increased risk for severe outcomes.

To facilitate vaccination of LTCF residents and staff, the Centers for Disease Control and Prevention (CDC) launched the Pharmacy Partnership for Long-Term Care Program in December 2020. This public-private partnership between CDC, CVS Pharmacy, Managed Health Care Associates Inc, and Walgreens provides on-site COVID-19 vaccination of residents and staff members at enrolled LTCFs, including skilled nursing facilities (SNFs), assisted living facilities, and other LTCFs across 54 jurisdictions (49 states, 4 cities, and 1 territory). Pharmacy partners provide comprehensive management of the vaccination process to include scheduling, cold chain management, patient counseling, and administration. This Insights by Gharpure, et al. (2021) describes estimated rates of early receipt of vaccine among residents and staff during the first month of the program, as recently reported in MMWR.

Infographic courtesy of JAMA

For this report, COVID-19 vaccine administration data were restricted to enrolled SNFs with a unique, valid Centers for Medicare & Medicaid Services (CMS) certification number and with an on-site vaccination clinic during the first month of the program (December 18, 2020-January 17, 2021). The number of residents eligible for vaccination was estimated using the mean weekly resident census counts for each facility during December 14, 2020, through January 17, 2021, from the National Healthcare Safety Network; the number of staff members eligible for vaccination was estimated using counts of unique staff members for each facility in July through September 2020 from the CMS Payroll-Based Journal. Inclusion criteria for national vaccination estimates were all CMS-certified SNFs with available denominator data and at least 1 on-site clinic in the first month of the program. Inclusion criteria for jurisdiction-level estimates were those in which more than 50 CMS-certified SNFs had at least 1 on-site clinic in the first month of the program. Data for participating cities were combined with those of their state for jurisdiction-level estimates. This activity was reviewed by CDC and was consistent with applicable federal law and CDC policy.

During December 18, 2020-January 17, 2021, among 12 702 CMS-certified SNFs enrolled in the Pharmacy Partnership for Long-Term Care Program, 11 460 (90.2%) had at least 1 on-site vaccination clinic through the program. A total of 713 909 residents and 582 104 staff members received at least a first dose of COVID-19 vaccine; administration of second doses was not analyzed. Among 11 376 (99.3%) facilities with available resident census data, the median estimated percentage of residents vaccinated per facility was 77.8% (IQR, 61.3%-93.1%), and among 11 134 (97.2%) facilities with available payroll data, the median estimated percentage of staff vaccinated was 37.5% (IQR, 23.2%-56.8%). Among 40 states that met inclusion criteria for jurisdiction-level estimates, the median percentage of residents vaccinated per facility by state ranged from 65.7% to more than 100% and of staff members, from 19.4% to 67.4%.

Reference: Gharpure R, et al. First-Dose COVID-19 Vaccination Coverage Among Skilled Nursing Facility Residents and Staff. JAMA. Published online Feb. 24, 2021. doi:10.1001/jama.2021.2352

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