Coronavirus Disease 2019 (COVID-19) Vaccination Rates and Staffing Shortages Among Healthcare Personnel in Nursing Homes Before, During, and After Implementation of Mandates for COVID-19 Vaccination Among 15 US Jurisdictions, National Healthcare...

Overview

Journal Infect Control Hosp Epidemiol

Publisher Cambridge University Press

Specialties Health Services
Infectious Diseases
Nursing
Public Health

Date 2023 May 5

PMID 37144294

Authors

Hannah E Reses

Minn Soe

Heather Dubendris

George Segovia

Emily Wong

Shanjeeda Shafi

Elizabeth J Kalayil

Meng Lu

Suparna Bagchi

Jonathan R Edwards

Andrea L Benin

Jeneita M Bell

Affiliations

Soon will be listed here.

Abstract

Objective: To examine temporal changes in coverage with a complete primary series of coronavirus disease 2019 (COVID-19) vaccination and staffing shortages among healthcare personnel (HCP) working in nursing homes in the United States before, during, and after the implementation of jurisdiction-based COVID-19 vaccination mandates for HCP.

Sample And Setting: HCP in nursing homes from 15 US jurisdictions.

Design: We analyzed weekly COVID-19 vaccination data reported to the Centers for Disease Control and Prevention's National Healthcare Safety Network from June 7, 2021, through January 2, 2022. We assessed 3 periods (preintervention, intervention, and postintervention) based on the announcement of vaccination mandates for HCP in 15 jurisdictions. We used interrupted time-series models to estimate the weekly percentage change in vaccination with complete primary series and the odds of reporting a staffing shortage for each period.

Results: Complete primary series vaccination among HCP increased from 66.7% at baseline to 94.3% at the end of the study period and increased at the fastest rate during the intervention period for 12 of 15 jurisdictions. The odds of reporting a staffing shortage were lowest after the intervention.

Conclusions: These findings demonstrate that COVID-19 vaccination mandates may be an effective strategy for improving HCP vaccination coverage in nursing homes without exacerbating staffing shortages. These data suggest that mandates can be considered to improve COVID-19 coverage among HCP in nursing homes to protect both HCP and vulnerable nursing home residents.

Citing Articles

Measures to Prevent and Control COVID-19 in Skilled Nursing Facilities: A Scoping Review.

Canter B, Ulyte A, McGarry B, Barnett M JAMA Health Forum. 2025; 6(1):e245175.

PMID: 39888638 PMC: 11786235. DOI: 10.1001/jamahealthforum.2024.5175.

Influenza and COVID-19 Vaccination Coverage Among Health Care Personnel - National Healthcare Safety Network, United States, 2023-24 Respiratory Virus Season.

Bell J, Meng L, Barbre K, Wong E, Lape-Newman B, Koech W MMWR Morb Mortal Wkly Rep. 2024; 73(43):966-972.

PMID: 39480706 PMC: 11527362. DOI: 10.15585/mmwr.mm7343a2.

Changes in vaccine attitudes and recommendations among US Healthcare Personnel during the COVID-19 pandemic.

Dudley M, Schuh H, Forr A, Shaw J, Salmon D NPJ Vaccines. 2024; 9(1):49.

PMID: 38418562 PMC: 10901873. DOI: 10.1038/s41541-024-00826-y.

Influenza and Up-to-Date COVID-19 Vaccination Coverage Among Health Care Personnel - National Healthcare Safety Network, United States, 2022-23 Influenza Season.

Bell J, Meng L, Barbre K, Haanschoten E, Reses H, Soe M MMWR Morb Mortal Wkly Rep. 2023; 72(45):1237-1243.

PMID: 37943704 PMC: 10651318. DOI: 10.15585/mmwr.mm7245a5.

References

Karanfil L, Bahner J, Hovatter J, Thomas W . Championing patient safety through mandatory influenza vaccination for all healthcare personnel and affiliated physicians. Infect Control Hosp Epidemiol. 2011; 32(4):375-9. DOI: 10.1086/659155. View

Taylor J, Carter R, Lehnertz N, Kazazian L, Sullivan M, Wang X . Serial Testing for SARS-CoV-2 and Virus Whole Genome Sequencing Inform Infection Risk at Two Skilled Nursing Facilities with COVID-19 Outbreaks - Minnesota, April-June 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(37):1288-1295. PMC: 7498172. DOI: 10.15585/mmwr.mm6937a3. View

Johnson A, Linde L, Ali A, DeSantis A, Shi M, Adam C . COVID-19 Incidence and Mortality Among Unvaccinated and Vaccinated Persons Aged ≥12 Years by Receipt of Bivalent Booster Doses and Time Since Vaccination - 24 U.S. Jurisdictions, October 3, 2021-December 24, 2022. MMWR Morb Mortal Wkly Rep. 2023; 72(6):145-152. PMC: 9925136. DOI: 10.15585/mmwr.mm7206a3. View

Septimus E, Perlin J, Cormier S, Moody J, Hickok J . A multifaceted mandatory patient safety program and seasonal influenza vaccination of health care workers in community hospitals. JAMA. 2011; 305(10):999-1000. DOI: 10.1001/jama.2011.244. View

Zeger S, Liang K, Albert P . Models for longitudinal data: a generalized estimating equation approach. Biometrics. 1988; 44(4):1049-60. View

McGarry B, Grabowski D, Barnett M . Severe Staffing And Personal Protective Equipment Shortages Faced By Nursing Homes During The COVID-19 Pandemic. Health Aff (Millwood). 2020; 39(10):1812-1821. PMC: 7598889. DOI: 10.1377/hlthaff.2020.01269. View

Prato S, Paladino M, Riva M, Belingheri M . COVID-19 Vaccination and Asymptomatic Infection: Effect of BNT162b2 mRNA Vaccine on the Incidence of COVID-19 and Duration of Sick Leave Among Healthcare Workers. J Occup Environ Med. 2021; 63(12):e868-e870. PMC: 8630929. DOI: 10.1097/JOM.0000000000002389. View

Frati P, La Russa R, Di Fazio N, Del Fante Z, Delogu G, Fineschi V . Compulsory Vaccination for Healthcare Workers in Italy for the Prevention of SARS-CoV-2 Infection. Vaccines (Basel). 2021; 9(9). PMC: 8473178. DOI: 10.3390/vaccines9090966. View

Rakita R, Hagar B, Crome P, Lammert J . Mandatory influenza vaccination of healthcare workers: a 5-year study. Infect Control Hosp Epidemiol. 2010; 31(9):881-8. DOI: 10.1086/656210. View

10.

Kimball A, Hatfield K, Arons M, James A, Taylor J, Spicer K . Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(13):377-381. PMC: 7119514. DOI: 10.15585/mmwr.mm6913e1. View

11.

Kidd F, Wones R, Momper A, Bechtle M, Lewis M . From 51% to 100%: mandatory seasonal influenza vaccination. Am J Infect Control. 2011; 40(2):188-90. DOI: 10.1016/j.ajic.2011.02.022. View

12.

Gilboa M, Regev-Yochay G, Mandelboim M, Indenbaum V, Asraf K, Fluss R . Durability of Immune Response After COVID-19 Booster Vaccination and Association With COVID-19 Omicron Infection. JAMA Netw Open. 2022; 5(9):e2231778. PMC: 9478782. DOI: 10.1001/jamanetworkopen.2022.31778. View

13.

Feemster K, Prasad P, Smith M, Feudtner C, Caplan A, Offit P . Employee designation and health care worker support of an influenza vaccine mandate at a large pediatric tertiary care hospital. Vaccine. 2011; 29(9):1762-9. DOI: 10.1016/j.vaccine.2010.12.115. View

14.

Gohar B, Lariviere M, Nowrouzi-Kia B . Sickness absence in healthcare workers during the COVID-19 pandemic. Occup Med (Lond). 2020; 70(5):338-342. PMC: 7313824. DOI: 10.1093/occmed/kqaa093. View

15.

McGarry B, Gandhi A, Syme M, Berry S, White E, Grabowski D . Association of State COVID-19 Vaccine Mandates With Staff Vaccination Coverage and Staffing Shortages in US Nursing Homes. JAMA Health Forum. 2022; 3(7):e222363. PMC: 9338409. DOI: 10.1001/jamahealthforum.2022.2363. View

16.

Moccia G, Carpinelli L, Savarese G, De Caro F . Vaccine Hesitancy and the Green Digital Pass: A Study on Adherence to the Italian COVID-19 Vaccination Campaign. Int J Environ Res Public Health. 2022; 19(5). PMC: 8910368. DOI: 10.3390/ijerph19052970. View

17.

Maltezou H, Panagopoulos P, Sourri F, Giannouchos T, Raftopoulos V, Gamaletsou M . COVID-19 vaccination significantly reduces morbidity and absenteeism among healthcare personnel: A prospective multicenter study. Vaccine. 2021; 39(48):7021-7027. PMC: 8556541. DOI: 10.1016/j.vaccine.2021.10.054. View

18.

Paterlini M . Covid-19: Italy makes vaccination mandatory for healthcare workers. BMJ. 2021; 373:n905. DOI: 10.1136/bmj.n905. View

19.

Bagchi S, Mak J, Li Q, Sheriff E, Mungai E, Anttila A . Rates of COVID-19 Among Residents and Staff Members in Nursing Homes - United States, May 25-November 22, 2020. MMWR Morb Mortal Wkly Rep. 2021; 70(2):52-55. PMC: 7808710. DOI: 10.15585/mmwr.mm7002e2. View

20.

Frogner B, Dill J . Tracking Turnover Among Health Care Workers During the COVID-19 Pandemic: A Cross-sectional Study. JAMA Health Forum. 2022; 3(4):e220371. PMC: 8994131. DOI: 10.1001/jamahealthforum.2022.0371. View