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Published on: November 10, 2023
Association of COVID-19 Vaccination Rates and Facility Characteristics on COVID-19 Cases, Hospitalizations, and
Aaron Carabajal-Johnson1, Danya M Qato2, Sean P Fleming1
1University of Maryland School of Pharmacy, Baltimore, MD, USA; The Peter Lamy Center on Drug Therapy and Aging, Baltimore, MD, USA.
Objectives:
Nursing home residents have been disproportionately affected by the COVID-19 pandemic. Despite recognition as a priority group for receipt of the COVID-19 vaccine, vaccine uptake and COVID-19 cases, hospitalizations, and deaths in nursing home facilities were variable across nursing homes. This study has 2 objectives: (1) to describe nursing facility characteristics associated with higher vs lower vaccination rates and (2) to estimate facility characteristics associated with COVID-19 cases, hospitalizations, and deaths, stratified by vaccination rate.
Design:
Cross-sectional study.
Setting And Participants:
Facility-level data from 12,811 US nursing home facilities.
Methods:
Using the CMS's Nursing Home COVID-19 Public File, we analyzed nursing home COVID-19 vaccination rates and outcomes from June 13, 2021, to September 19, 2021. We performed multivariable logistic regressions and identified facility characteristics associated with increased vaccination uptake and COVID-19 outcomes.
Results:
Nursing homes with average vaccination rates ≤80% experienced higher total average COVID-19 cases, hospitalizations, and deaths compared to facilities with >80% average vaccination rates during the Delta surge. Moreover, facility factors, such as higher average age of residents, proportion of non-white residents, nurse staffing hours, and occupancy rates, were variably associated with increased risk of COVID-19 outcomes.
Conclusions And Implications:
Facilities with higher resident vaccination rates experienced lower average COVID-19 cases, hospitalizations, and deaths in US nursing homes. Access to vaccines may play a role in mitigating harm associated with infectious diseases. Additionally, facility factors associated with increased adverse outcomes were variably associated with increased odds of COVID-19 outcomes, often, irrespective of vaccination level. As the COVID-19 pandemic continues to evolve and as the possibility of other infectious disease variants emerge, this research provides insight into facility factors, including vaccine uptake, that may mitigate adverse outcomes.
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