The Prevalence and Impact of Vaccination Programs: Differences Between Nursing Homes and Assisted Living Communities

To compare the prevalence of vaccination programs between nursing homes (NHs) and assisted living communities (ALs) and examine how these programs relate to perceived hospitalization risk and temporary admission suspensions due to outbreaks.

Descriptive analysis of facility-level survey data from the 2023 Ohio Biennial Survey of Long-Term Care Facilities, which has a >90% response rate.

All licensed NHs and ALs in Ohio were surveyed and answered questions related to vaccination programs (n = 736; n = 623).

Three measures were analyzed: presence of a vaccination program for 7 vaccine-preventable illnesses [influenza; COVID-19; respiratory syncytial virus (RSV); pneumococcal; hepatitis B; shingles; and tetanus, diphtheria, and pertussis (Tdap)], perceived risk of transferring residents to the hospital for these illnesses, and temporary suspension of admissions due to outbreaks. All measures were binary and sample averages were calculated separately for NHs and ALs. Facility characteristics associated with COVID-19-related admission suspensions were compared.

NHs had a higher prevalence of vaccination programs for all 7 vaccine-preventable illnesses compared with ALs. The largest differences were observed for RSV, pneumococcal, hepatitis B, shingles, and Tdap. ALs reported higher perceived risk of transferring residents to the hospital for all illnesses, whereas NHs reported the highest perceived risk for respiratory illnesses. Temporary admission suspensions due to outbreaks were uncommon; when reported, they were primarily associated with COVID-19. Facilities with COVID-19-related suspensions were more likely to be smaller and not-for-profit/government owned. NHs with outbreaks were more often located in rural areas, and ALs with outbreaks were more often located in urban areas.

Significant disparities exist in vaccination program implementation between NHs and ALs. Expanding vaccination programs in ALs may reduce hospitalization risk and strengthen outbreak prevention. Targeted policy efforts, improved education, and resource allocation are needed to ensure equitable access to comprehensive vaccination programs across long-term care settings.