Early COVID-19 First-Dose Vaccination Coverage Among Residents and Staff Members of Skilled Nursing Facilities Participating in the Pharmacy Partnership for Long-Term Care Program - United States, December 2020-January 2021

Abstract

Residents and staff members of long-term care facilities (LTCFs), because they live and work in congregate settings, are at increased risk for infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1,2). In particular, skilled nursing facilities (SNFs), LTCFs that provide skilled nursing care and rehabilitation services for persons with complex medical needs, have been documented settings of COVID-19 outbreaks (3). In addition, residents of LTCFs might be at increased risk for severe outcomes because of their advanced age or the presence of underlying chronic medical conditions (4). As a result, the Advisory Committee on Immunization Practices has recommended that residents and staff members of LTCFs be offered vaccination in the initial COVID-19 vaccine allocation phase (Phase 1a) in the United States (5). In December 2020, CDC launched the Pharmacy Partnership for Long-Term Care Program* to facilitate on-site vaccination of residents and staff members at enrolled LTCFs. To evaluate early receipt of vaccine during the first month of the program, the number of eligible residents and staff members in enrolled SNFs was estimated using resident census data from the National Healthcare Safety Network (NHSN^†) and staffing data from the Centers for Medicare & Medicaid Services (CMS) Payroll-Based Journal.^§ Among 11,460 SNFs with at least one vaccination clinic during the first month of the program (December 18, 2020-January 17, 2021), an estimated median of 77.8% of residents (interquartile range [IQR] = 61.3%- 93.1%) and a median of 37.5% (IQR = 23.2%- 56.8%) of staff members per facility received ≥1 dose of COVID-19 vaccine through the Pharmacy Partnership for Long-Term Care Program. The program achieved moderately high coverage among residents; however, continued development and implementation of focused communication and outreach strategies are needed to improve vaccination coverage among staff members in SNFs and other long-term care settings.

FIGURE 1

Estimated percentage of residents and staff members at skilled nursing facilities enrolled in the Pharmacy Partnership for Long-Term Care Program who received ≥1 dose of COVID-19 vaccine — United States, December 18, 2020–January 17, 2021 Abbreviations: CMS = Centers for Medicare & Medicaid Services; COVID-19 = coronavirus disease 2019. * Vaccination coverage >100% (not shown) was estimated for residents in 2,118 (18.5%) facilities and for staff members in 559 (4.8%) facilities. Estimated vaccination coverage in excess of 100% might reflect resident and staff member turnover, other variation in denominator estimates, or errors in reported vaccine administration data. ^† n = 11,376 facilities. The number of residents eligible for vaccination was estimated using the mean of National Healthcare Safety Network weekly resident census counts for each facility during December 14, 2020–January 17, 2021. ^§ n = 11,134 facilities. The number of staff members eligible for vaccination was estimated using CMS Payroll-Based Journal counts of unique staff members for each facility during July–September (Quarter 3) 2020. Vaccination estimates reflect staff members vaccinated through the Pharmacy Partnership for Long-Term Care Program; additional staff members might have been vaccinated through other programs. ^¶ Includes facilities with a unique, valid CMS Certification Number and with at least one on-site clinic conducted through the Pharmacy Partnership for Long-Term Care Program during December 18, 2020–January 17, 2021.

FIGURE 2

Estimated median percentage of residents and staff members at skilled nursing facilities enrolled in the Pharmacy Partnership for Long-Term Care Program who received ≥1 dose of COVID-19 vaccine, by jurisdiction — United States, December 18, 2020–January 17, 2021 Abbreviations: CMS = Centers for Medicare & Medicaid Services; COVID-19 = coronavirus disease 2019. * n = 11,376 facilities. The number of residents eligible for vaccination was estimated using the mean of National Healthcare Safety Network weekly resident census counts for each facility during December 14, 2020–January 17, 2021. ^† n = 11,134 facilities. The number of staff members eligible for vaccination was estimated using CMS Payroll-Based Journal counts of unique staff members for each facility during July–September (Quarter 3) 2020. Vaccination estimates reflect staff members vaccinated through the Pharmacy Partnership for Long-Term Care Program; additional staff members might have been vaccinated through other programs. ^§ Includes facilities with a unique, valid CMS Certification Number and with at least one on-site clinic conducted through the Pharmacy Partnership for Long-Term Care Program during December 18, 2020–January 17, 2021. ^¶ Participating jurisdictions do not include West Virginia. Jurisdiction-level estimates are only presented for 40 states that had >50 CMS-certified skilled nursing facilities with a vaccination clinic conducted during December 18, 2020–January 17, 2021. Data for Chicago, New York City, and Philadelphia were combined with those of their respective states for jurisdiction-level estimates. Washington, DC, and Puerto Rico had ≤50 skilled nursing facilities with an on-site clinic and available data and are not shown.