COVID-19 Vaccine Uptake Among Residents and Staff Members of Assisted Living and Residential Care Communities-Pharmacy Partnership for Long-Term Care Program, December 2020-April 2021

Abstract

Objectives: In December 2020, CDC launched the Pharmacy Partnership for Long-Term Care Program to facilitate COVID-19 vaccination of residents and staff in long-term care facilities (LTCFs), including assisted living (AL) and other residential care (RC) communities. We aimed to assess vaccine uptake in these communities and identify characteristics that might impact uptake.

Design: Cross-sectional study.

Setting and participants: AL/RC communities in the Pharmacy Partnership for Long-Term Care Program that had ≥1 on-site vaccination clinic during December 18, 2020-April 21, 2021.

Methods: We estimated uptake using the cumulative number of doses of COVID-19 vaccine administered and normalizing by the number of AL/RC community beds. We estimated the percentage of residents vaccinated in 3 states using AL census counts. We linked community vaccine administration data with county-level social vulnerability index (SVI) measures to calculate median vaccine uptake by SVI tertile.

Results: In AL communities, a median of 67 residents [interquartile range (IQR): 48-90] and 32 staff members (IQR: 15-60) per 100 beds received a first dose of COVID-19 vaccine at the first on-site clinic; in RC, a median of 8 residents (IQR: 5-10) and 5 staff members (IQR: 2-12) per 10 beds received a first dose. Among 3 states with available AL resident census data, median resident first-dose uptake at the first clinic was 93% (IQR: 85-108) in Connecticut, 85% in Georgia (IQR: 70-102), and 78% (IQR: 56-91) in Tennessee. Among both residents and staff, cumulative first-dose vaccine uptake increased with increasing social vulnerability related to housing type and transportation.

Conclusions and implications: COVID-19 vaccination of residents and staff in LTCFs is a public health priority. On-site clinics may help to increase vaccine uptake, particularly when transportation may be a barrier. Ensuring steady access to COVID-19 vaccine in LTCFs following the conclusion of the Pharmacy Partnership is critical to maintaining high vaccination coverage among residents and staff.

Keywords: COVID-19; long-term care; vaccination; vaccination coverage.

Fig. 1

First-dose COVID-19 vaccine uptake,∗ by social vulnerability index (SVI) theme^† and tertile,^‡ among residents and staff members of assisted living (A and B) and other residential care (C and D) communities—Pharmacy Partnership for Long-Term Care Program, December 2020–April 2021. ∗Includes cumulative first-dose vaccine uptake as of April 21, 2021. ^†SVI ranks counties according to 15 social factors (indicators): (1) percentage of persons with incomes below poverty threshold, (2) percentage of civilian population (aged ≥16 years) that is unemployed, (3) per capita income, (4) percentage of persons aged ≥25 years with no high school diploma, (5) percentage of persons aged ≥65 years, (6) percentage of persons aged ≤17 years, (7) percentage of civilian noninstitutionalized population with a disability, (8) percentage of single-parent households with children aged <18 years, (9) percentage of persons who are racial/ethnic minorities (all persons except non-Hispanic White), (10) percentage of persons aged ≥5 years who speak English “less than well,” (11) percentage of housing structures with ≥10 units (multiunit housing), (12) percentage of housing structures that are mobile homes, (13) percentage households with more persons than rooms (crowding), (14) percentage of households with no vehicle available, and (15) percentage of persons in group quarters. Estimates are created using 2014-2018 (5-year) data from the American Community Survey. The 15 indicators are categorized into 4 themes: (1) socioeconomic status (indicators 1-4), (2) household composition and disability (indicators 5-8), (3) racial/ethnic minority status and language English (indicators 9 and 10), and (4) housing type and transportation (indicators 11-15). Additional details are available at https://www.atsdr.cdc.gov/placeandhealth/svi/documentation/SVI_documentation_2018.html. ^‡Higher tertile indicates increased social vulnerability.