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. 2026 Jan 6;27(3):106029.
doi: 10.1016/j.jamda.2025.106029. Online ahead of print.

COVID-19 Vaccination and Impact on Morbidity Among Nursing Home Residents, October 2024-January 2025: An Ecological Analysis

Farid L Khan  1 , Jenny Boucher  2 , Timothy L Wiemken  2 , Angela D Cook  2 , Tobias Bergroth  2 , Alon Yehoshua  2 , Evan J Zasowski  2 , Santiago M C Lopez  2 , Laura A Puzniak  2
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Free article

COVID-19 Vaccination and Impact on Morbidity Among Nursing Home Residents, October 2024-January 2025: An Ecological Analysis

Farid L Khan et al. J Am Med Dir Assoc. .
Free article

Abstract

Objectives: US nursing home residents experience a disproportionate burden of COVID-19-associated cases and hospitalizations. COVID-19 vaccination may reduce the burden in this population; however, data on the association between vaccine uptake and outcomes for this vulnerable population are lacking.

Design: Retrospective, observational ecological study.

Setting and participants: Facility-level nursing home resident information from the Centers for Disease Control and Prevention's National Healthcare Safety Network Long-Term Care Facility COVID-19 Module database from October 5, 2024, to January 5, 2025.

Methods: Facility-level COVID-19 vaccination uptake and COVID-19 outcomes were linked with sociodemographic, economic, and facility characteristics. Generalized estimating equations were used to assess associations between vaccination uptake and COVID-19 cases and hospitalizations, controlling for potential confounders.

Results: The study included up to 13 weeks of data from 12,665 facilities (168,278 facility-weeks total). COVID-19 vaccination uptake increased from 14.8% to 40.0% over the study period. A 10% increase in vaccination uptake was associated with a significant reduction in COVID-19 cases [adjusted incidence rate ratio (ARR), 0.94; 95% CI, 0.91-0.97] and hospitalizations (ARR, 0.91; 95% CI, 0.86-0.95) among up-to-date residents. Facilities with higher vaccination rates experienced fewer weekly COVID-19 cases and hospitalizations.

Conclusions and implications: Increased COVID-19 vaccination rates among nursing home residents are associated with reduced cases and hospitalizations, underscoring the importance of vaccination as a public health strategy in this vulnerable population. Efforts to improve COVID-19 vaccine uptake are warranted and could include revision of quality measures ratings to align COVID-19 vaccination with flu vaccination requirements.

Keywords: COVID-19; morbidity; residents; vaccination.

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Conflict of interest statement

Disclosure All authors (F.L.K., J.B., T.L.W., A.D.C., T.B., A.Y., E.J.Z., S.M.C.L., and L.A.P.) are employees of, and hold shares and/or stock options of, the study sponsor and were compensated for their contributions to this study.

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