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

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.