Vaccination and COVID-19 Death Rates in Nursing Homes

All data presented here is from the week ending June 12, 2022

The Centers for Medicare & Medicaid Services (CMS) is part of the Department of Health and Human Services (HHS). A portion of what they do includes protecting and improving the care of nursing home residents, which includes tracking vaccination rates of both nursing home residents and staff. As you may remember, when COVID-19 vaccines were first released in December 2020, healthcare personnel (HCP) and long-term care facility (LTCF) residents were in Phase 1a, meaning that the Advisory Committee on Immunization Practices (ACIP) believed these groups to be in the highest risk group for COVID-19. Phase 1a was the initial phase of the vaccination program- these groups were eligible to receive vaccination first.

LTCF residents are considered to be at high risk for infection and severe COVID-19 disease based on their age, congregate living situations, and high rates of underlying medical conditions. HCP are at risk for transmitting the virus to these LTCF residents, as seen with community outbreaks. It is also important to vaccinate HCP in order to protect the workforce that is caring for these residents. If there is no workforce left, who is going to care for the LTCF residents?

As briefly mentioned, nursing homes report weekly data to the CDC’s National Healthcare Safety Network (NHSN) LTCF COVID-19 Module. This data as presented below is summarized by CMS. Keep in mind that this first set of data is collected at the national level.

RESIDENTS		STAFF
National % of Residents with Primary Vaccination per Facility	87.7%	National % of Staff with Primary Vaccination per Facility	87.0%
National % of Vaccinated Residents with Booster doses per Facility	82.3%	National % of Vaccinated Staff with Booster doses per Facility	53.0%
Total Resident COVID-19 Confirmed Cases	1,073,899	Total Staff COVID-19 Confirmed Cases	1,139,656
Total Resident COVID-19 Deaths	153,445	Total Staff COVID-19 Deaths	2,405

When we look at the same data above as compared to Missouri, specifically, you will see that on average, Missouri is slightly lower on all categories. This means that a lower percentage of both LTCF residents and staff are vaccinated in our state. This is something that our vaccine team at Corum has been working hard to combat. Theoretically, if we are able to increase the number of vaccinated and boosted residents and staff, we will decrease overall COVID-19 cases and therefore decrease death rate.

RESIDENTS (Missouri)		STAFF (Missouri)
% of Residents with Primary Vaccination per Facility	85.11%	% of Staff with Primary Vaccination per Facility	75.74%
% of Vaccinated Residents with Booster doses per Facility	77.77%	% of Vaccinated Staff with Booster doses per Facility	38.32%

Now, let’s compare this state-wide data from Missouri to a few of our Delmar Gardens facilities:

RESIDENTS (Delmar Gardens OTG)		STAFF (Delmar Gardens OTG)
Recent % of Current Residents who Received a Completed COVID-19 Vaccination at Any Time	94.74%	Recent % of Current HCP who Received a Completed COVID-19 Vaccination at Any Time	96.10%
Recent % of Current Residents with a Completed Vaccination who received a COVID-19 Vaccine Booster at Any Time	82.22%	Recent % of Current HCP with a Completed Vaccination who received a COVID-19 Vaccine Booster at Any Time	6.6%
RESIDENTS (Delmar Gardens Creve Coeur)		STAFF (Delmar Gardens Creve Coeur)
Recent % of Current Residents who Received a Completed COVID-19 Vaccination at Any Time	96.49%	Recent % of Current HCP who Received a Completed COVID-19 Vaccination at Any Time	95.65%
Recent % of Current Residents with a Completed Vaccination who received a COVID-19 Vaccine Booster at Any Time	100.0%	Recent % of Current HCP with a Completed Vaccination who received a COVID-19 Vaccine Booster at Any Time	36.36%
RESIDENTS (Delmar Gardens North)		STAFF (Delmar Gardens North)
Recent % of Current Residents who Received a Completed COVID-19 Vaccination at Any Time	92.73%	Recent % of Current HCP who Received a Completed COVID-19 Vaccination at Any Time	90.60%
Recent % of Current Residents with a Completed Vaccination who received a COVID-19 Vaccine Booster at Any Time	85.62%	Recent % of Current HCP with a Completed Vaccination who received a COVID-19 Vaccine Booster at Any Time	35.19%

I realize this data and all of these numbers can be overwhelming to look at and sift through. Some of these numbers are alarming (some good, some bad) but we will look at a few things in particular. I will choose Delmar Gardens of Creve Coeur (DGCC) for my comparison points:

Nationwide, 87.7% of residents in LTCFs have received a primary vaccination. In Missouri on average, this number drops to 85.11% (which is close!) but at DGCC, the rate jumps to 96.49%
What is really impressive is when we jump to the percentage of vaccinated residents who have received booster doses of the COVID-19 vaccine. The national number is 82.3% and the Missouri average drops to 77.77%. But at DGCC, the number is 100%! This means that all vaccinated residents who qualify for a COVID-19 booster, have received a booster. This is incredible and a model for what all LTCFs should strive for!

The negative side of these statistics that I would like to end with is related to COVID-19 deaths. If you reference the first table, you will see the national numbers (copied below):

Total Resident COVID-19 Confirmed Cases	1,073,899	Total Staff COVID-19 Confirmed Cases	1,139,656
Total Resident COVID-19 Deaths	153,445	Total Staff COVID-19 Deaths	2,405

Taking a step back, this is alarming. The total number of COVID-19 confirmed cases in staff is slightly higher than the total number in residents. However, the total number of deaths in residents is substantially higher than the total number deaths in staff members. From these numbers above, this shows that 14.29% of residents who tested positive for COVID-19 died, but only 0.21% of staff who tested positive for COVID-19 died. This loops back to the ACIP recommendations we discussed at the very beginning: LTCF residents are considered to be at high risk for infection and severe COVID-19 disease based on their age, congregate living situations, and high rates of underlying medical conditions.

As a pharmacist who has been deeply involved in the COVID-19 vaccination program at Corum Health Services since the very beginning, I feel that it is my duty to share this information with you. We have seen the highs and lows and shared many different feelings with you all along this journey. We have seen happy tears and people jump for joy to receive this vaccine. We have pushed through the low vaccine rates, answered questions and encouraged patients to talk to their physicians about the risks versus benefits of receiving this vaccine. It is our duty as healthcare workers to protect ourselves and protect our residents when we are able to do so. To me, this means getting vaccinated and encouraging others to do their research.

Here are some fun facts, looking back at our COVID-19 vaccination journey:

Corum found out on December 10, 2020 that we would be providing COVID-19 vaccines for some of our facilities
Corum’s first dose of Moderna COVID-19 was given on December 22, 2020
Corum’s first large vaccine clinic was on December 29, 2020 at Delmar Gardens On The Green
From December 22, 2020 to June 17, 2022, Corum has administered 9,350 doses
Of these 9,350 doses administered, 5,209 of them were given to patients age 65+
- This shows that 55.71% of our doses were administered to people in this high-risk age range. Per the CDC, adults 65 and older who received the primary vaccination series (2-doses) showed a 94% reduced risk of COVID-19-related hospitalization.
A fun look back: https://corumpharmacy.com/mr-mrs-claus-are-they-vaccinated/

Written by Megan Holland, PharmD –

pharmacist and immunizer at Corum Health Services