Most NC nursing home staff, residents not up-to-date on COVID vaccines, despite high risk

Less than half of nursing home residents in North Carolina are up-to-date with COVID-19 vaccines, according to the most recent AARP data from the end of October.

An even smaller minority of nursing home staff— about 19% — have all the shots recommended by the Centers for Disease Control and Prevention

Nursing home advocates worry that leaves staff more likely to spread the virus and residents more susceptible to contracting it.

Residents and staff are not unique in their apathy towards the most recent bivalent boosters. Just 15% of North Carolinians have been vaccinated with the bivalent booster, which became available in September and offers significant protection against the dominant strains in the U.S.

However, older adults are uniquely vulnerable to COVID-related complications and death. In September 2022, people 65 and older accounted for 88% of COVID-19 deaths, according to an analysis from the Kaiser Family Foundation.

Living in a congregate living setting, like a nursing home, makes a COVID-19 infection even riskier.

“It’s like kids and chicken pox: You put one child with chicken pox in the classroom and before you know it, the whole classroom has the disease,” said Catherine Harvey Sevier, the NC AARP president. “It’s going to burn through the whole nursing home.”

COVID fatigue

Vaccination rates for nursing home staff reached an all-time high of 91% in the summer of 2021, shortly after the federal government mandated the two-shot series for healthcare workers.

However, every time a new booster became available, a smaller and smaller share of staff signed up for the shot.

The percentage of nursing home staff who has received the bivalent booster is higher than that of the general public in North Carolina. The booster vaccination rate is still about 5 percentage points lower than the nationwide average for nursing home staff, according to AARP data.

The problem is not a lack of access to the bivalent booster, which has been made available to all nursing home residents and staff, said Adam Sholar, President & CEO of the NC Health Care Facilities Association, said in a statement.

Harvey Sevier adds, “We’ve got a new problem and that is COVID fatigue.”

Nursing homes have few tools to combat the attitude. The facilities are often so strapped for staff that administrators are hesitant to impose any vaccine mandate that could drive them away, said Ted Goins, President and CEO of Lutheran Services, which operates several nursing homes across North Carolina.

Goins and other administrators have had to rely on encouragement and education to raise their numbers.

“Each progressive vaccine has been a harder sell,” he said.

The N.C. Department of Health and Human Services sent a letter to long-term care facilities earlier this month, encouraging the facilities to increase their booster uptake to protect the state’s “most vulnerable population.”

“We share the concern about low booster uptake in nursing homes,” a spokesperson for the department said in a statement.

But Bill Lamb, board member for Friends of Residents in Long Term Care, said he thinks family members will ultimately have to advocate on behalf of their loved ones to prompt change.

“I don’t understand why healthcare professionals, who should know better, are lagging in immunization,” he said. “If your mother was at high risk, would you want somebody who was not vaccinated caring for her?”

Lamb said he worries low booster uptake, which could lead to more cases in the facilities, could threaten family visitations, which were curtailed during the height of the pandemic.

“Family members need to be aware that access to their loved ones is fragile,” he said.

Teddy Rosenbluth covers science and healthcare for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work.

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