There's a troubling gap in nursing home COVID-19 vaccinations

A question for Minnesotans with a loved one living in long-term care:

Do you know what percentage of the facility's residents and staff have been fully vaccinated against COVID-19?

While life feels like it's returning to normal, the pandemic is nowhere near the end. The virus is still circulating, and more transmissible variants are developing. Troubling outbreaks in Missouri and other states with low vaccination rates underscore the continuing threat.

The elderly, particularly those living in nursing homes, are at high risk for severe illness and death from infection. The COVID vaccine is the best way to protect them, which is why knowing the answer to the vaccination question posed above is vital.

Families are always free to inquire with facilities. But a new, easy-to-use tool also can help in assessing how well individual long-term care centers are doing.

The tool is a searchable database of information collected by a federal agency — the Centers for Medicare and Medicaid Services (CMS) — from nursing homes across the nation. Users can type in a city, state or ZIP code into a search box, which yields a map showing individual facilities' locations as dots.

Clicking on them yields vaccination rates for residents and staff, as well as other useful information. Downloadable spreadsheets are also available. Note that the data is for nursing homes, though some assisted-living facilities have volunteered information.

Breaking out how individual facilities are doing empowers families to hold facilities accountable if vaccination rates lag. Before now, most publicly available information about COVID vaccination rates in long-term care facilities has involved statewide averages. For example, you could easily find out what percentage of Minnesota's long-term care residents have been vaccinated.

The CMS tool also puts that high-level information at fingertips and allows for easy state-to-state comparisons. Minnesota's performance is mixed. The state is in the top 10 when it comes to percentage of nursing home residents — around 89%, according to the latest CMS data — fully vaccinated against COVID.

But Minnesota's performance is middling when it comes to nursing home staff vaccinations. It ranks 18th, with this federal metric showing 62% of employees fully vaccinated.

That's a significant vaccination gap between residents and staff. It's troubling because infected workers could bring the virus into work. This puts unvaccinated residents at risk. And while the vaccines are highly effective, breakthrough infections can occur in those who got the shots.

States doing better at staff vaccination than Minnesota include Hawaii, Vermont and California. An inquiry to California, which ranks second among states, didn't yield any secret to its success. About 76% of nursing home employees there are fully vaccinated. Both California and Minnesota appear to be wielding similar strategies — education, awareness — to encourage vaccination among these workers. But clearly, there's room for improvement.

State health officials said Minnesota nursing home and assisted-living staff vaccinations are continuing to climb, with progress from May through July. State long-term care industry officials told an editorial writer they are working hard as well. At the same time, worker hiring and retention is a challenge at these facilities in the best of times, so heavy-handed approaches, such as mandates, could backfire.

Families of long-term care residents have an important role to play, too. The expectation ought to be that all workers are vaccinated, with medical exemptions if necessary. Communicating that expectation to staff and facilities' leadership will help ensure that this remains a priority and that progress continues.