Background

COVID-19 has disproportionately affected nursing home (NH) staff and residents in the U.S., with the highest rates of infection and mortality in both groups.[1, 2] Facility outbreaks vary geographically and over time.[3] Aside from morbidity, COVID-19 has been extremely costly for NHs due to declining admissions, purchasing of personal protective equipment (PPE)[4-6] and testing. It is estimated the U.S. government may pay more than $15 billion to cover COVID-19 costs in NHs alone.[7]

Two vaccine candidates were released in December 2020, with NH direct care staff and residents scheduled to be in the first group in the country to be offered the vaccine. The two vaccines (Pfizer and Moderna) use a novel messenger RNA technology. Phase two trials have already been conducted on over 50,000 and 30,000 persons for the Pfizer and Moderna vaccines, respectively, with demonstrated safety and efficacy against COVID-19.[8]

References

  1. Abbasi, J., "Abandoned" Nursing Homes Continue to Face Critical Supply and Staff Shortages as COVID-19 Toll Has Mounted. JAMA, 2020.

  2. McGarry BE, P.L., Grabowski DC., Nursing Home Workers Now Have the Most Dangerous Jobs in America. They Deserve Better. in Washington Post. 2020.

  3. Services, C.f.M.M. COVID-19 Nursing Home Data. 2020 [cited 2020 June 30]; Available from: https://data.cms.gov/stories/s/COVID-19-Nursing-Home-Data/bkwz-xpvg.

  4. Amir, O., et al., Incidence of hip fracture in Native American residents of U.S. nursing homes. Bone, 2019. 123: p. 204-210.

  5. Cai, S., et al., Despite small improvement, black nursing home residents remain less likely than whites to receive flu vaccine. Health Aff (Millwood), 2011. 30(10): p. 1939-46.

  6. Hausmann, L.R., et al., Racial and ethnic disparities in pneumonia treatment and mortality. Med Care, 2009. 47(9): p. 1009-17.

  7. Werner, R.M., A.K. Hoffman, and N.B. Coe, Long-Term Care Policy after Covid-19 - Solving the Nursing Home Crisis. N Engl J Med, 2020.

  8. Polack, F.P., et al., Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med, 2020.