Feds: Long Island nursing home residents lag on COVID-19 shots

Fewer than half of Long Island nursing home residents on average are up to date on their COVID-19 vaccines, even though they represent a population most at risk of severe illness from the disease.

Federal statistics show that on average, 42.15% of people living in Nassau and Suffolk nursing homes are up to date.

The statistics from the Centers for Medicare and Medicaid Services consider nursing homes residents up to date if they have received the latest bivalent booster, or completed their primary series of the first two COVID-19 vaccines less than two months ago. 

Long Island mirrors a state and national trend, figures show, with an average of about 49.50% of residents in nursing homes across New York State up to date on their COVID-19 vaccines. The average for nursing homes across the United States is about 46.66%.

At the A. Holly Paterson Extended Care facility in Uniondale, getting residents interested in the latest COVID-19 booster has been a challenge, acknowledged Dr. Grace Ting, interim chief medical officer at Nassau University Medical Center, which operates the facility.

About 18.5% of residents have received the booster, according to Ting.

“There is a lot of refusal,” Ting said. “We are asking everybody and their family members. We sent letters out to health care proxies and next of kin. We ask the patients that can consent and they are not willing.”

Experts said the reasons for below-average rates on the latest booster are complex. Some patients and family members have told administrators they are not interested in receiving it, echoing so-called “vaccine fatigue” currently seen in the general population.

But some advocates said that had there been a more organized rollout — similar to the one for the initial vaccine by the federal government nearly two years ago — more people might be inclined to receive it.

Protecting the most vulnerable

“Recent data show every one-in-five COVID-19 deaths has been in a nursing facility since the start of the pandemic,” said Priya Chidambaram, senior policy analyst for the Kaiser Family Foundation, a nonprofit focused on national health issues. “This is a very, very high risk population.”

Older adults — especially those over the age of 65 as well as people with chronic illnesses — are more likely to get severe illness from COVID-19, according to the Centers for Disease Control and Prevention. Many people in that vulnerable population are also residents of nursing homes.

Experts have said the best way for older adults to prevent severe illness is to stay up to date with COVID-19 vaccinations, including the most recent booster.

The latest COVID-19 booster shot, known as the bivalent booster, became available in September and was designed to better protect people from the omicron variant and its subvariants currently circulating locally and around the nation.

In announcing a six-week campaign last month to boost lagging booster rates, Dr. Ashish Jha, the White House COVID-19 response coordinator, reiterated the importance of the shots for seniors and nursing home residents.

While 93.9% of people over the age of 65 have completed their primary COVID-19 vaccine series nationwide, only 35.7% have received the updated booster, according to estimates by the CDC.

In late November, the CMS encouraged nursing homes across the United States to increase vaccination efforts. The agency said it was “disappointed” some facilities reported zero residents getting the updated bivalent vaccine and vowed to be “looking closely” at those sites.

AARP has also tracked the low COVID-19 booster rates. Ari Houser, who helped research a recent AARP study on booster rates among nursing home residents and staff, pointed out that even fully vaccinated staff members may be able to bring COVID-19 into facilities.

“The staff is the link between the community and the facility,” said Houser, senior methods adviser at the AARP Public Policy Institute. “It’s important that the residents be protected at the individual level by these boosters.”

According to a KFF brief co-authored by Chidambaram, there was a spike in nursing home COVID-19 deaths after the holidays last year — from 35 deaths per 100,000 in mid-November 2021 to 131 deaths per 100,000 in mid-January 2022. 

"That spike raises concerns about the potential for a similar spike in preventable deaths among nursing home residents in the upcoming post-holiday season," according to the brief.

Limited interest

At nursing homes on Long Island, the rate of residents who are up to date varies from more than 96% to as little as 2%, according to a Newsday analysis of federal data through Dec. 4. The facilities are required to educate residents and their families about the vaccines and boosters and offer the shots.

Michael Balboni, executive director of the Greater New York Health Care Facilities Association, a trade association representing long-term care facilities, blamed “shot fatigue” and a focus on flu shots for the low COVID-19 booster rates.

In recent weeks, flu cases and related hospitalizations have skyrocketed in New York and across the country.

Richard Mollot, executive director of the Long Term Care Community Coalition, which advocates for people in nursing homes and long-term care facilities, said he has been concerned about the low booster rates.

“Just like in the general population, there is vaccine fatigue,” he said. “And I don’t think trust in government has increased.”

Residents at the Gurwin Jewish Nursing & Rehabilitation Center in Commack have shown less interest in getting the booster, said Stuart Almer, chief executive of the Gurwin Healthcare System. Another important factor is that residents who had COVID-19 during August only became eligible for the booster at the end of November, Almer said.

Gurwin officials said they have a 43% vaccination rate for the bivalent booster among residents who are eligible. Staff has reached out to patients and their families to educate them about the updated shot.

Finding solutions

Several experts pointed to the successful rollout of the COVID-19 vaccine in nursing homes two years ago as a possible playbook for increasing booster rates.

“There was a real effort from the federal government to create partnerships and make sure people were getting those shots,” said Houser. “Right now, the nursing homes are really left to do it for themselves.”

Chidambaram agreed, saying “involvement from local government and the federal government made a big difference.”

Mollot said that even though CMS has made increasing booster uptake a priority, many people just don’t seem interested in getting one more shot to battle COVID-19.

“They probably don’t see it as critical anymore,” he said.