Strategies associated with COVID-19 vaccine coverage among nursing home staff

• Main Authors: Baier, R.R (Author), Berry, S.D (Author), Bishnoi, C. (Author), Gharpure, R. (Author), Gifford, D.R (Author), Gouskova, N. (Author), Leitson, M. (Author), Link-Gelles, R. (Author), Patel, U. (Author), Stone, N.D (Author), Syme, M. (Author)
• Format: Article
• Language: English
• Published: John Wiley and Sons Inc 2022
• Subjects: administration and dosage; adult; Adult; Article; case control study; Case-Control Studies; clinical article; controlled study; coronavirus disease 2019; COVID-19; COVID-19 Vaccines; disease control; female; Female; human; Humans; logistic regression analysis; long term care; male; Male; middle aged; Middle Aged; motivation; Motivation; nursing home; nursing home personnel; Nursing Homes; nursing staff; Nursing Staff; odds ratio; prevention and control; random sample; reward; Reward; SARS-CoV-2 vaccine; United States; vaccination; Vaccination; vaccination coverage; Vaccination Hesitancy; vaccine hesitancy
• Online Access: View Fulltext in Publisher

 Background: After the first of three COVID-19 vaccination clinics in U.S. nursing homes (NHs), the median vaccination coverage of staff was 37.5%, indicating the need to identify strategies to increase staff coverage. We aimed at comparing the facility-level activities, policies, incentives, and communication methods associated with higher staff COVID-19 vaccination coverage. Methods: Design. Case–control analysis. Setting. Nationally stratified random sample of 1338 U.S. NHs participating in the Pharmacy Partnership for Long-Term Care Program. Participants. Nursing home leadership. Measurement. During February 4–March 2, 2021, we surveyed NHs with low (<35%), medium (40%–60%), and high (>75%) staff vaccination coverage, to collect information on facility strategies used to encourage staff vaccination. Cases were respondents with medium and high vaccination coverage, whereas controls were respondents with low coverage. We used logistic regression modeling, adjusted for county and NH characteristics, to identify strategies associated with facility-level vaccination coverage. Results: We obtained responses from 413 of 1338 NHs (30.9%). Compared with facilities with lower staff vaccination coverage, facilities with medium or high coverage were more likely to have designated frontline staff champions (medium: adjusted odds ratio [aOR] 3.6, 95% CI 1.3–10.3; high: aOR 2.9, 95% CI 1.1–7.7) and set vaccination goals (medium: aOR 2.4, 95% 1.0–5.5; high: aOR 3.7, 95% CI 1.6–8.3). NHs with high vaccination coverage were more likely to have given vaccinated staff rewards such as T-shirts compared with NHs with low coverage (aOR 3.8, 95% CI 1.3–11.0). Use of multiple strategies was associated with greater likelihood of facilities having medium or high vaccination coverage: For example, facilities that used ≥9 strategies were three times more likely to have high staff vaccination coverage than facilities using <6 strategies (aOR 3.3, 95% CI 1.2–8.9). Conclusions: Use of designated champions, setting targets, and use of non-monetary awards were associated with high NH staff COVID-19 vaccination coverage. © 2021 The American Geriatrics Society.