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Nursing home residents in Orange County, California, receive COVID-19 vaccinations. MediaNews Group/Orange County Register via Getty Images
  • Officials report that the number of new COVID-19 cases at nursing homes has declined by nearly 50 percent in recent weeks.
  • They say vaccination programs are a major factor.
  • They note that the success came despite a high percentage of nursing home employees refusing to get vaccinated.
  • The nursing home case reduction bodes well for the rest of the country as vaccination programs are expanded, say experts.

The situation with COVID-19 and long-term care facilities in the United States has certainly changed drastically in recent weeks.

At the end of June, more than 54,000 residents and employees at nursing homes had died from the disease, according to a report from the AARP.

AARP officials pointed out that residents of long-term care facilities constitute less than 1 percent of the U.S. population, yet 43 percent of all COVID-19 deaths through June occurred in these facilities.

By Thanksgiving, the death toll among residents and employees at long-term facilities had surpassed 100,000.

In the past 2 months, however, the number of cases has dropped dramatically, thanks in large part to vaccination programs.

On Monday, the U.S. Centers for Medicare & Medicaid Services reported that in the past 4 weeks, COVID-19 cases in nursing homes had declined by more than 50 percent.

During the week ending December 20, the centers reported more than 33,000 cases of the virus.

But during the week ending January 24, the federal agency said there were slightly more than 15,000 cases in nursing homes.

To some extent, the development reflects a downward trend in new cases across the country, health experts say.

That’s because COVID-19 cases in nursing homes are driven to a great extent by infections in the rest of the community, Dr. Ashish K. Jha, MPH, the dean of the Brown University School of Public Health, told the New York Timesthis week.

But Jha emphasized that the drop in nursing home cases is more pronounced than it is nationally. It also began earlier.

“That combination really does make me think this is not just broad national patterns, but that vaccines probably are playing a role,” Jha told the Times.

“I’m optimistic, this is good,” he said.

Other experts tell Healthline that the success at nursing homes bodes well for the vaccination program overall in the coming months.

However, they note there are still issues that need to be resolved at long-term care facilities, not the least of which is the hesitation among nursing home employees to get vaccinated.

Since the vaccines were first distributed, nursing home residents and staff have been a top priority.

As of Saturday, more than 3.5 million shots had been administered in long-term care facilities, according to the Centers for Disease Control and Prevention (CDC).

But the vaccine rollout in nursing home facilities has been problematic and will continue to be, officials tell Healthline.

The CDC looked at more than 11,000 nursing homes and skilled nursing facilities that had at least one vaccination clinic between the middle of December and the middle of January.

The researchers found that while 78 percent of residents got at least one shot, only 37 percent of staff members did.

People who work in nursing homes and long-term care facilities also get flu vaccines at lower rates than other health-care workers, the CDC noted.

Why is this happening?

Experts suggest that long-term care workers are skeptical that the shots work and don’t think viruses spread easily from them to the people they care for.

Charlene Harrington, PhD, RN, a professor of behavioral sciences at the University of California San Francisco, has been studying nursing homes for 40 years.

She tells Healthline that there are no excuses for nursing home employees to refuse the vaccines.

“It is an educational issue,” Dr. Harrington said. “Leadership at nursing homes needs to do a better job to educate their staff and show them that the vaccines are not dangerous.”

Some nursing homes give incentives such as gift cards to convince them to take the vaccine, Harrington noted.

She adds that all staff members at these facilities should take the vaccine for the safety of the residents and themselves.

“A substantial percentage of the care given at nursery homes come from nursing assistants who only have four weeks of educational training,” Harrington said. “These are entry level jobs. They’re not that informed and maybe quite afraid of taking a vaccine.”

Dr. Deborah Lehman, a professor of clinical pediatrics and infectious disease expert at the David Geffen School of Medicine at the University of California Los Angeles, tells Healthline that she and her colleagues are paying close attention to what is happening at nursing homes.

She hopes it bodes well for all of us.

“We are all watching the numbers closely,” Lehman said. “Nursing homes were the main drivers of the early spikes and accounted for the majority of cases early in the epidemic. Many were so devastated early in the pandemic.”

Lehman says it’s encouraging the numbers have declined.

“It is likely due to the virus ravaging them early, leaving few untouched,” she said. “They also learned early about the importance of infection control, specifically for this airborne virus — with high infectivity — and so by not allowing outside visitors, aggressive testing, and other very strict rules, they were able to lower their numbers.”

Dr. William Schaffner, an infectious disease specialist at Vanderbilt University in Tennessee, is also encouraged by the decline.

“I am optimistic that the decline in COVID-19 cases in nursing homes was largely the consequence of vaccination,” Schaffner told Healthline. “It follows that enhanced vaccination of the general public also will result in a decline in cases. Nursing homes are a well-defined, enclosed population, so the decrease in cases is easy to measure; it may take longer for the decrease of cases in the general populations to be appreciated.”

Lehman says she and her colleagues will watch developments closely.

“We are now past the holiday surge and so lower numbers are expected,” she said. “That, along with the start of some vaccine protection, are important factors that will hopefully continue to show us decline. No Super Bowl parties, please.”

As for the fact that so many workers at nursery homes are not opting for the vaccine, Lehman said, “I can only say that it is very unfortunate, especially in light of what they have seen over the past year. I think we all need to do a better job addressing vaccine hesitancy, especially among healthcare workers.”