In a letter addressed to Rochelle P. Walensky, the Director Centers for Disease Control and Prevention, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) is requesting further guidance, data-sharing, and urgency into researching the effectiveness of the COVID-19 vaccination, especially in regard to the elderly population. The AHCA/NCAL, represents more than 14,000 nursing homes and assisted living communities across the country that provide care to approximately five million people each year.
The AHCA/NCAL reports: “need for urgency on this matter is painfully evident. For nearly a year, long term care residents have been unable to visit with their loved ones in-person or participate in enriching social activities. Despite our staff’s heroic efforts to keep residents engaged and fill the void of family members, we are deeply concerned that the prolonged isolation of our residents is impacting their health and wellbeing. Prioritizing research on the vaccines’ effectiveness among our population would help ensure these facilities can swiftly and safely reopen, improving the lives of our vulnerable seniors.”
While earlier guidance from the CDC urged nursing homes to restrict group activities and visitors, the vaccination has now been administered millions of nursing home residents. As a result of this, the AHCA/NCAL hopes to see changes in the guidance previously administered by the CDC in order to improve the quality of life for their residents under these new conditions.
To achieve this goal, the NHCA/NCAL is asking for CDC’s support to rapidly evaluate the vaccines’ effectiveness among the long term care population in both preventing spread and in reducing morbidity and mortality. The NHCA reports that the organization understands that clinical trials only evaluated the effectiveness in preventing symptomatic disease and severe illness, and participants did not include long term care residents. Therefore, they are requesting further study regarding the vaccines’ impact on transmission and the elderly population before revising guidance to long term care settings. The NHCA/NCAL asks that the CDC expedite this evaluation of the vaccines in order to bring clarity to states, providers, residents and family members as soon as possible.
Fortunately, preliminary analysis by AHCA/NCAL reports that the vaccines may be as effective as hoped. Their research division, the Center for Health Policy Evaluation in Long Term Care (CHPE), found that COVID-19 cases decreased at a faster rate among nursing homes that had completed their first vaccine clinic, compared to nearby nursing homes that had not yet administered the vaccine. More specifically, the CHPE analysis reports:
- Vaccinated nursing homes experienced a 48% decline in new resident cases three weeks after the first clinic, compared to a 21% decline among non-vaccinated nursing homes located in the same county.
- Similarly, new staff cases declined by 33% in vaccinated nursing homes compared to 18% in non-vaccinated facilities.
While encouraging, further study is needed to determine if these trends will continue in subsequent clinics or after the second dose of the vaccine. The AHCA/NCAL requests that data and funding be made available to the research community to expedite this ongoing analysis. Both organizations are willing to assist the CDC in this effort through facilitating data sharing between providers and researchers, as well as connecting with experts from the public and private sector to assist with data waiting to be evaluated.
As the CDC has taken great effort to administer residents and staff their second dose of the vaccine, many states have started planning reopening strategies. The AHCA/NCAL reports on the reopenings: “State governments play a vital role in contributing to the protection of our residents and staff during this time. However, in this situation, we believe that cohesion is needed to ensure effective outcomes. Without guidance from the federal government, states may create confusing or inconsistent practices.”
In hope of creating consistent practices surrounding reopening, the American Health Care Association and National Center for Assisted Living is requesting that the CDC reiterate their most up-to-date guidance on COVID-19 safety practices. Since the effectiveness of the vaccine isn’t fully determined, the AHCA/NCAL emphasizes the importance of clear communication with stakeholders to make sure that everyone understands the stressed importance and vigilance of vaccination efforts.
