Vaccination rates in nursing homes are lower in commercial settings, in those with lower Medicare star ratings, according to the study.

As nursing homes prepare for a federal mandate for the COVID-19 vaccine for healthcare workers, researchers have identified which types of facilities to climb the most.

A new study shows that commercial and online nursing homes, Medicare star-rated sites, and facilities with shorter lifespan staff have the lowest vaccination rates among the 14,900 nursing homes that submitted vaccination data to the National Health Safety Net. As of July 18, 60% of nursing home employees and 81% of residents are fully vaccinated.

Vaccination rates were 2.5 percentage points lower for workers and 3.5 percentage points lower for residents of commercial nursing homes, according to a study published Thursday in JAMA Internal Medicine. Each additional star on the Medicare nursing home rankings is associated with a 1.4 percentage point increase in vaccination rates for employees and 1.2 percentage points for residents.

Establishments with a large number of non-white staff and residents also had lower vaccination rates, as did places where the average length of service was shorter than 33 weeks.

The study found that for every 10 percentage point increase in the number of adults vaccinated in the county, the facility’s vaccination rate increases by 2.7 percentage points and 1.4 percentage points, respectively, for staff and residents. For every 10 percentage point increase in local Republican votes during the 2020 presidential election, staff vaccination rates were 1.4 percentage points lower.

“We find that many things are of little or moderate importance. I think this is something that is difficult to address with targeted communications campaigns, ”said Brian McGarry, assistant professor of geriatrics and aging at the University of Rochester. and one of the study authors.

The federal mandate will have a major impact on the level of staff vaccination. McGarry said. “The results do give some credibility to oppressive political approaches like the mandate, because it’s not just one thing that needs to be addressed, it’s a lot of things,” McGarry said.

The federal government, by authorizing vaccinations in place of individual employers, could facilitate discussion of vaccination issues between management and staff.

“There is a relief not to be the bad guy in this scenario, and a new emphasis on working with staff to help them come to terms,” McGarry said. “In a sense, since the outcome is predetermined, it could kind of change their relationship and allow nursing homes to have more impact on some of the outreach efforts.”

Although overall staff vaccination rates are low, they are even lower among certified nurses who have the most direct contact with patients. McGarry said. The results show that higher educational attainment is associated with a higher likelihood of vaccination among medical personnel as well as among the general population. Just under half of registered nurses were vaccinated during the study, compared with 61% of registered nurses and licensed practitioners, 71% of general practitioners, and 77% of physicians, nurse practitioners and paramedics.

The American Health Association and the National Center for Life Assistance, as well as other health care industry groups, support vaccination requirements as long as they are extended to all health care providers to avoid increasing the workload for nursing homes.

“We applaud the president [Joe] Biden for expanding COVID-19 vaccination requirements for all Medicare and Medicaid certified healthcare facilities and large businesses. This will help prevent unvaccinated nursing home staff from finding new jobs, alleviating some of the staffing challenges that too many long-term care facilities currently face, ”AHCA / NCAL President and CEO Mark Parkinson said in a press release when Biden announced its broader mandate for vaccination.