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Publication Briefs

Two Studies Show Positive Impact of COVID-19 Vaccinations on VA and Community Nursing Home Residents

VA Community Living Centers (CLCs) rapidly disseminated COVID-19 vaccination among the Veterans in residence. This retrospective analysis conducted from October 1, 2020 to February 14, 2021, describes the proportion of COVID-19 positive tests among 130 CLCs before and after COVID-19 vaccination. Using weekly CLC data, COVID-19 testing and vaccination results were summarized at the CLC level. For a reference on community prevalence, non-VA nursing home data reported by CMS were included for counties with CLCs.


  • Over half of CLC residents received their first vaccination by December 20, 2020. As of January 21, 2021, 82% of CLC residents had begun or completed the vaccination process, 13% refused the vaccination, and 5% were contraindicated. The number of COVID-19 positive tests dropped among all CLC residents in the fourth week after vaccination, with an approximately 75% drop in the proportion of COVID-19 positive tests. In data from non-VA nursing homes, a higher proportion of COVID-19 tests were positive than in VA but there was a similar decline in COVID-19 positive tests after vaccine availability. Results indicate that by reducing infection, COVID-19 vaccinations hold promise as a mechanism to decrease the pandemic-related isolation of nursing home residents.

    This study was partly funded by HSR&D. Dr. Rudolph is the Director of HSR&D’s Center of Innovation in Long-Term Services and Supports (LTSS-COIN), Providence, RI.

U.S. nursing homes incurred more than one-third of COVID-19 fatalities in the United States and began vaccine clinics in mid-December. This study compared incident COVID-19 infection and 30-day hospitalization or death among residents with COVID-19 between nursing homes with earlier versus later vaccine clinics. Among 280 (non-VA) nursing homes in 21 states, early clinics vaccinated between December 18, 2020, and January 2, 2021 and later clinics between January 3, 2021, and January 18, 2021.


  • One week after their initial vaccine clinics, nursing homes with earlier vaccination (12,157 residents at 136 facilities) had 2.5 fewer new COVID-19 infections per 100 at-risk residents than expected relative to later vaccination (13,221 residents at 144 facilities). Cumulatively over 7 weeks, earlier vaccination facilities had 5.2 fewer infections per 100 at-risk residents and 5 fewer hospitalizations and/or deaths per 100 infected residents. These results suggest that COVID-19 vaccines accelerated the rate of decline of incident infections, morbidity, and mortality in this large multi-state nursing home population. Further, this evidence supports efforts to begin resuming family visitation and to lessen other restrictions in nursing homes.

Dr. Mor is also with LTSS-COIN.


Rudolph J, et al. Proportion of SARS-CoV-2 Positive Tests and Vaccination in VA Community Living Centers. Journal of the American Geriatrics Society April 16, 2021; online ahead of print.

Mor V, et al. Short-term Impact of Nursing Home SARS-CoV-2 Vaccinations on New Infections, Hospitalizations, and Deaths. JAGS. April 16, 2021; online ahead of print.

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What are HSR Publication Briefs?

HSR requires notification by HSR-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR published articles. Visit the HSR citations database for a complete listing of HSR articles and presentations.

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