Objective: The COVID-19 pandemic had a profound impact on long-term care facilities, particularly nursing homes and assisted living communities (ALCs), leading to high mortality rates among residents. Vaccination of residents and staff in long-term care mitigated virus spread. However, we know little about vaccine uptake in assisted living compared with the nursing home setting. The purpose of this paper was to compare assisted living staff vaccination rates with similarly collected data on nursing homes soon after the vaccines became available, and to elucidate organizational factors that may have influenced assisted living staff vaccination.
Design: Cross-sectional study using data collected by the State of Florida through its emergency reporting system.
Setting and participants: Florida nursing homes and ALCs that provided data to the state on total numbers of staff who received 2 doses of the COVID-19 vaccine by February 8, 2021 (n = 2585), and February 15, 2021 (n = 2731).
Methods: The study compared vaccination rates for nursing homes and ALCs during 2 time points a week apart. It used logistic regression models to understand the organizational factors (eg, size, rurality, ownership status) associated with vaccination rates in assisted living, given the lack of knowledge on this setting.
Results: ALCs, particularly smaller communities, had lower initial vaccination rates, but vaccination rates in the smaller communities (<25 beds) increased significantly by February 15, 2025. Organizational factors such as for-profit status and rural location were identified as significant predictors of vaccination, with higher rates among smaller, urban ALCs that accept state supplemental funding and lower rates among larger, for-profit ALCs.
Conclusions and implications: This study suggests that planning for future pandemics and emergency response in assisted living should include preparedness strategies that consider long-term care organizational barriers and facilitators, including size, location, and profit status.
