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Nearly half of Missouri nursing home workers never got a COVID vaccine. New rules may require it

“We’ve got staff that are out and about in their communities that may have pockets of high positivity rates and then they’re coming back into the facility and potentially bringing that to a resident,” said Jenny Hollandsworth, Long-Term Care Ombudsman for the state of Missouri.
“We’ve got staff that are out and about in their communities that may have pockets of high positivity rates and then they’re coming back into the facility and potentially bringing that to a resident,” said Jenny Hollandsworth, Long-Term Care Ombudsman for the state of Missouri.

Missouri’s nursing home workers have the second-lowest COVID-19 vaccination rate in the nation, according to newly released federal data.

Though the vast majority of long-term care residents in Missouri are now vaccinated, rates have lagged among the workers responsible for their care, with 45% still unvaccinated. A pending federal mandate could soon require unvaccinated nursing home staff statewide to roll up their sleeves — or risk losing their jobs.

Since the onset of the pandemic, 3,791 nursing home residents in Missouri have died of COVID-19. Nearly 1 in 3 of these deaths have occurred in St. Louis County.

Just over 86% of Missouri’s nursing home residents are fully vaccinated, slightly higher than the U.S. national average.

Unvaccinated people in their 80s have the highest chance of dying from COVID-19 — but even for vaccinated people in this age group, the disease can be deadly. Fully vaccinated people over the age of 80 have an almost 13 times higher chance of dying from COVID-19, compared to vaccinated people of all ages.

Because elderly nursing home residents living in close quarters are very vulnerable to infection, workers can unknowingly trigger outbreaks within a facility, said Jenny Hollandsworth, long-term care ombudsman for the state of Missouri.

“We’ve got staff that are out and about in their communities that may have pockets of high positivity rates, and then they’re coming back into the facility and potentially bringing that to a resident,” Hollandsworth said. “Having staff vaccinated adds another layer of protection.”

Some advocacy organizations, including AARP, have called on facilities to require employee vaccinations, following a rise in the number of cases among nursing home residents and staff over the summer.

“The high COVID death rates of residents and staff in nursing homes have been a national disgrace,” AARP Executive Vice President Nancy A. LeaMond said in a press release. “As the new variants are emerging, facilities cannot let preventable problems be repeated. The key is to increase vaccinations, and do it now.”

Concerns over worsening staff shortages

The Biden administration announced in August that all U.S. nursing homes would be required to vaccinate staff or risk losing their federal funding.

But the Centers for Medicare and Medicaid Services, which regulates the health care industry, has yet to issue official rules on the mandate. Without a clear idea of when the regulations will take effect, nursing home operators have been left in limbo.

Some managers are concerned that vaccine mandates could worsen longstanding staff shortages, said Jessica Rogalski, an ombudsman with VOYCE, a nonprofit that advocates for nursing home residents and their families.

“I've talked to a lot of facility managers, and they’re very worried about what the future is going to hold,” said Rogalski, who covers the northeast corner of Missouri. “They're already having a hard enough time just trying to get employees, but if they cut employees because of the mandate, how are they going to get more?”

Several smaller facilities where the majority of staff are unvaccinated have told her they’ll be forced to shut down once the mandate takes effect, Rogalski said.

Federal officials have not explicitly specified whether all nursing home staff, including janitorial and food service workers, will be required to get the vaccine — or if requirements will be limited to health care workers.

Given that many hospitals already require vaccinations, nursing home workers who choose to forgo the vaccine may find it difficult to find another job in the health care industry, said Hollandsworth.

“If you're going to stay in the health care field at all, it's likely you're going to have to get the vaccine wherever you go,” she said. “So we're hopeful that might encourage people who really are passionate about long-term care to go ahead and get vaccinated.”

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