Retrospective facility-level multivariate regression analysis of 38 long-term care facilities (LTCFs) in Hawai'i examining the relationship between COVID-19 vaccination coverage among residents and staff and COVID-19 outcomes (infections and deaths) over two years (June 2022 – May 2024).
Median vaccination coverage fell by 15% for residents and 53% for staff over the study period. A 10% relative increase in staff vaccination coverage was associated with 2.7 fewer resident COVID-19 infections per 100 beds. Only 27% of small and 12% of medium facilities showed any positive relative change in staff coverage.
Small sample of 38 facilities limits generalizability; facility-level (not individual-level) data prevent causal inference; findings from Hawai'i may not reflect mainland U.S. or international LTCF contexts.
Staff COVID-19 vaccination coverage in LTCFs has dropped sharply post-pandemic — driving it back up meaningfully reduces resident infections. Infection control teams should prioritize staff vaccination campaigns as a concrete, measurable intervention.
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