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Justice in Aging Supports Mandatory COVID Vaccinations in Long-Term Care Facilities

October 1, 2021

To Protect Older Americans’ Health and Quality of Life, Justice in Aging Supports Mandatory COVID Vaccinations for Staff and Residents of Long-Term Care Facilities

COVID-19 has been particularly deadly for older Americans, especially those living in nursing facilities or other residential long-term care facilities. To this point, COVID-19 has led to the death of nearly 700,000 Americans, including over 185,000 nursing facility residents and many thousands of others in assisted living facilities and other long-term care facilities. In all settings, older adults of color and low-income individuals have died at disproportionately higher rates. 

Across-the-board vaccination offers the best hope for protecting both lives and quality of life. For these reasons, Justice in Aging supports COVID vaccine requirements for staff and residents of long-term care facilities. 

Older adults are at greater risk from the virus, and being in close quarters in long-term care facilities accelerates transmission. The sheer number of deaths and illness is tragic, as is the isolation caused by visitation restrictions and similar precautions. In most long-term care facilities, residents lived in isolation for months, prevented from seeing both family and friends.  

When COVID vaccinations first became available in early 2021, long-term care facility residents and staff were given first priority. The vaccines have been extremely successful, leading to an immediate and drastic reduction in COVID rates within facilities. In many facilities, the rates of COVID cases and deaths fell to almost zero. As vaccination rates have stagnated, however, and variants have arisen, COVID rates have begun an ominous rise. More consistent vaccination is the key to moving forward.  

We recognize and strongly support the right to make personal health care decisions, but refusing a vaccine affects all facility staff and residents, not just the specific individual. As the Supreme Court said in rejecting a challenge to a smallpox vaccination requirement, “a community has the right to protect itself against an epidemic of disease which threatens the safety of its members.” To ensure fairness, exemptions should be granted for persons whose medical conditions do not allow for vaccination, and long-term care facilities must be required to ensure vaccine availability (including recommended boosters) for all individuals subject to the requirement. 

Now is not the time for half measures. To protect both lives and quality of lives for older adults, Justice in Aging recommends that states establish requirements for long-term care facilities to ensure that all staff and residents are vaccinated. The federal Centers for Medicare & Medicaid Services should establish comparable requirements for facilities participating in the Medicare or Medicaid programs.  

The past 20 months have been marked by continuous tragedy—and more tragic still would be to subject older Americans unnecessarily to the risk of further death, illness, and isolation. A broad vaccination requirement offers the best path to safer and better lives for long-term care facility residents.  

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