Importance of COVID-19 Vaccination for
Residents of Long-term Care Facilities

The Centers for Disease Control is recommending that those who reside in
long-term care facilities be some of the first to receive the COVID-19 vaccine.


Source: CDC/ Robert Denty

In this 2020 photograph, captured inside a clinical setting, a health care provider places a bandage on the injection site of a patient, who just received an influenza vaccine. Influenza infections typically effect millions of people yearly. Since the beginning of the pandemic, almost 22 million people have been infected by Coronavirus. A new COVID-19 mRNA Vaccine has been approved by the Food and Drug Administration for Emergency Use. The COVID-19 Vaccine began distribution across the United States in mid-December. Currently the Food and Drug Administration has approved a vaccine from Pfizer and BioNTech, as well as one from Moderna. About 15.4 million vaccine doses have been distributed in the US, but only 4.5 million people have received their first doses, as of mid-January, according to the CDC.

Based on recommendations from the Advisory Committee on Immunization Practices (ACIP), an independent panel of medical and public health experts, CDC recommends residents of long-term care facilities (LTCF) be included among those offered the first supply of COVID-19 vaccines.

Vaccinating LTCF residents will save lives

Making sure LTCF residents can receive COVID-19 vaccination as soon as vaccines are available will help save the lives of those who are most at risk of dying from COVID-19. According to ACIP’s recommendations, LTCF residents include adults who reside in facilities that provide a range of services, including medical and personal care, to persons who are unable to live independently. The communal nature of LTCFs and the population served (generally older adults often with underlying medical conditions) puts facility residents at increased risk of infection and severe illness from COVID-19. By November 6, 2020, approximately 569,000–616,000 COVID-19 cases and 91,500 deaths were reported among LTCF residents and staff members in the United States, accounting for 39% of deaths nationwide.

Benefits of vaccination believed to outweigh possible risks

All COVID-19 vaccines were tested in clinical trials involving tens of thousands of people to make sure they meet safety standards and protect adults of different races, ethnicities, and ages, including adults over the age of 65, participated in the clinical trials. There were no serious safety concerns. The most common side effects were pain at the injection site and signs and symptoms like fever and chills. After a review of all the available information, ACIP and CDC agreed the lifesaving benefits of COVID-19 vaccination for LTCF residents outweigh the risks of possible side effects.

The safety of COVID-19 vaccines is a top priority

To help make important unapproved medical products, including vaccines, available quickly during the COVID-19 pandemic, the US Food and Drug Administration (FDA) can use what is known as an Emergency Use Authorization (EUA)external icon. Before any vaccine can be authorized for use under an EUA, FDA must determine that the vaccine’s benefits outweigh possible risks.

CDC and FDA are monitoring vaccine safety closely. The United States is using existing robust systems and data sources to conduct ongoing safety monitoring. An additional layer of safety monitoring has also been added that allows CDC and FDA to evaluate COVID-19 vaccine safety almost immediately. Learn more about COVID-19 vaccine safety monitoring.

For LTCFs in particular, CDC will work with pharmacies and other partners to report possible side effects (called adverse events) to the Vaccine Adverse Event Reporting System (VAERS)external icon. Facility staff and residents’ families are encouraged to also report any adverse events immediately.

CDC is working with pharmacies and other partners to provide communication materials to help LTCFs educate residents and their families about the vaccine, answer their questions about vaccine safety and other issues, and prepare them for vaccination clinics. For some COVID-19 vaccines, two shots are needed to provide the best protection, and the shots are given several weeks apart. Each recipient or caregiver will receive a vaccination record card to ensure they receive the correct vaccine for the second dose.

Risks and benefits will be explained to everyone offered a COVID-19 vaccination

Explaining the risks and benefits of any treatments to a patient – in a way that they understand – is the standard of care. Written consent is not required by federal law for COVID-19 vaccination in the United States; however, COVID-19 vaccine providers should consult with their own legal counsel for state requirements related to consent. In LTCFs, consent or assent for vaccination should be obtained from residents (or the person appointed to make medical decisions on their behalf) and documented in the resident’s chart per standard practice.

Pharmacy partners that are administering COVID-19 vaccine at LTCFs as part of the Federal Pharmacy Partnership for Long-term Care Program may require verbal, email, or written consent from recipients before vaccination. This is at the discretion of the pharmacy. LTCF administrators can request pharmacy partners obtain consent from residents’ families in advance when they are serving as medical proxies.

Pharmacy partners will also work directly with LTCFs to ensure staff and residents who receive the vaccine also receive an EUA fact sheet before vaccination. The EUA fact sheet explains the risks and benefits of the COVID-19 vaccine they are receiving and what to expect. Each LTCF resident’s medical chart must note that this information was provided to the resident. If a resident is unable to make medical decisions due to decreased mental capacity or illness, the EUA fact sheet will be provided to the person appointed to make medical decisions on their behalf (the medical proxy or power of attorney).