The residents least likely to be vaccinated were in the South, and Black

Long-term care residents are **vulnerable to SARS-CoV-2 because of advanced
age, medical complexity and congregate living**, and **vaccination is an
effective means of reducing COVID-19 incidence** among them. No population
benefits more per dose.

Between 31 October 2022 and 7 May 2023, bivalent coverage among residents
of participating facilities differed by race and by geography.

Why this is different from most vaccination disparities

For most vaccines, the explanation runs through access: whether someone can
reach a clinic, get time off, afford it, find a provider they trust.

A long-term care resident faces none of that. **They live in the building where
the vaccine is administered.** The facility has their record, their consent
process, their clinical staff, and a federal reporting obligation.

So the usual explanations do not apply, and what is left points at the
facilities themselves — how each one runs its vaccination programme, what it
does about a resident or family who hesitates, how hard it tries. A disparity
in a population that cannot travel is a disparity created where they are.

It also compounds an existing one: these are the same groups with higher
COVID-19 illness and death, being reached least by the thing that prevents it.

What is asked

**Strategies aimed at increasing COVID-19 vaccination coverage should
consider these demographic disparities to develop and implement targeted
strategies to reduce inequities in COVID-19 morbidity and vaccination
coverage.**

Targeted, rather than more of the same nationally — because a national
campaign has already run, and these are the gaps it left.

(Data: facilities participating in the National Healthcare Safety Network.)

Source: Centers for Disease Control and Prevention, MMWR.