Illustration: Long-Term Care Facility Residents

Preparing Residents for COVID-19 Vaccination

For LTCF administrators and clinical leadership

Long-term care facility (LTCF) administrators and clinical leadership are encouraged to use the following information and resources to educate residents and their families about the importance of COVID-19 vaccination.

Encourage COVID-19 Vaccination Among Your Residents

Making sure LTCF residents can receive COVID-19 vaccination as soon as a vaccine is available will help save the lives of those who are most at risk of dying from COVID-19. Approximately 3 million adults receive care or reside in LTCFs, which include skilled nursing facilities, nursing homes, and assisted living facilities. Because of their age, high prevalence of underlying medical conditions, and group living situations, LTCF residents are at high risk for infection and severe illness from COVID-19. As a result, the Advisory Committee on Immunization Practices (ACIP) and CDC recommend that the lifesaving benefits of COVID-19 vaccination for residents outweigh the possible risks.

Engage in Effective COVID-19 Vaccine Conversations

You can begin to talk with residents and their families now about COVID-19 vaccination in your facility, even before vaccines arrive. This will give you the opportunity to set expectations about the vaccine and learn about any concerns they have. Seek to understand your residents’ concerns and provide information they need in a way they can understand. Many residents may have similar questions about COVID-19 vaccines. Prepare for common questions and learn techniques to use during your vaccination conversations.

Answer Questions about Consent

Explain that consent or assent for vaccination will be obtained from residents (or persons appointed to make medical decisions on their behalf) and documented in their charts per your facility’s standard practice. In addition, residents who receive vaccine (or their medical proxies) will also receive an Emergency Use Authorization (EUA) Fact Sheet before vaccination. The EUA Fact Sheet explains the risks and benefits of COVID-19 vaccination.

Some COVID-19 vaccination providers may require written, email, or verbal consent from recipients before vaccination. This is at their discretion; written consent is not required by federal law for COVID-19 vaccination in the United States.

Lastly, residents (or their medical proxies) will receive a vaccination record card or printout that tells them what COVID-19 vaccine they received and the date they received it. This should also be recorded in their medical chart.

For more information, check out frequently asked questions about COVID-19 vaccination in LTCFs.

Distribute COVID-19 Vaccination Resources

Facilities can use or adapt these ready-made materials to build confidence in COVID-19 vaccination among residents:

Additional strategies for building vaccine confidence include:

  • Encourage residents’ families to discuss the vaccination clinics with their loved ones to prepare and reassure them.
  • Share a video and photos of facility administrators, clinicians, and nursing staff getting vaccinated.
  • Provide staff members and residents who have been vaccinated with buttons or stickers they can wear to show other residents they support vaccination.
  • Encourage staff to share their reasons for getting vaccinated with residents.
  • Remind and encourage unvaccinated residents to get a COVID-19 vaccine via e-mail, letters, telephone calls to them and/or their families, and in person requests.
  • Host virtual town hall meetings for residents and families where they can ask questions, and you can address their concerns.

Discuss What Residents and Families Can Expect After Vaccination

LTCF residents and families may want to know if visitation policies or mask requirements will change for those who get vaccinated. It is important to explain that all facility residents and staff will need to continue following CDC guidance to prevent the spread of COVID-19 in healthcare settings. This guidance includes:

  • Follow recommendations for infection prevention and control (IPC) practices for routine healthcare delivery during the pandemic.
  • Screen and triage everyone entering the healthcare facility for signs and symptoms of COVID-19 and following facility guidance on visitation.
  • Require everyone entering the healthcare facility to wear a mask, stay 6 feet away from others, and clean hands often.

Educate Residents and Families about Vaccine Administration and Potential Side Effects

Many LTCFs have enrolled in the federal Pharmacy Partnership for Long-Term Care Program, which aims to facilitate safe and efficient on-site COVID-19 vaccination clinics at LTCFs. Through this program, facility staff and residents will have an opportunity to get vaccinated on site. Everyone who gets vaccinated will also receive a vaccination record card to ensure they receive the correct vaccine for the second dose if they leave the facility before the second on-site clinic.

It will be important to educate residents on the most common side effects from vaccination and let them know that side effects should go away on their own within a few days. It may be hard to tell the difference between side effects from the vaccine and symptoms of COVID-19.

  • Explain that side effects are signs that the immune system is working.
  • Provide a comparison for the resident, if appropriate (for example, pain after receiving Shingrix for those who have received it).
  • Make sure residents know that a fever is a potential side effect and when to notify LTCF staff.
  • This fact sheetpdf icon will help residents know what to expect after getting vaccinated, including when to alert staff in the facility.
  • Remind residents the vaccine cannot give someone COVID-19 and it will not cause them to test positive on a COVID-19 viral test.

Facility administrators should work with staff, residents and family members to report any health problems that occur after vaccination to the Vaccine Adverse Event Reporting System (VAERS)external icon, even if unsure the vaccine caused the health problem. We call these types of health problems possible side effects or adverse events. Healthcare professionals are required by law to report certain adverse events after COVID-19 vaccineexternal icon. For more information on how the vaccine safety is monitored in the U.S., visit CDC’s website on Ensuring the Safety of COVID-19 Vaccines in the United States.

In addition, encourage residents with access to a smartphone to enroll in v-safe, a smartphone tool they can use to tell CDC if they have side effects after getting a COVID-19 vaccine. If serious side effects are reported, someone from CDC will call to follow up. Information on the v-safe after vaccination health checker is available in several languages, including English, Spanish, Korean, Vietnamese, and Simplified Chinese.

It is important to talk to residents about what will happen if they experience side effects from the vaccine that are similar to the symptoms of COVID-19. CDC has released guidance you can use to help plan for managing post-vaccination symptoms in residents. This guidance is meant to limit unnecessary COVID-19 testing and additional infection control measures that may not be necessary.

Page last reviewed: February 22, 2021