March 17, 2026
Assisted living communities were significantly less likely than nursing homes to offer vaccination programs for seven vaccine-preventable illnesses and more likely to report transferring residents to the hospital for those same conditions, according to the results of a study published in the Journal of the Post-Acute and Long-Term Care Medical Association.
The researchers found significant disparities between the two settings. They said expanding vaccination programs in assisted living may reduce hospitalization risk and strengthen outbreak prevention.
Researchers at Miami University’s Scripps Gerontology Center in Oxford, OH, analyzed data from the 2023 Ohio Biennial Survey of Long-Term Care Facilities, which covered 623 assisted living communities and 736 nursing homes. The study examined three measures: whether communities and facilities offered vaccination programs, the perceived risk of hospitalizing residents for vaccine-preventable illnesses, and temporary admission suspensions due to outbreaks.
Although both settings had near-universal vaccination programs for influenza and COVID-19, assisted living communities were less likely to offer programs for several other illnesses. Fewer than half, for instance, reported programs for shingles (47%) or Tdap (tetanus, diphtheria, pertussis; 38.2%), compared with 71.7% and 58.3% of nursing homes, respectively. Assisted living communities also lagged nursing homes in respiratory syncytial virus, or RSV, as well as pneumococcal and hepatitis B coverage.
That narrower coverage corresponded with higher perceived hospitalization risk. Assisted living communities reported sometimes or frequently transferring residents to the hospital at significantly higher rates across all seven vaccine-preventable illnesses studied. Temporary admission suspensions due to outbreaks were uncommon in both settings, but when they did occur, COVID-19 overwhelmingly was the cause, affecting 7.2% of assisted living communities and 9.1% of nursing homes in 2023.
The study’s authors attributed the disparities in part to structural differences between the two settings. Assisted living communities generally operate with fewer clinical resources and less regulatory oversight than nursing homes, and care typically is paid out of pocket by residents, whereas Medicaid is the primary payer for long-stay nursing home residents. Those factors, combined with staffing shortages and billing complexity, may make it more difficult for assisted living operators to implement comprehensive multivaccine programs, they wrote.
The investigators recommended targeted policy efforts, improved education and greater resource allocation to close the gap. For assisted living operators, they said, such efforts could start with practical steps: building out vaccination programs beyond influenza and COVID-19 to include shingles, Tdap and hepatitis B; strengthening staff education on vaccine benefits; and addressing cost and access barriers that limit resident uptake.