SC nursing homes have some of the lowest COVID vaccination rates across the U.S.

Despite prioritizing COVID-19 vaccinations at long-term care facilities above all but a handful of states, South Carolina has some of the lowest vaccination rates among nursing home residents and staff in the nation, according to federal data.

Roughly 76% of the state’s nursing home residents and about 50% of nursing home staff are fully vaccinated, putting South Carolina behind most states in both metrics, according to the U.S. Centers for Medicare and Medicaid Services, which tracks coronavirus cases, deaths and vaccinations at nursing homes across the country.

Nursing home vaccination rates vary widely between facilities and between states, but nationally about 80% of nursing home residents and 57% of health-care staff working in nursing homes were fully vaccinated as of July 4, according to CMS data.

Only one in five facilities nationally reported staff vaccination rates at or above the 75% industry target, and in South Carolina, just 7.8% of nursing homes hit that benchmark, an AARP analysis of CMS data found.

While the low vaccination rates here haven’t translated into more infections — COVID-19 cases and deaths at South Carolina nursing homes are currently at or below national averages — advocates are concerned that too many of the state’s most vulnerable residents remain unprotected as the delta variant sweeps the Palmetto State.

“Residents and staff of nursing homes were devastated by this virus and we can’t let that happen again,” AARP South Carolina director Teresa Arnold said. “We must remain vigilant and redouble efforts to encourage residents and staff in long-term care facilities to get a free COVID vaccine to protect themselves, their family and their community.”

Long-term care facilities, which include nursing homes, assisted living facilities and facilities for people with intellectual disabilities, have accounted for 3.4% of all coronavirus cases in South Carolina since the start of the pandemic, but more than 20%, or nearly 2,000, of the state’s deaths, according to the state Department of Health and Environmental Control.

Over the past month, however, South Carolina’s 750 long-term care homes have reported just 54 COVID-19 cases combined and no deaths, DHEC data show.

“The drop in cases and deaths in nursing homes is welcome news,” Arnold said. “But the potential for the highly contagious delta variant causing more harm to residents and staff is very real.”

Public health experts believe the extremely transmissible variant, first identified in India, is responsible for the spike in COVID-19 cases currently being felt across the country.

After accounting for just 5% of COVID-19 cases statewide in June, delta now likely makes up the majority of infections in South Carolina, according to genomic sequencing data.

All three COVID-19 vaccines on the market in the U.S. are considered highly effective against the delta strain, if administered as recommended.

Research has shown, however, that partially vaccinated individuals are far less protected from delta than they were from the original SARS-CoV-2.

As of Wednesday, almost 44% of eligible South Carolinians were fully vaccinated and about 50% were partially vaccinated against COVID-19, according to DHEC data. Nearly 190,000 of those partially vaccinated individuals are more than a month late for their second dose of the Pfizer-BioNTech or Moderna vaccines, health officials said.

SC prioritized vaccinations at long-term care homes

In December, state health officials set aside more than 200,000 doses, the entirety of its initial allotment of Moderna shots, for use at long-term care facilities.

South Carolina, like many states, partnered with CVS and Walgreens to get those shots into the arms of residents and staff at every extended care home in the state.

While most states squirreled away just a fraction of the doses they believed would be necessary to vaccinate all long-term care residents and staff and used the rest to inoculate health care workers, seniors and first-responders, South Carolina set aside all the shots it estimated would be needed for extended care homes upfront.

The state’s estimate, based on facility bed counts, significantly overshot the number of doses needed for long-term care facilities and left South Carolina with fewer doses to administer to the roughly 1 million frontline health workers and seniors eligible for shots at the time.

In the end, CVS and Walgreens needed only about half the doses they’d been allocated to vaccinate long-term care residents and staff due to a combination of reduced facility headcounts and lower-than-expected uptake.

DHEC sent the excess doses to other providers in South Carolina who at the time were struggling to meet the intense public demand for vaccine.

The agency has defended its decision to prioritize vaccinations at long-term care facilities, even though it likely slowed down the inoculation of other eligible populations, arguing it helped save lives.

DHEC spokesman Derrek Asberry said in April, shortly after the pharmacies wrapped up vaccinations at extended care homes, that the agency had no regrets about initially keeping so many doses in reserve.

“Our number one priority has been and continues to be to save lives,” he said. “When vaccine doses were initially very limited, it was critical to ensure those most susceptible to this virus and who were living in shared living spaces were among the first to receive their shots in order to save as many lives as possible.”

The agency did not immediately respond to questions about the relatively low COVID-19 vaccination rates that persist at South Carolina nursing homes or what threat the delta variant might pose to the unvaccinated among those fragile populations.

Nikki Hutchison, associate director of advocacy and governmental affairs at AARP South Carolina, said the organization has been doing outreach in areas with high rates of vaccine hesitancy to explain why inoculation against COVID-19 is important for older Americans.

The organization also recently sent a letter to CMS Administrator Chiquita Brooks-LaSure stressing its desire that the federal agency require vaccine education at long-term care facilities and offer all residents and staff the opportunity to be tested for and vaccinated against COVID-19 for the foreseeable future.

In South Carolina, long-term care residents who have been vaccinated are granted certain privileges not afforded to unvaccinated residents.

Vaccinated long-term care residents, for example, cannot have their indoor visitation limited when county COVID-19 positivity rates exceed 10% and fewer than 70% of facility residents are fully vaccinated, according to DHEC’s visitation guidelines.

They’re also not required to quarantine when newly admitted to a facility or when returning to an extended care home after a multi-day trip, as is recommended for unvaccinated individuals.