Differences In Nursing Home Staff COVID-19 Testing Rates And Odds Of Vaccination Across Work Shifts

Elizabeth M. White, Jasmine L. Travers, Natalia Gouskova, Gahee Oh, Maggie Syme, Xiaofei Yang, Ana Montoya, Richard A. Feifer, David C. Grabowski, Vincent Mor, Sarah D. Berry

Research output: Contribution to journalArticlepeer-review


COVID-19 vaccination and regular testing of nursing home staff have been critical interventions for mitigating COVID-19 outbreaks in US nursing homes. Although implementation of testing has largely been left to nursing home organizations to coordinate, vaccination occurred through a combination of state, federal, and organization efforts. Little research has focused on structural variation in these processes. We examined whether one structural factor, the primary shift worked by staff, was associated with differences in COVID-19 testing rates and odds of vaccination, using staff-level data from a multistate sample of 294 nursing homes. In facility fixed effects analyses, we found that night-shift staff had the lowest testing rates and lowest odds of vaccination, whereas day-shift staff had the highest testing rates and odds of vaccination. These findings highlight the need to coordinate resources and communication evenly across shifts when implementing large-scale processes in nursing homes and other organizations with shift-based workforces.

Original languageEnglish (US)
Pages (from-to)217-226
Number of pages10
JournalHealth affairs (Project Hope)
Issue number2
StatePublished - Feb 1 2023

ASJC Scopus subject areas

  • Health Policy


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