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Post COVID-19 Vaccine Considerations for LTC Residents - IHCA

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Post COVID-19 Vaccine Considerations for LTC Residents

Posted Dec 20, 20203 min Read

Regulatory & Clinical

Last week, the CDC issued this guidance on strategies to evaluate and managed post-vaccination signs and symptoms for LTC residents.  The guidance intended to balance the risks of unnecessary testing and use of Transmission Based Precautions with residents displaying only post-vaccination symptoms with the risk of inadvertently allowing residents with COVID-19 to expose others in the facility.

Current data on the COVID-19 indicated post-vaccination signs and symptoms are mild, occur within the first three days of vaccination, and resolve within 1-2 days of onset.  Immediate reactions and local pain/redness at the injection site are not consistent with COVID-19.

Importantly, cough, shortness of breath, runny nose, sore throat, or lost of taste or smell are not consistent with post-vaccination symptoms and may be signs of COVID-19 or another infection.  Please refer to the chart in the CDC guidance for additional detail on suggested management approaches.

A person recently exposed to COVID-19 (within 2-14 days) of receiving the vaccine can still become infected with COVID-19.  The vaccine itself does not cause a person to become infected.

When evaluating new-onset post-vaccination signs and symptoms, the CDC recommends the following for any HCP who received the COVID-19 vaccine in the prior three days (including the day of vaccination)

  • Signs and Symptoms from vaccine unlikely to be from vaccine – presence of any systemic COVID-19 sign or symptom (cough, shortness of breath, runny nose, sore throat, or lost of tase or smell) or other infectious diseases like flu.
    • Evaluate resident for COVID-19.  Pending evaluation place resident in single room (if available) in TBP.  Residents should not be cohorted with other residents confirmed to have COVID-19 unless and until the resident also confirmed to have COVID-19 through testing.
    • TBP can be discontinued pending results of the above evaluation and testing.
  • Signs and Symptoms from vaccine that may be from either the vaccine, COVID-19, or other infection (fever above 100F, fatigue, headache, chills, muscle or joint pain).
    • Evaluate the resident and restrict to current room (except for medically necessary procedures) and closely monitor until:
      • Any fever resolves and
      • Symptoms improve.
    • HCPs caring for these residents should wear all PPE consistent with TBP.  If resident’s symptoms resolve within 2 days, TBP can be discontinued.  Fever, if present, must have resolved for at least 24 hours before discontinuing TBP.
    • COVID-19 testing should be considered for any residents with symptoms that are not improving or persist for longer than 2-days (outbreak testing and exposure testing criteria still apply too).
  • See note in CDC guidance regarding antigen tests being confirmed with a n nucleic acid amplification test.
  • Positive viral (nucleic acid or antigen) tests for SARS-CoV-2, if performed, should not be attributed to the COVID-19 vaccine, as vaccination does not influence the results of tests.

About the Author

Zach Cattell, President, Indiana Health Care Association