Long-term care industry groups said they welcome Monday’s release of interim public health recommendations from the Centers for Disease Control and Prevention on how fully vaccinated individuals in non-healthcare settings can change their behaviors. But they are eagerly anticipating guidance specific to long-term care settings.

According to the CDC, fully vaccinated older adults in the greater community now can visit indoors with their unvaccinated and healthy children and grandchildren without masking or social distancing — as long as no one is at risk of severe COVID-19. The recommendations apply to all fully vaccinated individuals in non-healthcare settings.

A growing body of evidence suggests that fully vaccinated people are less likely to have asymptomatic infection and are potentially less likely to transmit the virus to others, the agency said. People are considered fully vaccinated if it has been at least two weeks since they received a second dose of a two-dose vaccine such as the one by Pfizer/BioNTech or Moderna, or two weeks since they received one dose of a single-dose vaccine such as Johnson & Johnson’s Janssen vaccine.

“The benefits of reducing social isolation and relaxing some measures such as quarantine requirements may outweigh the residual risk of fully vaccinated people becoming ill with COVID-19 or transmitting SARS-CoV-2 to others,” the guidelines read. Relaxing certain measures for vaccinated individuals may improve COVID-19 vaccine acceptance and uptake, according to the agency.

The American Health Care Association / National Center for Assisted Living said although guidance is “welcomed progress,” the groups are seeking clarity on recommendations for assisted living communities and skilled nursing facilities.

“Our dedicated staff members have done an extraordinary job filling in for loved ones and adapting visitations during this difficult time, but nothing can replace engaging with family members in person,” the associations said. “For our residents’ health and wellbeing, we are eager to safely reopen and reunite loved ones now that millions have been fully vaccinated.”

LeadingAge President and CEO Katie Smith Sloan said it is “especially good news” that the CDC is offering new ways for people to safely connect. COVID-19, she added, has had an “outsized impact” on older adults, with the “ripple effects of restrictions” causing physical, emotional and mental hardship.

“This progress re-enforces how significant COVID-19 vaccines are to offering new hope to older adults and that we can’t forget those who are in residential care settings,” Sloan said. “We hope to see additional guidance from CDC and the [Centers for Medicare & Medicaid Services] specifically for long-term care that will ease restrictions in a way that is safe.”

CDC Director Rochelle Walensky, M.D., MPH, said that 59 million people in the United States have received at least one dose of the vaccine, and 9.2% of the population is now fully vaccinated. According to the CDC COVID Data Tracker, 7.4 million vaccine doses have been administered to residents and staff members in long-term care facilities such as nursing homes and assisted living communities.

The guidance also addresses unvaccinated older adults, who are at risk for severe disease. Those visits, according to the CDC, should take place outdoors, with masking and physical distancing. 

According to the guidance, fully vaccinated people can:

  • Visit with other fully vaccinated people indoors without wearing masks or physical distancing.
  • Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing.
  • Refrain from quarantine and testing following a known exposure if asymptomatic.

The guidance also states fully vaccinated individuals should continue to:

  • Take precautions in public, such as wearing a well-fitted mask and practicing physical distancing.
  • Wear masks, practice physical distancing and adhere to other prevention measures when visiting with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease.
  • Wear masks, maintain physical distance and practice other prevention measures when visiting with unvaccinated people from multiple households.
  • Avoid medium- and large-sized in-person gatherings.
  • Get tested if experiencing COVID-19 symptoms.
  • Follow guidance issued by individual employers.
  • Follow CDC and health department travel requirements and recommendations.

Increasing vaccination rates prompted American Seniors Housing Association President David Schless in February to ask the nation’s governors to begin easing visitation restrictions in senior living communities.

“It is imperative that the states take steps to allow residents to visit with families and loved ones,” he told the National Governors Association and all state governors, noting that research has shown that prolonged social isolation, lack of engagement and loneliness can contribute to functional and cognitive decline, as well as depression and anxiety, in older adults.