PALTmed Issues COVID-19 Vaccine Guidance for Post-Acute and Long-Term Care Settings

The Infection Advisory Committee of the Post-Acute and Long-Term Care Medical Association (PALTmed) has issued new recommendations for the 2025-2026 COVID-19 vaccine, addressing the unique risks faced by residents and staff in post-acute and long-term care (PALTC) environments. The guidance, to be published in JAMDA, aligns with national Centers for Disease Control and Prevention (CDC) recommendations while tailoring its focus to the clinical realities of PALTC populations.

Residents of PALTC facilities, who are primarily 65 years and older and often have multiple comorbidities, remain among the most vulnerable to severe illness from COVID-19. Staff—both clinical and nonclinical—face increased exposure risks and play a key role in maintaining a safe care environment. According to the statement, “Maintaining high vaccination coverage among staff also supports adequate staffing levels which is essential for resident safety and to ensure necessary care needs are being met.”

PALTmed underscores that COVID-19 vaccines continue to demonstrate safety and effectiveness in preventing serious outcomes, including hospitalization, death, and long-term sequelae such as Long COVID. The statement encourages clinicians to engage residents and staff in individualized discussions about vaccination benefits and risks.

PALTmed recommends that all PALTC residents aged 18 years and older receive 1 dose of the 2025-2026 COVID-19 vaccine, unless contraindicated. Acceptable vaccine products include Moderna’s Spikevax and Mnexspike, Pfizer-BioNTech’s Comirnaty, and Novavax’s Nuvaxovid. The committee advises that Spikevax, Nuvaxovid, and Comirnaty be given at least 2 months after any prior COVID-19 vaccine dose, while Mnexspike should be administered at least 3 months after a previous dose.

For residents with moderate to severe immunocompromise, PALTmed recommends at least 2 doses of the updated vaccine, with a preferred 6-month interval. However, during outbreaks or in higher-risk settings, doses may be given as soon as 2 months apart. Additional booster doses may be considered based on clinical judgment and shared decision-making.

All staff members—including clinical, administrative, contracted, and trainee personnel—should receive a single dose of the 2025-2026 vaccine, with additional doses for those who are immunocompromised. Any US Food and Drug Administration (FDA)-licensed vaccine appropriate for the individual’s age group may be used.

To ensure equitable and efficient vaccine delivery, PALTmed advises that facilities provide on-site vaccination whenever possible. Collaboration with community pharmacies, public health departments, or third-party vaccinators is encouraged to facilitate staff access. The guidance points to available tools to boost vaccination rates, including PALTmed’s Guide to Support Effective Immunization Practices in PALTC.

Clinicians and administrators should prioritize on-site vaccination whenever possible to reduce barriers and maintain high coverage among residents and staff. Careful review of vaccine intervals and eligibility criteria is essential, particularly for individuals who are immunocompromised or at increased risk of severe illness. Open communication about vaccination decisions—both within interdisciplinary care teams and with residents and their families—can foster trust and improve uptake. Finally, facilities should prepare for potential outbreak contingencies by establishing plans that allow for accelerated dosing schedules when needed to protect vulnerable populations and ensure continuity of care.

The committee concludes that vaccination remains the most effective strategy for protecting both residents and staff in PALTC settings. “The best protection against severe outcomes of COVID-19 is to receive the 2025-2026 COVID-19 vaccine,” the statement affirms.

Reference

Recommendations for COVID-19 Vaccine in PALTC residents and staff. Post-Acute and Long-Term Care Medical Association. October 14, 2025. Accessed October 17, 2025. https://paltmed.org/news-media/recommendations-covid-19-vaccine-paltc-residents-and-staff