The Kentucky Department for Public Health and a local health department investigated a COVID-19 outbreak in a skilled nursing facility that occurred after all residents and health care personnel had been offered vaccination. Among 83 residents and 116 health care personnel, 75 residents and 61 staff, respectively, received 2 vaccine doses. Twenty-six residents and 20 health care personnel received positive test results for SARS-CoV-2, the virus that causes COVID-19, including 18 residents and four health care personnel who had received their second vaccine dose >14 days before the outbreak began.
An R.1 lineage variant was detected with whole genome sequencing. Although the R.1 variant has multiple spike protein mutations, vaccinated residents and HCP were 87% less likely to have symptomatic COVID-19 compared with those who were unvaccinated. Vaccination of skilled nursing facility populations, including health care personnel, is critical to reduce the risk for SARS-CoV-2 introduction, transmission, and severe outcomes in skilled nursing facilities.