Cross-Policy Effects: Lockdown Stringency, Race, and the COVID-19 Vaccine in US Nursing Homes

In a health crisis, how do early mitigation policies affect the effectiveness of later interventions? Using the lens of the COVID-19 pandemic in the United States, we show that the stringency of early public health and safety interventions increased vaccine uptake among nursing homes' residents and employees; however, the effect was negative in states with low lockdown compliance. This negative effect was exacerbated in nursing homes with a larger proportion of Black residents. The analysis highlights the present-day relevance of the historical mistrust between Black populations and health authorities and how this manifests in long-term care institutions.