Though the U.S. population is aging and the need for elder care is growing, nursing home capacity has dropped from pre-COVID rates.

A study published on Monday in JAMA Internal Medicine showed that the decline varied widely by geographic area. One quarter of U.S. counties experienced reductions of 15 percent or more from 2019 to 2024, with the greatest loses (of 25 percent or more) reported in rural areas.

Findings reveal a general decline in vaccine hesitancy during the 15 months following the COVID-19 vaccine roll-out in 2021-2022, with almost two-thirds of those initially hesitant going on to receive one or more COVID-19 vaccinations.

The most common reasons for original COVID-19 vaccine hesitancy were concerns around vaccine effectiveness and side effects. But people who cited these reasons for hesitancy were more likely to change their minds and subsequently get vaccinated.

 In contrast, participants who reported being hesitant because of a generalised anti-vaccine sentiment, a mistrust of vaccine developers, or having a low perceived risk from COVID-19 remained more reluctant to receive a COVID-19 vaccine.

The authors say that public health officials and policymakers need to recognise that certain types of vaccine hesitancy are highly context-specific and may be more readily addressed, while others are more resistant to change.