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Vaccination of nursing home (NH) staff against COVID-19 has lagged behind resident vaccination but impacts resident outcomes when community transmission is high. In a study of over 12,000 NHs, among facilities with the lowest versus highest staff vaccination coverage, there were an estimated 1.6 additional COVID-19 cases and 0.19 COVID-19-related deaths per hundred beds in counties with the highest prevalence of COVID-19. Efforts to improve staff acceptance of COVID-19 vaccination should continue to be a priority in the NH setting.