Widening Access to Trials in Care Homes (WATCH) project

Care home residents are more prone to infections and often have worse outcomes. For example, at the start of the COVID-19 pandemic, the highest proportion of deaths across the world were reported from care homes. Outbreaks of common infections (e.g. influenza, COVID-19, Respiratory Syncytial Virus (RSV), Norovirus, Clostridium difficile) in care homes lead to hospitalisation and adverse outcomes in this population which in turn increase the burden on the NHS.

Many of these infections can be prevented by vaccines. However, vaccines are usually tested only in younger and healthier people and older people, particularly care home residents, are often excluded from vaccine trials. For clinicians to understand that vaccines work well in the care home population, it is important to include care home residents in vaccines trials.

Challenges in recruiting care home residents to vaccine trials

Recruiting frail and vulnerable care home residents to vaccine trials poses many challenges and is also time consuming. Around 80% of care home residents lack capacity to give informed consent, and the majority are physically dependent on others for daily living. Nevertheless, the challenges could be overcome by designing trials that would suit the needs of care home residents to take part.

To find innovative solutions that will enable recruitment of care home residents to vaccine trials, a team of experts in Scotland set up the Widening Access to Trials in Care Homes (WATCH) project. WATCH will produce best practice guidance that will help researchers and pharmaceutical companies to recruit care home residents and conduct vaccine trials in care homes.