COVID-19 booster or additional primary vaccination dose for SARS-CoV-2 omicrons in nursing home residents

Recent studies submitted to the Centers for Disease Control and Prevention (CDC) Weekly morbidity and mortality report (MMWR) Evaluated Effectiveness of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) primary series vaccination, additional initial dose, or booster immunity to SARS-CoV-2 omicron infection in nursing homes.

Background

Morbidity and mortality associated with SARS-CoV-2 are common in nursing home residents. They were the highest priority population for early COVID-19 vaccination. CoV Disease 2019 (COVID-19) Early Series of Vaccine-Induced Immunity Reported post-immunization reduction, ie two primary doses of the messenger ribonucleic acid (mRNA) vaccine (mRNA-1273 or BNT162b2) or one primary Ad26.COV2 vaccine The inoculated CDC advised that all persons over the age of 12 be vaccinated with the SARS-CoV-2 booster vaccine. In addition, additional primary SARS-CoV-2 vaccination doses are recommended for individuals with severe or moderate immunodeficiency, primarily consisting of residents of many nursing homes.

Nonetheless, information on the vaccine efficacy (VE) of additional early or boosted SARS-CoV-2 vaccination against COVID-19 in nursing home residents, primarily against highly contagious SARS-CoV-2 omicron variants. Is almost nonexistent.

About research

In this study, researchers conducted weekly weekly nursing home resident-wide provision to the CDC’s National Healthcare Safety Network (NHSN) by a skilled nursing facility (SNF) from February 14 to March 27, 2022. We analyzed SARS-CoV-2 vaccination rates and surveillance data. .. SARS-CoV-2 omicron variants were found in more than 99% of isolates sequenced during the study period.

The authors controlled variability between calendar week and SNF by evaluating SARS-CoV-2 vaccination and monitoring data, followed by SARS-CoV-2 booster or additional initial dose and COVID for primary series vaccination. The purpose was to determine the comparative VE for -19. From over 15,000 SNFs.

A nursing facility accredited by the Centers for Medicaid & Medicare Services (CMS) reported weekly to NHSN an incident confirmed between staff and residents based on vaccination status. This study used CMS-certified SNF case data. For SNF with contact tracking capabilities, only close contact with SARS-CoV-2 infected residents or staff was evaluated. The vaccination status of infected people is divided into four categories: 1) main series only, 2) booster or booster dose, 3) no vaccination, and 4) other (unspecified vaccination or single dose of mRNA vaccine). It was divided.

Weekly censuses of residents by vaccination status were also reported weekly by the SNF. In addition, we calculated the occupants / week using the average number of residents per week for each SNF vaccination status. The authors compared weekly COVID-19 cases describing each SNF vaccination status with two weeks before the weekly resident rate for each vaccination status.

result

The study results showed that the SARS-CoV-2 booster or additional primary dose comparison VE was significantly significant compared to the primary series vaccination after considering the variation between SNF and calendar week. These data suggest that additional primary or boosted immune doses of COVID-19 provide greater protection against Omicron mutation infections in long-term care residents than the first series of vaccinations alone.

From February 14th to March 27th, 2022, 15,090 SNFs submitted a weekly COVID-19 case count report of 89,671 and 15,102 SNFs submitted a week of 89,969 from January 31st to March 13th, 2022. I submitted the next resident count report. Levels of weekly SARS-CoV-2 infection with relevant resident data and application of exclusion criteria. The median number of weeks recorded was 1,126,198, with approximately 22% receiving only main series vaccination and 65% receiving additional primary or booster immunization. In addition, more than 90% of long-term care facility residents who were recipients of primary immunization, additional initial injections, or booster immunization received mRNA-based COVID-19 vaccination.

Coarse COVID-19 rates, confirmed weekly during the study, were reduced in all vaccinated cohorts of nursing homes. Nevertheless, SARS-CoV-2 infection rates among residents who received booster immunity or additional primary doses are significantly higher than those among unvaccinated residents or those who received only primary series vaccines. It was low.

Approximately 7,510 confirmed COVID-19 cases within 1,509,674 / week were reported in primary series vaccination-only residents, compared with 11,334 confirmed SARS-CoV-2 cases. It was reported during 4,416,401 people / week who received immunization or boosters. In addition, the adjusted comparative VE for COVID-19 for boosters or additional first doses was 46.9% compared to the first vaccination series vaccine alone.

Conclusion

Studies show that boosters or additional SARS-CoV-2 primary vaccine doses provide higher protection against COVID-19 than primary series immunization alone during the prevalence of Omicron mutants in nursing home residents. Showed to give. The authors found that all care facility residents with weakened immunity received additional primary COVID-19 vaccine doses and, if eligible, boosted immunization to protect against SARS-CoV-2 infection. It was recommended to administer the dose. They also use other SARS-CoV-2 preventive techniques such as vaccination and nursing home visitor and staff testing in parallel with initiatives to keep nursing home residents in time for COVID-19 vaccination. Reported that it should be done.

In addition, this study should assess the efficacy and endurance of booster immunity or additional main doses against evolving SARS-CoV-2 mutants by continuously tracking VE across the population of nursing homes. I suggested that.