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. 2021 Oct 13;9(10):1174.
doi: 10.3390/vaccines9101174.

Course and Lethality of SARS-CoV-2 Epidemic in Nursing Homes after Vaccination in Florence, Italy

Giulia Rivasi  1 , Matteo Bulgaresi  2 , Enrico Mossello  1 , Primo Buscemi  3 , Chiara Lorini  3 , Daniela Balzi  4 , Riccardo Barucci  2 , Ilaria Del Lungo  2 , Salvatore Gangemi  2 , Sante Giardini  2 , Cecilia Piga  2 , Eleonora Barghini  2 , Serena Boni  2 , Giulia Bulli  2 , Paolo Carrai  5 , Andrea Crociani  5 , Antonio Faraone  5 , Aldo Lo Forte  5 , Letizia Martella  2 , Simone Pupo  2 , Giacomo Fortini  2 , Irene Marozzi  1 , Giulia Bandini  6 , Claudia Cosma  3 , Lorenzo Stacchini  3 , Gabriele Vaccaro  3 , Lorenzo Baggiani  7 , Giancarlo Landini  8 , Guglielmo Bonaccorsi  3 , Andrea Ungar  1 , Enrico Benvenuti  2
Affiliations

Course and Lethality of SARS-CoV-2 Epidemic in Nursing Homes after Vaccination in Florence, Italy

Giulia Rivasi et al. Vaccines (Basel). .

Abstract

Evidence on the effectiveness of SARS-CoV-2 vaccines in nursing home (NHs) residents is limited. We examined the impact of the BNT162b2 mRNA SARS-CoV-2 vaccine on the course of the epidemic in NHs in the Florence Health District, Italy, before and after vaccination. Moreover, we assessed survival and hospitalization by vaccination status in SARS-CoV-2-positive cases occurring during the post-vaccination period. We calculated the weekly infection rates during the pre-vaccination (1 October-26 December 2020) and post-vaccination period (27 December 2020-31 March 2021). Cox analysis was used to analyze survival by vaccination status. The study involved 3730 residents (mean age 84, 69% female). Weekly infection rates fluctuated during the pre-vaccination period (1.8%-6.5%) and dropped to zero during the post-vaccination period. Nine unvaccinated (UN), 56 partially vaccinated (PV) and 35 fully vaccinated (FV) residents tested SARS-CoV-2+ during the post-vaccination period. FV showed significantly lower hospitalization and mortality rates than PV and UV (hospitalization: FV 3%, PV 14%, UV 33%; mortality: FV 6%, PV 18%, UV 56%). The death risk was 84% and 96% lower in PV (HR 0.157, 95%CI 0.049-0.491) and FV (HR 0.037, 95%CI 0.006-0.223) versus UV. SARS-CoV-2 vaccination was followed by a marked decline in infection rates and was associated with lower morbidity and mortality among infected NH residents.

Keywords: COVID-19; hospitalization; lethality; mortality; nursing home residents; older adults; vaccine.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The weekly incidence rate of COVID-19 in NHs of the Florence Health District (per 100 people; blue line) and in the general population of Tuscany (per 100,000 people; red line), before and after the start of the vaccination campaign (dashed vertical line). Data on the general population were obtained from the Italian Ministry of Health. The date on the x-axis indicates the first day of the monitoring week.
Figure 2
Figure 2
Kaplan–Meier survival estimates for COVID-19-related mortality depending on vaccination status (unvaccinated, partially vaccinated and fully vaccinated residents, log-rank test).
See this image and copyright information in PMC

References

    1. Burton J.K., Bayne G., Evans C., Garbe F., Gorman D., Honhold N., McCormick D., Othieno R., Stevenson J.E., Swietlik S., et al. Evolution and effects of COVID-19 outbreaks in care homes: A population analysis in 189 care homes in one geographical region of the UK. Lancet Health Longev. 2020;1:e21–e31. doi: 10.1016/S2666-7568(20)30012-X. - DOI - PMC - PubMed
    1. Rutten J.J.S., van Loon A.M., van Kooten J., van Buul L.W., Joling K.J., Smalbrugge M., Hertogh C.M.P.M. Clinical Suspicion of COVID-19 in Nursing Home Residents: Symptoms and Mortality Risk Factors. J. Am. Med. Dir. Assoc. 2020;21:1791–1797.e1. doi: 10.1016/j.jamda.2020.10.034. - DOI - PMC - PubMed
    1. Graham N.S.N., Junghans C., Downes R., Sendall C., Lai H., McKirdy A., Elliott P., Howard R., Wingfield D., Priestman M., et al. SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes. J. Infect. 2020;81:411–419. doi: 10.1016/j.jinf.2020.05.073. - DOI - PMC - PubMed
    1. Tang O., Bigelow B.F., Sheikh F., Peters M., Zenilman J.M., Bennett R., Katz M.J. Outcomes of Nursing Home COVID-19 Patients by Initial Symptoms and Comorbidity: Results of Universal Testing of 1970 Residents. J. Am. Med. Dir. Assoc. 2020;21:1767–1773.e1. doi: 10.1016/j.jamda.2020.10.011. - DOI - PMC - PubMed
    1. Fulop T., Pawelec G., Castle S., Loeb M. Immunosenescence and vaccination in nursing home residents. Clin. Infect. Dis. 2009;48:443–448. doi: 10.1086/596475. - DOI - PubMed

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