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. 2022 May;70(5):1336-1341.
doi: 10.1111/jgs.17773. Epub 2022 Apr 4.

Long-term effects of SARS-CoV-2 vaccination in the nursing home setting

Giulia Rivasi  1 , Matteo Bulgaresi  2 , Chiara Bandinelli  2 , Daniela Balzi  3 , Francesca Tarantini  1 , Silvia Tognelli  2 , Chiara Lorini  4 , Primo Buscemi  4 , Lorenzo Baggiani  5 , Giancarlo Landini  6 , Andrea Ungar  1 , Guglielmo Bonaccorsi  4 , Enrico Mossello  1 , Enrico Benvenuti  2
Affiliations

Long-term effects of SARS-CoV-2 vaccination in the nursing home setting

Giulia Rivasi et al. J Am Geriatr Soc. 2022 May.

Abstract

Background: SARS-CoV-2 vaccination has significantly reduced infection, hospitalization, and lethality rates among nursing home (NH) residents, but durability of vaccine effects remains unknown. This study investigated the long-term impact of BNT162b2 SARS-CoV-2 vaccine on breakthrough infection rates in the NHs of Florence, Italy.

Methods: Participants included residents living in Florence NHs as of April 1st, 2021, who had completed the primary SARS-CoV2 vaccination course by February 15th, 2021. Weekly rates of breakthrough infection were calculated between April 1st and October 31st 2021, with 7-day incidence defined as the number of new confirmed SARS-CoV-2-positive residents over the vaccinated resident census. Hospital admissions and deaths were recorded from local administrative and clinical sources. Patients admitted to NHs after April 1st were excluded to avoid confounding effect of different vaccination timing.

Results: Among 2271 vaccinated residents (mean age 86.6, 74% female), we recorded 105 cases of breakthrough infections. Rates of breakthrough infection remained very low in the 6 months after vaccination, but started to rise over the following months, peaking at 0.94%, and then became stable around 0.2%-0.3%. Over the study period, infection rates remained low as compared to the incidence of SARS-CoV-2 infection during pre-vaccination period. Overall hospitalization and lethality rates were 8%.

Conclusions: Among vaccinated NH residents, rates of breakthrough SARS-CoV-2 infection, hospitalization and lethality remained low up to 9 months following primary vaccination course. A mild resurgence of SARS-CoV-2 infection, after 6 months from vaccination, suggests a decline of vaccine effectiveness in preventing transmission.

Keywords: COVID-19; breakthrough infection; nursing home residents; older adults; vaccine.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Weekly incidence rates of SARS‐CoV‐2 new cases in nursing homes of the Florence Health District during the pre‐ and post‐vaccination period (October 1st, 2020–October 31st, 2021). The date on the x axis indicates the first day of the monitoring week. Vertical lines indicate administration of the first (dashed line) and second (solid line) vaccine dose
FIGURE 2
FIGURE 2
Deaths and hospital admissions in SARS‐CoV2 infected residents up to 6 months after the primary vaccination course (April 1–July 31) and during the subsequent 3 months (August 1–October 31). Absolute numbers are reported in the figure and percentages on the y axis
See this image and copyright information in PMC

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