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. 2022 Sep 30;71(39):1235-1238.
doi: 10.15585/mmwr.mm7139a2.

Effectiveness of a Second COVID-19 Vaccine Booster Dose Against Infection, Hospitalization, or Death Among Nursing Home Residents - 19 States, March 29-July 25, 2022

Kevin W McConeghy, Elizabeth M White, Carolyn Blackman, Christopher M Santostefano, Yoojin Lee, James L Rudolph, David Canaday, Andrew R Zullo, John A Jernigan, Tamara Pilishvili, Vincent Mor, Stefan Gravenstein

Effectiveness of a Second COVID-19 Vaccine Booster Dose Against Infection, Hospitalization, or Death Among Nursing Home Residents - 19 States, March 29-July 25, 2022

Kevin W McConeghy et al. MMWR Morb Mortal Wkly Rep. .

Abstract

Nursing home residents continue to experience significant COVID-19 morbidity and mortality (1). On March 29, 2022, the Advisory Committee on Immunization Practices (ACIP) recommended a second mRNA COVID-19 vaccine booster dose for adults aged ≥50 years and all immunocompromised persons who had received a first booster ≥4 months earlier.* On September 1, 2022, ACIP voted to recommend bivalent mRNA COVID-19 vaccine boosters for all persons aged ≥12 years who had completed the primary series using monovalent vaccines ≥2 months earlier (2). Data on COVID-19 booster dose vaccine effectiveness (VE) in the nursing home population are limited (3). For this analysis, academic, federal, and private partners evaluated routine care data collected from 196 U.S. community nursing homes to estimate VE of a second mRNA COVID-19 vaccine booster dose among nursing home residents who had received 3 previous COVID-19 vaccine doses (2 primary series doses and 1 booster dose). Residents who received second mRNA COVID-19 vaccine booster doses during March 29-June 15, 2022, with follow-up through July 25, 2022, were found to have 60-day VE of 25.8% against SARS-CoV-2 (the virus that causes COVID-19 infection), 73.9% against severe COVID-19 outcomes (a combined endpoint of COVID-19-associated hospitalizations or deaths), and 89.6% against COVID-19-associated deaths alone. During this period, subvariants BA.2 and BA.2.12.1 (March-June 2022), and BA.4 and BA.5 (July 2022) of the B.1.1.529 and BA.2 (Omicron) variant were predominant. These findings suggest that among nursing home residents, second mRNA COVID-19 vaccine booster doses provided additional protection over first booster doses against severe COVID-19 outcomes during a time of emerging Omicron variants. Facilities should continue to ensure that nursing home residents remain up to date with COVID-19 vaccination, including bivalent vaccine booster doses, to prevent severe COVID-19 outcomes.

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Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Kevin W. McConeghy, Stefan Gravenstein, and Andrew R. Zullo have received investigator-initiated support from Sanofi-Pasteur, Seqirus, and Pfizer Inc. for other non–COVID-19 vaccine-related work. Dr. Zullo was also supported by grants from the National Institute on Aging and the National Institute of General Medical Sciences. Vincent Mor reports support from the National Institute on Aging, serves as chair of the Scientific Advisory Committee at naviHealth, Inc., was former chair of the Independent Quality Committee at HCR ManorCare, is the former director of PointRight Inc, where he holds less than 1% equity, and received personal fees from naviHealth, Inc., outside the submitted work. No other potential conflicts of interest were disclosed.

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References

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