SARS-CoV-2 B 1.1.7 Variant Outbreak in a Fully Vaccinated Nursing Home—Madrid, June 2021

Mateos‐Nozal, Jesús; Montemayor, Juan Carlos Galán; Torres, Silvia Lores; Barreiro, Pablo; Zamora, Ana; Martínez, Fernando; Castelo, Diana García; Torres, Silvia Grandez; Rodríguez-Domínguez, Mario; Peromingo, Francisco Javier Martínez; Cruz-Jentoft, A.J.

doi:10.1016/j.jamda.2021.08.032

Cited by 7 publications

(11 citation statements)

References 6 publications

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“…Older adults living in nursing homes, even though vaccinated, may still be at high risk for a complicated bout of COVID-19, given their age, frailty, and need for care. These breakthrough infections of older adults, but not members of the staff, have been previously reported [22]. Greater age is related to lower response to SARS-CoV-2 vaccination Linear regression analysis including age, sex, personal status (resident or staff), and serological evidence of COVID-19 (positive IgG-N) showed that IgG-S concentration after vaccination was associated with age (OR: −0.03 per 10 years-old (95% CI, −0.04 to −0.02 [p < 0.001]) and evidence of past COVID-19 (OR: 1.14 (95% CI, 1.08 to 1.20 [p < 0.001]) (Table 2).…”

Section: Discussionsupporting

confidence: 59%

Section: Discussionsupporting

confidence: 55%

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Humoral and Cellular Response after mRNA Vaccination in Nursing Homes: Influence of Age and of History of COVID-19

Jesús

Candel

Moreno³

et al. 2022

Vaccines

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Background: Most residents and staff in nursing homes have received full vaccination. Factors related to the immune response to vaccination might be related to the risk of future severe COVID-19 and may guide the need for vaccine boosters. Design: Nursing homes that were tested in a point survey in July-October 2020 were again analyzed after a vaccination campaign in June-July 2021. Immune responses according to IgG against nucleocapsid and spike antigens, and CD4 and CD8 interferon-gamma release assay against spike antigens, were evaluated. Results: A total of 1973 subjects were tested (61.7% residents, 48.3% staff), with a mean (SD) follow-up of 46.4 (3.6) weeks between assessments. More than half of residents and more than a third of staff had evidence of COVID-19 before vaccination; 26.9% and 22.7% had seroreversion of IgG-N, and 8.9% and 4.6% had IgG-N seroconversion at second assessment, respectively. Up to 96.8% of residents and 98.1% of workers had positive IgG-S after a mean of 19.9 (2.1) weeks after vaccination. In residents with vs without a history of COVID-19, IgG-S titers were 4.11 (0.54) vs. 2.73 (0.74) logAU/mL (p < 0.001); in workers these titers were 3.89 (0.61) vs. 3.15 (0.64) logAU/mL (p < 0.001). Linear regression analysis showed that younger age (OR: −0.03 per 10 years-older [95% CI, −0.04 to −0.02], p < 0.001) and evidence of COVID-19 (OR: 1.14 [95% CI, 1.08 to 1.20], p < 0.001) are associated with greater IgG-S titers after vaccination. A direct association was found between IgG-S titers and the intensity of IFN-gamma response against spike antigens. Conclusions: Waning of humoral response and reinfection seems to be more frequent in older as compared to younger adults, although cellular responses shortly after vaccination are comparable between these groups. Younger age and prior COVID-19 are related to greater humoral response after vaccination against SARS-CoV-2.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionsupporting

confidence: 55%

Humoral and Cellular Response after mRNA Vaccination in Nursing Homes: Influence of Age and of History of COVID-19

Jesús

Candel

Moreno³

et al. 2022

Vaccines

Self Cite

View full text Add to dashboard Cite

show abstract

“…27,38e40 Increasingly, SARS-CoV-2 outbreaks in nursing home populations reflect circulating variants of concern, tied closely to strains circulating in the wider community. This includes documented outbreaks in nursing homes of the delta, 41,42 gamma, 43,44 alpha, 45,46 and beta 47,48 strains. Although early epidemiologic data for the Omicron variant suggest increased risk of infection and milder disease course compared to other variants of concern in vaccinated or previously infected individuals, the full impact of the Omicron variant on nursing homes is not currently clear.…”

Section: Breakthrough Infections Postvaccination and Emergence Of Var...mentioning

confidence: 99%

Managing the Impact of COVID-19 in Nursing Homes and Long-Term Care Facilities: An Update

Dyer

Fallon

Noonan

et al. 2022

Journal of the American Medical Directors Association

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“…In many countries, morbidity and mortality due to the SARS‐CoV‐2 viral illness have been high among older adults residing in communal living environments, such as Nursing Homes (NHs). 1 , 2 , 3 , 4 , 5 Accordingly, once COVID‐19 vaccines became available in Canada, they were strategically prioritized for NH residents and healthcare providers. 6 In Canada, NHs are regulated residential facilities providing 24‐h nursing care and health services to residents by healthcare personnel.…”

Section: Introductionmentioning

confidence: 99%

“…7,8 To date, most studies on vaccine efficacy in NHs were performed prior to the emergence of the BA.2 variant of SARS-CoV-2 (Omicron) as the dominant strain, and before a third vaccine dose was recommended. [2][3][4][5]9 Moreover, many of these nursing home studies looked at primarily urban as opposed to rural NH populations. 10,11 This report analyzes the effect of prior vaccination of NH residents during recent outbreaks of SARS-CoV-2 in NHs in rural Manitoba, Canada.…”

Section: Introductionmentioning

confidence: 99%

Protective effects of prior third dose mRNA vaccination in rural nursing home residents during SARS‐CoV‐2 outbreaks

Rhynold

Quan

Orr

et al. 2022

J American Geriatrics Society

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Background In Canada, mortality due to SARS‐CoV‐2 disproportionately impacted residents of nursing homes (NH). In November 2021, NH residents in the Canadian province of Manitoba became eligible to receive three doses of mRNA vaccine but coverage with three doses has not been universal. The objective of this study was to compare the protection from infection conferred by one, two, and three doses of COVID‐19 mRNA vaccine compared to no vaccination among residents of nursing homes experiencing SARS‐CoV‐2 outbreaks. Methods Infection Prevention and Control reports from 8 rural nursing homes experiencing outbreaks of SARS‐CoV‐2 between January 6, 2022, and March 5, 2022, were analyzed. Attack rates and the number needed to vaccinate (NNV) were calculated. Results SARS‐CoV‐2 attack rate was 65% among NH residents not vaccinated, 58% among residents who received 1–2 doses of mRNA COVID‐19 vaccine, and 28% among residents who had received 3 vaccine doses. The NNV to prevent one nursing home resident from SARS‐CoV‐2 infection during an outbreak was 3 for a vaccination with 3 doses and 14 for 1–2 doses of COVID‐19 mRNA vaccine. The superiority of receiving the third dose was statistically significant compared to 1–2 doses (Chi‐Squared, p < 0.00001). Conclusions Nursing home residents who received three doses of COVID‐19 mRNA vaccine were at lower risk of SARS‐CoV‐2 infection compared to those who received 1–2 doses. Our analyses lend support to the protective effects of the third dose of mRNA vaccine for NH residents in the event of a SARS‐CoV‐2 outbreak.

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SARS-CoV-2 B 1.1.7 Variant Outbreak in a Fully Vaccinated Nursing Home—Madrid, June 2021

Abstract: A SARS-CoV-2 B.1.1.7 variant outbreak has occurred in a fully vaccinated NH and managed by different stakeholders. Among 47 assisted residents, 93.5% presented reactive IgG against Spike protein and 46.8% had COVID-19 infection.

Cited by 7 publications

References 6 publications

Humoral and Cellular Response after mRNA Vaccination in Nursing Homes: Influence of Age and of History of COVID-19

Humoral and Cellular Response after mRNA Vaccination in Nursing Homes: Influence of Age and of History of COVID-19

Managing the Impact of COVID-19 in Nursing Homes and Long-Term Care Facilities: An Update

Protective effects of prior third dose mRNA vaccination in rural nursing home residents during SARS‐CoV‐2 outbreaks

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