A study released on April 21, 2021 in the CDC’s Morbidity and Mortality Weekly Report (MMWR) entitled “COVID-19 Outbreak Associated with a SARS-CoV-2 R.1 Lineage Variant in a Skilled Nursing Facility After Vaccination Program — Kentucky, March 2021” reported: “In a COVID-19 outbreak at a Kentucky SNF involving a newly introduced variant to the region, unvaccinated residents and health care personnel (HCP) had 3.0 and 4.1 times the risk of infection as did vaccinated residents and HCP. Vaccine was 86.5% protective against symptomatic illness among residents and 87.1% protective among HCP.”
Limited data are available on effectiveness of COVID-19 vaccinations in skilled nursing facilities (SNFs) and against emerging variants. The Kentucky Department for Public Health (KDPH) and a local health department investigated a COVID-19 outbreak in a SNF that occurred after all residents and health care personnel (HCP) had been offered vaccination. In a SNF with 90.4% of residents vaccinated, an outbreak of COVID-19 occurred after introduction from an unvaccinated, symptomatic HCP. Attack rates were three to four times as high among unvaccinated residents and HCP as among those who were vaccinated; vaccinated persons were significantly less likely to experience symptoms or require hospitalization. The risk for poor outcomes among unvaccinated SNF residents is highlighted by the hospitalization of four of the six unvaccinated, infected residents, and two subsequent deaths, including in one previously infected resident.
Among 83 residents and 116 HCP, 75 (90.4%) and 61 (52.6%), respectively, received 2 vaccine doses. Twenty-six residents and 20 HCP received positive test results for SARS-CoV-2, the virus that causes COVID-19, including 18 residents and four HCP who had received their second vaccine dose >14 days before the outbreak began.
Although the R.1 variant has multiple spike protein mutations, vaccinated residents and HCP were 87% less likely to have symptomatic COVID-19 compared with those who were unvaccinated. Vaccine effectiveness (VE) against symptomatic COVID-19 was 86.5% (95% CI = 65.6%–94.7%) among residents and 87.1% (95% CI = 46.4%–96.9%) among HCP. VE against hospitalization was 94.4% (95% CI = 73.9%–98.8%) among residents; no HCP were hospitalized. Three residents died, two of whom were unvaccinated (VE = 94.4%; 95% CI = 44.6%–99.4%).
Four possible reinfections were identified (one resident and three HCP); of these, one HCP was vaccinated. All four persons experienced symptomatic illness. One resident was infected 300 days earlier and had nine consecutive negative RT-PCR tests before reinfection, including two within 30 days of the outbreak. This resident was hospitalized and died.
The study concluded: “Nationally, a median of 37.5% of HCP working in long-term care facilities had received at least 1 dose of vaccine by mid-January 2021. Although the vaccination rate in this SNF surpassed this early national rate, approximately one half of HCP were vaccinated. To protect SNF residents, it is imperative that HCP, as well as SNF residents, be vaccinated. A continued emphasis on strategies for prevention of disease transmission, even among vaccinated populations, is also critical. Timely implementation of infection control strategies after outbreak identification likely contributed to the rapid decline in new cases during the second week of the outbreak.”
If you or a loved one suffered injuries (or worse) while a resident of a nursing home in the United States due to an infection acquired in a nursing home, nursing home neglect, nursing home negligence, nursing home abuse, or nursing home fraud, you should promptly contact a local nursing home claim attorney in your state who may investigate your nursing home claim for you and file a nursing home claim on your behalf, if appropriate.
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