Short-term impact of nursing home SARS-CoV-2 vaccinations on new infections, hospitalizations, and deaths
Short-term impact of nursing home SARS-CoV-2 vaccinations on new infections, hospitalizations, and deaths
复制标题
DOI：
10.1111/jgs.17176
复制
发表时间：
2021-04-16
影响因子：
6.3
通讯作者：
Gravenstein, Stefan A.
中科院分区：
文献类型：
--
作者：
Mor, Vincent;Gutman, Roee;Gravenstein, Stefan A.
目的比较早期和晚期SARS-CoV-2疫苗门诊的养老院中确诊感染的居民的SARS-CoV-2感染事件率和30天住院或死亡率。设计对2020年12月18日至2021年1月2日期间首次疫苗门诊的养老院与2021年1月3日至1月18日期间首次疫苗门诊的养老院进行配对分析。2021.匹配的设施有他们的最初的疫苗诊所之间的12和16天的间隔。设置和参与者280疗养院在21个州拥有和经营的最大的长期护理提供者在美国。测量事件SARS冠状病毒2感染每100个高危居民每周;结果早期接种组包括136个设施和12，157名居民;后期接种组包括144个设施，13 221名居民。1周后，早期接种疫苗的设施每周每100名高危居民的SARS-CoV-2感染事件预计比基于后期接种疫苗设施的经验预期的少2.5例（95%CI：1.2-4.0）。这一比率在几个星期内一直很低。在5周内累积，预计新发感染减少为每100名高危居民5.2例（95% CI：3.2-7.3）。到疫苗接种后5至8周，早期接种疫苗的设施每天每100名感染居民的住院和/或死亡人数预计减少1.1至3.8人，根据后期接种设施的经验，平均每100名感染居民每天5起事件的累积平均差异。2疫苗似乎加速了这一大型多州疗养院人群的事件感染、发病率和死亡率的下降速度。
Objective To compare rates of incident SARS-CoV-2 infection and 30-day hospitalization or death among residents with confirmed infection in nursing homes with earlier versus later SARS-CoV-2 vaccine clinics.Design Matched pairs analysis of nursing homes that had their initial vaccine clinics between December 18, 2020, and January 2, 2021, versus between January 3, 2021, and January 18, 2021. Matched facilities had their initial vaccine clinics between 12 and 16 days apart.Setting and Participants Two hundred and eighty nursing homes in 21 states owned and operated by the largest long-term care provider in the United States.Measurements Incident SARS-CoV-2 infections per 100 at-risk residents per week; hospital transfers and/or deaths per 100 residents with confirmed SARS-CoV-2 infection per day, averaged over a week.Results The early vaccinated group included 136 facilities with 12,157 residents; the late vaccinated group included 144 facilities with 13,221 residents. After 1 week, early vaccinated facilities had a predicted 2.5 fewer incident SARS-CoV-2 infections per 100 at-risk residents per week (95% CI: 1.2-4.0) compared with what would have been expected based on the experience of the late vaccinated facilities. The rates remained significantly lower for several weeks. Cumulatively over 5 weeks, the predicted reduction in new infections was 5.2 cases per 100 at-risk residents (95% CI: 3.2-7.3). By 5 to 8 weeks post-vaccine clinic, early vaccinated facilities had a predicted 1.1 to 3.8 fewer hospitalizations and/or deaths per 100 infected residents per day, averaged by week than expected based on late vaccinated facilities' experience for a cumulative on average difference of 5 events per 100 infected residents per day.Conclusions The SARS-CoV-2 vaccines seem to have accelerated the rate of decline of incident infections, morbidity, and mortality in this large multi-state nursing home population.