A new study on COVID-19 among nursing home residents and staff found that the cases decreased at a faster rate among both groups after the first vaccine clinic took place in facilities, suggesting that transmission could decline in three weeks after receiving the first vaccine dose.
“Vaccinated nursing homes experienced a 48% decline in new resident cases three weeks after the first clinic, compared to a 21% decline among non-vaccinated nursing homes located in the same county,” the report from The Center for Health Policy Evaluation in Long-Term Care (HPE) found. “Similarly, new staff cases declined by 33% in vaccinated nursing homes compared to 18% in non-vaccinated facilities.”
The study examined 797 nursing homes that conducted their first vaccination clinic from December 18, 2020, to December 27, 2020, comparing them to 1,709 nursing homes in the same counties that had not yet had a clinic.
The authors found that while trends in new COVID-19 infections among residents were dropping even before the first vaccine clinics, the declines were greater in the SNFs that had vaccine clinics in the first week of the program, compared with SNFs that did not have a vaccine clinic in the same county.
“Three weeks after the first vaccine clinic the rates of new COVID-19 infection dropped more in the 797 SNFs that held vaccine clinic compared to those that did not in the same county (48% vs 21%, respectively),” study authors Marsida Domi, Michael Leitson, David Gifford, and Kiran Sreenivas wrote.
Gifford is the chief medical officer of the American Health Care Association (AHCA), the largest trade and lobbying group for nursing homes; he also serves as director of the AHCA-affiliated HPE.
Vaccine uptake among residents and staff has been mixed, with most skilled nursing operators seeing high rates of compliance among residents and significantly lower ones among staff, as recently reported by the Centers for Disease Control and Prevention. Some operators have reported higher rates of staff uptake than that average, but for the most part, residents are taking the shots at significantly higher rates than workers.
The success of vaccination efforts is directly tied to the restoration of visitation, according to Mark Parkinson, the president and CEO of AHCA; the study authors emphasized the need to prevent the spread of COVID to allow visitation, communal dining, and group activities for residents.
“Evaluation on vaccine effectiveness in the LTC setting needs to be a priority,” they wrote.
The two vaccines that received emergency use authorization from the Food and Drug Administration (FDA) require two doses for roughly 95% efficacy, but data from the trials of each vaccine — from Pfizer (NYSE: PFE)-BioNTech and Moderna (Nasdaq: MRNA) — did suggest that there was some effectiveness at a lower level.
The authors also chose to examine the change in the rate of new COVID-19 infections among staff and residents in nursing homes with three weeks of follow-up data on COVID-19 because antibody levels would not rise to protective levels until about two weeks after exposure to the virus.
“This analysis is the first look at the relationship between the COVID-19 vaccine and spread in long term care, and it suggests that spread may be decreased starting three weeks after receiving the first dose of the vaccine,” the authors wrote. “While promising, further evaluations are needed to confirm this finding.”