Proportion of SARS-CoV-2 positive tests and vaccination in Veterans Affairs Community Living Centers.


Journal

Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062

Informations de publication

Date de publication:
08 2021
Historique:
revised: 07 04 2021
received: 24 03 2021
accepted: 10 04 2021
pubmed: 17 4 2021
medline: 31 8 2021
entrez: 16 4 2021
Statut: ppublish

Résumé

COVID-19 has caused significant morbidity and mortality in nursing homes. Vaccination against SARS-COV-2 holds promise for reduction in COVID-19. This operational analysis describes the proportion of SARS-COV-2 positive tests before, during, and after vaccination. Retrospective longitudinal cohort analysis from October 1, 2020 until February 14, 2021. A total of 130 Department of Veterans Affairs (VA) Community Living Centers (CLC), analogous to nursing homes. Vaccination for SARS-CoV-2. The primary measure is the proportion of SARS-CoV-2 positive tests among CLC residents. In a pooled analysis of weekly testing and vaccine data, the proportion of positive tests was compared for the unvaccinated, first dose, and second dose. For each CLC, we identified the week in which 50% of CLC residents were vaccinated (index week). The analysis aligned the index week for CLCs and examined the proportion of SARS-CoV-2 positive tests at the CLC level before and after. As a reference, we plotted the proportion of positive tests in nursing homes in the same county as the CLC using publicly reported data. Within the pooled VA CLCs, the first SARS-CoV-2 vaccine dose was delivered to 50% of CLC residents within 1 week of availability and second dose within 5 weeks. Relative to the index week, the risk ratio of SARS-CoV-2 positive tests in the vaccinated relative to unvaccinated was significantly lower in Week 4 (relative risk 0.37, 95% confidence interval 0.20-0.68). Throughout the study period, the proportion of SARS-CoV-2 positive tests in community nursing homes was higher compared to VA CLC and also declined after vaccine availability. The proportion of SARS-CoV-2 positive tests significantly declined in VA CLCs 4 weeks after vaccine delivery and continued to decline in vaccinated and unvaccinated residents. The results describe the importance of SARS-CoV-2 surveillance and vaccination in VA nursing home residents.

Sections du résumé

BACKGROUND/OBJECTIVES
COVID-19 has caused significant morbidity and mortality in nursing homes. Vaccination against SARS-COV-2 holds promise for reduction in COVID-19. This operational analysis describes the proportion of SARS-COV-2 positive tests before, during, and after vaccination.
DESIGN
Retrospective longitudinal cohort analysis from October 1, 2020 until February 14, 2021.
SETTING
A total of 130 Department of Veterans Affairs (VA) Community Living Centers (CLC), analogous to nursing homes.
INTERVENTION
Vaccination for SARS-CoV-2.
MEASUREMENTS
The primary measure is the proportion of SARS-CoV-2 positive tests among CLC residents. In a pooled analysis of weekly testing and vaccine data, the proportion of positive tests was compared for the unvaccinated, first dose, and second dose. For each CLC, we identified the week in which 50% of CLC residents were vaccinated (index week). The analysis aligned the index week for CLCs and examined the proportion of SARS-CoV-2 positive tests at the CLC level before and after. As a reference, we plotted the proportion of positive tests in nursing homes in the same county as the CLC using publicly reported data.
RESULTS
Within the pooled VA CLCs, the first SARS-CoV-2 vaccine dose was delivered to 50% of CLC residents within 1 week of availability and second dose within 5 weeks. Relative to the index week, the risk ratio of SARS-CoV-2 positive tests in the vaccinated relative to unvaccinated was significantly lower in Week 4 (relative risk 0.37, 95% confidence interval 0.20-0.68). Throughout the study period, the proportion of SARS-CoV-2 positive tests in community nursing homes was higher compared to VA CLC and also declined after vaccine availability.
CONCLUSION
The proportion of SARS-CoV-2 positive tests significantly declined in VA CLCs 4 weeks after vaccine delivery and continued to decline in vaccinated and unvaccinated residents. The results describe the importance of SARS-CoV-2 surveillance and vaccination in VA nursing home residents.

Identifiants

pubmed: 33861871
doi: 10.1111/jgs.17180
pmc: PMC8250473
mid: NIHMS1704527
doi:

Substances chimiques

COVID-19 Vaccines 0

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2090-2095

Subventions

Organisme : Intramural VA
ID : CIN 13-465
Pays : United States
Organisme : NIA NIH HHS
ID : 3P01AG027296-11S2
Pays : United States
Organisme : Health Services Research and Development
ID : C19-20-213
Organisme : NIA NIH HHS
ID : P01 AG027296
Pays : United States
Organisme : Health Services Research and Development
ID : CIN 13-419

Informations de copyright

Published 2021. This article is a U.S. Government work and is in the public domain in the USA.

Références

MMWR Morb Mortal Wkly Rep. 2020 Dec 11;69(49):1857-1859
pubmed: 33301429
MMWR Morb Mortal Wkly Rep. 2021 Jan 15;70(2):52-55
pubmed: 33444301
J Am Geriatr Soc. 2021 Aug;69(8):2090-2095
pubmed: 33861871
MMWR Morb Mortal Wkly Rep. 2020 Apr 03;69(13):377-381
pubmed: 32240128
Health Aff (Millwood). 2021 Apr;40(4):655-663
pubmed: 33705204

Auteurs

James L Rudolph (JL)

Center of Innovation in Long Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA.
Department of Veterans Affairs, Office of Geriatrics and Extended Care, Veterans Health Administration, Washington, District of Columbia, USA.
Division of Geriatric and Palliative Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Center for Gerontology and Health Services Research, Brown University School of Public Health, Providence, Rhode Island, USA.

Scotte Hartronft (S)

Department of Veterans Affairs, Office of Geriatrics and Extended Care, Veterans Health Administration, Washington, District of Columbia, USA.

Kevin McConeghy (K)

Center of Innovation in Long Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA.
Center for Gerontology and Health Services Research, Brown University School of Public Health, Providence, Rhode Island, USA.

Michael Kennedy (M)

Department of Veterans Affairs, Office of Healthcare Transformation, Veterans Health Administration, Washington, District of Columbia, USA.

Orna Intrator (O)

Geriatrics and Extended Care Data Analysis Center, Veterans Health Administration, Canandaigua, New York, USA.
Department of Public Health Sciences, University of Rochester, Rochester, New York, USA.

Lisa Minor (L)

Department of Veterans Affairs, Office of Geriatrics and Extended Care, Veterans Health Administration, Washington, District of Columbia, USA.

Terrence L Hubert (TL)

Department of Veterans Affairs, Healthcare Operations Center, Veterans Health Administration, Washington, District of Columbia, USA.

Mary K Goldstein (MK)

Department of Veterans Affairs, Office of Geriatrics and Extended Care, Veterans Health Administration, Washington, District of Columbia, USA.
Stanford Health Policy, Stanford University, Stanford, California, USA.

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