Effectiveness of successive booster vaccine doses against SARS-CoV-2 related mortality in residents of long-term care facilities in the VIVALDI study.


Journal

Age and ageing
ISSN: 1468-2834
Titre abrégé: Age Ageing
Pays: England
ID NLM: 0375655

Informations de publication

Date de publication:
01 08 2023
Historique:
received: 09 03 2023
medline: 21 8 2023
pubmed: 18 8 2023
entrez: 18 8 2023
Statut: ppublish

Résumé

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused severe disease in unvaccinated long-term care facility (LTCF) residents. Initial booster vaccination following primary vaccination is known to provide strong short-term protection, but data are limited on duration of protection and the protective effect of further booster vaccinations. To evaluate the effectiveness of third, fourth and fifth dose booster vaccination against SARS-CoV-2 related mortality amongst older residents of LTCFs. Prospective cohort study. LTCFs for older people in England participating in the VIVALDI study. Residents aged >65 years at participating LTCFs were eligible for inclusion if they had at least one polymerase chain reaction or lateral flow device result within the analysis period 1 January 2022 to 31 December 2022. We excluded individuals who had not received at least two vaccine doses before the analysis period. Cox regression was used to estimate relative hazards of SARS-CoV-2 related mortality following 1-3 booster vaccinations compared with primary vaccination, stratified by previous SARS-CoV-2 infection and adjusting for age, sex and LTCF size (total beds). A total of 13,407 residents were included. Our results indicate that third, fourth and fifth dose booster vaccination provide additional short-term protection against SARS-CoV-2 related mortality relative to primary vaccination, with consistent stabilisation beyond 112 days to 45-75% reduction in risk relative to primary vaccination. Successive booster vaccination doses provide additional short-term protection against SARS-CoV-2 related mortality amongst older LTCF residents. However, we did not find evidence of a longer-term reduction in risk beyond that provided by initial booster vaccination.

Sections du résumé

BACKGROUND
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused severe disease in unvaccinated long-term care facility (LTCF) residents. Initial booster vaccination following primary vaccination is known to provide strong short-term protection, but data are limited on duration of protection and the protective effect of further booster vaccinations.
OBJECTIVE
To evaluate the effectiveness of third, fourth and fifth dose booster vaccination against SARS-CoV-2 related mortality amongst older residents of LTCFs.
DESIGN
Prospective cohort study.
SETTING
LTCFs for older people in England participating in the VIVALDI study.
METHODS
Residents aged >65 years at participating LTCFs were eligible for inclusion if they had at least one polymerase chain reaction or lateral flow device result within the analysis period 1 January 2022 to 31 December 2022. We excluded individuals who had not received at least two vaccine doses before the analysis period. Cox regression was used to estimate relative hazards of SARS-CoV-2 related mortality following 1-3 booster vaccinations compared with primary vaccination, stratified by previous SARS-CoV-2 infection and adjusting for age, sex and LTCF size (total beds).
RESULTS
A total of 13,407 residents were included. Our results indicate that third, fourth and fifth dose booster vaccination provide additional short-term protection against SARS-CoV-2 related mortality relative to primary vaccination, with consistent stabilisation beyond 112 days to 45-75% reduction in risk relative to primary vaccination.
CONCLUSIONS
Successive booster vaccination doses provide additional short-term protection against SARS-CoV-2 related mortality amongst older LTCF residents. However, we did not find evidence of a longer-term reduction in risk beyond that provided by initial booster vaccination.

Identifiants

pubmed: 37595069
pii: 7241725
doi: 10.1093/ageing/afad141
pmc: PMC10438206
pii:
doi:

Substances chimiques

COVID-19 Vaccines 0

Types de publication

Evaluation Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Wellcome Trust
ID : 222907/Z/21/Z
Pays : United Kingdom
Organisme : Department of Health
ID : CS-2016-007
Pays : United Kingdom
Organisme : Medical Research Council
Pays : United Kingdom
Organisme : Chief Scientist Office
Pays : United Kingdom

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society.

Références

Lancet Infect Dis. 2023 May;23(5):556-567
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J Infect Dis. 2023 Apr 18;227(8):977-980
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Lancet Healthy Longev. 2022 Jan;3(1):e13-e21
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N Engl J Med. 2023 Feb 9;388(6):481-483
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MMWR Morb Mortal Wkly Rep. 2022 Dec 02;71(48):1526-1530
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Sociol Health Illn. 2021 Aug;43(7):1614-1626
pubmed: 34255866
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pubmed: 33564722
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BMJ. 2022 Jul 6;378:e071502
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MMWR Morb Mortal Wkly Rep. 2022 Sep 30;71(39):1235-1238
pubmed: 36173757

Auteurs

Oliver Stirrup (O)

Institute for Global Health, University College London, London, UK.

Madhumita Shrotri (M)

UCL Institute of Health Informatics, University College London, London, UK.

Natalie L Adams (NL)

UCL Institute of Health Informatics, University College London, London, UK.

Maria Krutikov (M)

UCL Institute of Health Informatics, University College London, London, UK.

Borscha Azmi (B)

UCL Institute of Health Informatics, University College London, London, UK.

Igor Monakhov (I)

UK Health Security Agency, London, UK.

Gokhan Tut (G)

Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.

Paul Moss (P)

Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.

Andrew Hayward (A)

UCL Institute of Epidemiology & Healthcare, University College London, London, UK.
Health Data Research UK, London, UK.

Andrew Copas (A)

Institute for Global Health, University College London, London, UK.

Laura Shallcross (L)

UCL Institute of Health Informatics, University College London, London, UK.

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Classifications MeSH