Two Studies Show Positive Impact of COVID-19 Vaccinations on VA and Community Nursing Home Residents

SUMMARY:
VA Community Living Centers (CLCs) rapidly disseminated COVID-19 vaccination among the Veterans in residence. This retrospective analysis conducted from October 1, 2020 to February 14, 2021, describes the proportion of COVID-19 positive tests among 130 CLCs before and after COVID-19 vaccination. Using weekly CLC data, COVID-19 testing and vaccination results were summarized at the CLC level. For a reference on community prevalence, non-VA nursing home data reported by CMS were included for counties with CLCs.

FINDINGS:

• Over half of CLC residents received their first vaccination by December 20, 2020. As of January 21, 2021, 82% of CLC residents had begun or completed the vaccination process, 13% refused the vaccination, and 5% were contraindicated. The number of COVID-19 positive tests dropped among all CLC residents in the fourth week after vaccination, with an approximately 75% drop in the proportion of COVID-19 positive tests. In data from non-VA nursing homes, a higher proportion of COVID-19 tests were positive than in VA but there was a similar decline in COVID-19 positive tests after vaccine availability. Results indicate that by reducing infection, COVID-19 vaccinations hold promise as a mechanism to decrease the pandemic-related isolation of nursing home residents.
  
  This study was partly funded by HSR&D. Dr. Rudolph is the Director of HSR&D’s Center of Innovation in Long-Term Services and Supports (LTSS-COIN), Providence, RI.

SUMMARY:
U.S. nursing homes incurred more than one-third of COVID-19 fatalities in the United States and began vaccine clinics in mid-December. This study compared incident COVID-19 infection and 30-day hospitalization or death among residents with COVID-19 between nursing homes with earlier versus later vaccine clinics. Among 280 (non-VA) nursing homes in 21 states, early clinics vaccinated between December 18, 2020, and January 2, 2021 and later clinics between January 3, 2021, and January 18, 2021.

FINDINGS:

• One week after their initial vaccine clinics, nursing homes with earlier vaccination (12,157 residents at 136 facilities) had 2.5 fewer new COVID-19 infections per 100 at-risk residents than expected relative to later vaccination (13,221 residents at 144 facilities). Cumulatively over 7 weeks, earlier vaccination facilities had 5.2 fewer infections per 100 at-risk residents and 5 fewer hospitalizations and/or deaths per 100 infected residents. These results suggest that COVID-19 vaccines accelerated the rate of decline of incident infections, morbidity, and mortality in this large multi-state nursing home population. Further, this evidence supports efforts to begin resuming family visitation and to lessen other restrictions in nursing homes.

Dr. Mor is also with LTSS-COIN.

AUTHOR/FUNDING INFORMATION:

Rudolph J, et al. Proportion of SARS-CoV-2 Positive Tests and Vaccination in VA Community Living Centers. Journal of the American Geriatrics Society April 16, 2021; online ahead of print.

Mor V, et al. Short-term Impact of Nursing Home SARS-CoV-2 Vaccinations on New Infections, Hospitalizations, and Deaths. JAGS. April 16, 2021; online ahead of print.