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COVID-19 infection risk amongst 14,104 vaccinated care home residents: a national observational longitudinal cohort study in Wales, UK, December 2020–March 2021

Joe Hollinghurst, Laura North, Malorie Perry, Ashley Akbari Orcid Logo, Michael Gravenor Orcid Logo, Ronan Lyons Orcid Logo, Rich Fry Orcid Logo

Age and Ageing, Volume: 51, Issue: 1

Swansea University Authors: Joe Hollinghurst, Laura North, Ashley Akbari Orcid Logo, Michael Gravenor Orcid Logo, Ronan Lyons Orcid Logo, Rich Fry Orcid Logo

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DOI (Published version): 10.1093/ageing/afab223

Abstract

Backgroundvaccinations for COVID-19 have been prioritised for older people living in care homes. However, vaccination trials included limited numbers of older people.Aimwe aimed to study infection rates of SARS-CoV-2 for older care home residents following vaccination and identify factors associated...

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Published in: Age and Ageing
ISSN: 0002-0729 1468-2834
Published: Oxford University Press (OUP) 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa58868
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However, vaccination trials included limited numbers of older people.Aimwe aimed to study infection rates of SARS-CoV-2 for older care home residents following vaccination and identify factors associated with increased risk of infection.Study Design and Settingwe conducted an observational data-linkage study including 14,104 vaccinated older care home residents in Wales (UK) using anonymised electronic health records and administrative data.Methodswe used Cox proportional hazards models to estimate hazard ratios (HRs) for the risk of testing positive for SARS-CoV-2 infection following vaccination, after landmark times of either 7 or 21 days post-vaccination. We adjusted HRs for age, sex, frailty, prior SARS-CoV-2 infections and vaccination type.Resultswe observed a small proportion of care home residents with positive polymerase chain reaction (tests following vaccination 1.05% (N&#x2009;=&#x2009;148), with 90% of infections occurring within 28 days. For the 7-day landmark analysis we found a reduced risk of SARS-CoV-2 infection for vaccinated individuals who had a previous infection; HR (95% confidence interval) 0.54 (0.30, 0.95). For the 21-day landmark analysis, we observed high HRs for individuals with low and intermediate frailty compared with those without; 4.59 (1.23, 17.12) and 4.85 (1.68, 14.04), respectively.Conclusionsincreased risk of infection after 21 days was associated with frailty. 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spelling 2022-08-15T17:10:01.3042858 v2 58868 2021-12-02 COVID-19 infection risk amongst 14,104 vaccinated care home residents: a national observational longitudinal cohort study in Wales, UK, December 2020–March 2021 d7c51b69270b644a11b904629fe56ab0 Joe Hollinghurst Joe Hollinghurst true false a255822cf77a0184cb6922e9fbea39e9 Laura North Laura North true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 70a544476ce62ba78502ce463c2500d6 0000-0003-0710-0947 Michael Gravenor Michael Gravenor true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false d499b898d447b62c81b2c122598870e0 0000-0002-7968-6679 Rich Fry Rich Fry true false 2021-12-02 FGMHL Backgroundvaccinations for COVID-19 have been prioritised for older people living in care homes. However, vaccination trials included limited numbers of older people.Aimwe aimed to study infection rates of SARS-CoV-2 for older care home residents following vaccination and identify factors associated with increased risk of infection.Study Design and Settingwe conducted an observational data-linkage study including 14,104 vaccinated older care home residents in Wales (UK) using anonymised electronic health records and administrative data.Methodswe used Cox proportional hazards models to estimate hazard ratios (HRs) for the risk of testing positive for SARS-CoV-2 infection following vaccination, after landmark times of either 7 or 21 days post-vaccination. We adjusted HRs for age, sex, frailty, prior SARS-CoV-2 infections and vaccination type.Resultswe observed a small proportion of care home residents with positive polymerase chain reaction (tests following vaccination 1.05% (N = 148), with 90% of infections occurring within 28 days. For the 7-day landmark analysis we found a reduced risk of SARS-CoV-2 infection for vaccinated individuals who had a previous infection; HR (95% confidence interval) 0.54 (0.30, 0.95). For the 21-day landmark analysis, we observed high HRs for individuals with low and intermediate frailty compared with those without; 4.59 (1.23, 17.12) and 4.85 (1.68, 14.04), respectively.Conclusionsincreased risk of infection after 21 days was associated with frailty. We found most infections occurred within 28 days of vaccination, suggesting extra precautions to reduce transmission risk should be taken in this time frame. Journal Article Age and Ageing 51 1 Oxford University Press (OUP) 0002-0729 1468-2834 COVID-19, SARS-CoV-2, vaccination, care homes, older people 1 1 2022 2022-01-01 10.1093/ageing/afab223 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University SU Library paid the OA fee (TA Institutional Deal) HCRW_SCG-19-1654/HCRW/HCRW_/United Kingdom, MR/V028367/1/MRC_/Medical Research Council/United Kingdom, HDR-9006/HCRW/HCRW_/United Kingdom, ES/S007393/1/Economic and Social Research Council. 2022-08-15T17:10:01.3042858 2021-12-02T09:39:10.2370517 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Joe Hollinghurst 1 Laura North 2 Malorie Perry 3 Ashley Akbari 0000-0003-0814-0801 4 Michael Gravenor 0000-0003-0710-0947 5 Ronan Lyons 0000-0001-5225-000X 6 Rich Fry 0000-0002-7968-6679 7 58868__21977__624636f781cf4bf4ae7abf9949783a06.pdf 58868.pdf 2021-12-31T13:43:12.2575315 Output 374268 application/pdf Version of Record true © The Author(s) 2021. This is an Open Access article distributed under the terms of the Creative Commons Attribution License true eng http://creativecommons.org/licenses/by/4.0/
title COVID-19 infection risk amongst 14,104 vaccinated care home residents: a national observational longitudinal cohort study in Wales, UK, December 2020–March 2021
spellingShingle COVID-19 infection risk amongst 14,104 vaccinated care home residents: a national observational longitudinal cohort study in Wales, UK, December 2020–March 2021
Joe Hollinghurst
Laura North
Ashley Akbari
Michael Gravenor
Ronan Lyons
Rich Fry
title_short COVID-19 infection risk amongst 14,104 vaccinated care home residents: a national observational longitudinal cohort study in Wales, UK, December 2020–March 2021
title_full COVID-19 infection risk amongst 14,104 vaccinated care home residents: a national observational longitudinal cohort study in Wales, UK, December 2020–March 2021
title_fullStr COVID-19 infection risk amongst 14,104 vaccinated care home residents: a national observational longitudinal cohort study in Wales, UK, December 2020–March 2021
title_full_unstemmed COVID-19 infection risk amongst 14,104 vaccinated care home residents: a national observational longitudinal cohort study in Wales, UK, December 2020–March 2021
title_sort COVID-19 infection risk amongst 14,104 vaccinated care home residents: a national observational longitudinal cohort study in Wales, UK, December 2020–March 2021
author_id_str_mv d7c51b69270b644a11b904629fe56ab0
a255822cf77a0184cb6922e9fbea39e9
aa1b025ec0243f708bb5eb0a93d6fb52
70a544476ce62ba78502ce463c2500d6
83efcf2a9dfcf8b55586999d3d152ac6
d499b898d447b62c81b2c122598870e0
author_id_fullname_str_mv d7c51b69270b644a11b904629fe56ab0_***_Joe Hollinghurst
a255822cf77a0184cb6922e9fbea39e9_***_Laura North
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
70a544476ce62ba78502ce463c2500d6_***_Michael Gravenor
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
d499b898d447b62c81b2c122598870e0_***_Rich Fry
author Joe Hollinghurst
Laura North
Ashley Akbari
Michael Gravenor
Ronan Lyons
Rich Fry
author2 Joe Hollinghurst
Laura North
Malorie Perry
Ashley Akbari
Michael Gravenor
Ronan Lyons
Rich Fry
format Journal article
container_title Age and Ageing
container_volume 51
container_issue 1
publishDate 2022
institution Swansea University
issn 0002-0729
1468-2834
doi_str_mv 10.1093/ageing/afab223
publisher Oxford University Press (OUP)
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description Backgroundvaccinations for COVID-19 have been prioritised for older people living in care homes. However, vaccination trials included limited numbers of older people.Aimwe aimed to study infection rates of SARS-CoV-2 for older care home residents following vaccination and identify factors associated with increased risk of infection.Study Design and Settingwe conducted an observational data-linkage study including 14,104 vaccinated older care home residents in Wales (UK) using anonymised electronic health records and administrative data.Methodswe used Cox proportional hazards models to estimate hazard ratios (HRs) for the risk of testing positive for SARS-CoV-2 infection following vaccination, after landmark times of either 7 or 21 days post-vaccination. We adjusted HRs for age, sex, frailty, prior SARS-CoV-2 infections and vaccination type.Resultswe observed a small proportion of care home residents with positive polymerase chain reaction (tests following vaccination 1.05% (N = 148), with 90% of infections occurring within 28 days. For the 7-day landmark analysis we found a reduced risk of SARS-CoV-2 infection for vaccinated individuals who had a previous infection; HR (95% confidence interval) 0.54 (0.30, 0.95). For the 21-day landmark analysis, we observed high HRs for individuals with low and intermediate frailty compared with those without; 4.59 (1.23, 17.12) and 4.85 (1.68, 14.04), respectively.Conclusionsincreased risk of infection after 21 days was associated with frailty. We found most infections occurred within 28 days of vaccination, suggesting extra precautions to reduce transmission risk should be taken in this time frame.
published_date 2022-01-01T04:15:44Z
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