Antibody Response to Influenza Vaccination in Nursing Home Residents and Healthcare Workers During Four Successive Seasons in Niigata, Japan

2005 ◽  
Vol 26 (11) ◽  
pp. 859-866 ◽  
Author(s):  
Mizuho Sato ◽  
Reiko Saito ◽  
Naohito Tanabe ◽  
Makoto Nishikawa ◽  
Asami Sasaki ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Nursing Home ◽  
Antibody Response ◽  
Healthcare Workers ◽  
Geometric Mean ◽  
Nursing Home Residents ◽  
Antibody Responses ◽  
Fourfold Increase ◽  
Almost All ◽  
Underlying Diseases

AbstractObjective:To evaluate the antibody response to influenza vaccines in nursing home residents and healthcare workers (HCWs) and its relation to residents' functional and chronic disease status during four successive seasons.Design:Before-after study.Setting:Nine nursing homes during the 1998-1999 season and two during the 1999-2000, 2000-2001, and 2001-2002 seasons.Participants:Two hundred fifty-nine residents and 79 HCWs during the 1998-1999 season; 180 and 71, respectively, during the 1999-2000 season; 162 and 71, respectively, during the 2000-2001 season; and 153 and 79, respectively, during the 2001-2002 season.Results:Multivariate analysis indicated that the mean fold increase in the geometric mean titers (GMTs) of hemagglutination inhibition (HI) antibodies and the response rate (the proportion of vaccinées resulting in a significant, at least fourfold increase in antibody titer) were good and no significant differences occurred for almost all strains in both residents and HCWs. The GMTs of HI antibodies and the protection rate (the proportion of participants with HI antibody titers & 40) were increased in both residents and HCWs, but were significantly lower for almost all strains in residents than in HCWs. Furthermore, multivariate analysis indicated that subdivision of residents into three groups by level of daily activities and into four groups according to underlying diseases revealed only minor differences in immune responses.Conclusions:Antibody responses to the influenza vaccine were lower in residents than in HCWs. However, residents showed similar antibody responses regardless of their level of daily activity or underlying diseases.

scholarly journals Reduced BNT162b2 mRNA vaccine response in SARS-CoV-2-naive nursing home residents

2021 ◽  
Author(s):  
David H. Canaday ◽  
Lenore Carias ◽  
Oladayo A. Oyebanji ◽  
Debbie Keresztesy ◽  
Dennis Wilk ◽  
...  
Keyword(s):  
Nursing Home ◽  
Healthcare Workers ◽  
Nursing Home Residents ◽  
Antibody Responses ◽  
Control Measures ◽  
Vaccine Response ◽  
Infection Control Measures ◽  
Data Gap ◽  
Antibody Levels ◽  
Care Worker

AbstractThe SARS-CoV-2 pandemic impact on nursing home (NH) residents prompted their prioritization for early vaccination. To fill the data gap for vaccine immunogenicity in NH residents, we examined antibody levels after BNT162b2 mRNA vaccine to spike, receptor binding domain (RBD) and for virus neutralization in 149 NH residents and 111 health care worker controls. SARS-CoV-2-naive NH residents mount antibody responses with nearly 4-fold lower median neutralization titers and half the anti-spike level compared to SARS-CoV-2-naive healthcare workers. By contrast, SARS-CoV-2-recovered vaccinated NH residents had neutralization, anti-spike and anti-RBD titers similar to SARS-CoV-2-recovered vaccinated healthcare workers. NH residents’ blunted antibody responses have important implications regarding the quality and durability of protection afforded by neoantigen vaccines. We urgently need better longitudinal evidence on vaccine effectiveness specific to NH resident populations to inform best practices for NH infection control measures, outbreak prevention and potential indication for a vaccine boost.

scholarly journals Vaccination strategy and anti - SARS-CoV-2 S titers in healthcare workers of the INT – IRCCS “Fondazione Pascale” Cancer Center (Naples, Italy)

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ernesta Cavalcanti ◽  
Maria Antonietta Isgrò ◽  
Domenica Rea ◽  
Lucia Di Capua ◽  
Giusy Trillò ◽  
...  
Keyword(s):  
Immune Response ◽  
Immune Responses ◽  
Healthcare Workers ◽  
Geometric Mean ◽  
Vaccination Strategy ◽  
Antibody Responses ◽  
Cancer Center ◽  
Serum Samples ◽  
Humoral Immune ◽  
History Of

Abstract Background Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and the resulting disease, coronavirus disease 2019 (COVID-19), have spread to millions of people globally, requiring the development of billions of different vaccine doses. The SARS-CoV-2 spike mRNA vaccine (named BNT162b2/Pfizer), authorized by the FDA, has shown high efficacy in preventing SARS-CoV-2 infection after administration of two doses in individuals 16 years of age and older. In the present study, we retrospectively evaluated the differences in the SARS-CoV-2 humoral immune response after vaccine administration in the two different cohorts of workers at the INT - IRCCS “Fondazione Pascale” Cancer Center (Naples, Italy): previously infected to SARS-CoV-2 subjects and not infected to SARS-CoV-2 subjects. Methods We determined specific anti-RBD (receptor-binding domain) titers against trimeric spike glycoprotein (S) of SARS-CoV-2 by Roche Elecsys Anti-SARS-CoV-2 S immunoassay in serum samples of 35 healthcare workers with a previous documented history of SARS-CoV-2 infection and 158 healthcare workers without, after 1 and 2 doses of vaccine, respectively. Moreover, geometric mean titers and relative fold changes (FC) were calculated. Results Both previously infected and not infected to SARS-CoV-2 subjects developed significant immune responses to SARS-CoV-2 after the administration of 1 and 2 doses of vaccine, respectively. Anti-S antibody responses to the first dose of vaccine were significantly higher in previously SARS-CoV-2-infected subjects in comparison to titers of not infected subjects after the first as well as the second dose of vaccine. Fold changes for subjects previously infected to SARS-CoV-2 was very modest, given the high basal antibody titer, as well as the upper limit of 2500.0 BAU/mL imposed by the Roche methods. Conversely, for naïve subjects, mean fold change following the first dose was low ($$ \overline{x} $$ x ¯ =1.6), reaching 3.8 FC in 72 subjects (45.6%) following the second dose. Conclusions The results showed that, as early as the first dose, SARS-CoV-2-infected individuals developed a remarkable and statistically significant immune response in comparison to those who did not contract the virus previously, suggesting the possibility of administering only one dose in previously SARS-CoV-2-infected subjects. FC for previously infected subjects should not be taken into account for the generally high pre-vaccination values. Conversely, FC for not infected subjects, after the second dose, were = 3.8 in > 45.0% of vaccinees, and ≤ 3.1 in 19.0%, the latter showing a potential susceptibility to further SARS-CoV-2 infection.

scholarly journals Significant reduction in humoral immunity among healthcare workers and nursing home residents 6 months after COVID-19 BNT162b2 mRNA vaccination

2021 ◽  
Author(s):  
David H. Canaday ◽  
Oladayo A. Oyebanji ◽  
Debbie Keresztesy ◽  
Michael Payne ◽  
Dennis Wilk ◽  
...  
Keyword(s):  
Nursing Home ◽  
Humoral Immunity ◽  
Healthcare Workers ◽  
Limit Of Detection ◽  
Nursing Home Residents ◽  
Good Health ◽  
Neutralization Assay ◽  
Vaccine Response ◽  
Post Vaccination ◽  
Antibody Levels

AbstractHigh COVID-19 mortality among nursing home (NH) residents led to their prioritization for SARS-CoV-2 vaccination; most NH residents received BNT162b2 mRNA vaccination under the Emergency Use Authorization due to first to market and its availability. With NH residents’ poor initial vaccine response, the rise of NH breakthrough infections and outbreaks, characterization of the durability of immunity to inform public health policy on the need for boosting is needed. We report on humoral immunity from 2 weeks to 6-months post-vaccination in 120 NH residents and 92 ambulatory healthcare worker controls with and without pre-vaccination SARS-CoV-2 infection. Anti-spike and anti-receptor binding domain (RBD) IgG, and serum neutralization titers, were assessed using a bead-based ELISA method and pseudovirus neutralization assay. Anti-spike, anti-RBD and neutralization levels dropped more than 84% over 6 months’ time in all groups irrespective of prior SARS-CoV-2 infection. At 6 months post-vaccine, 70% of the infection-naive NH residents had neutralization titers at or below the lower limit of detection compared to 16% at 2 weeks after full vaccination. These data demonstrate a significant reduction in levels of antibody in all groups. In particular, those infection-naive NH residents had lower initial post-vaccination humoral immunity immediately and exhibited the greatest declines 6 months later. Healthcare workers, given their younger age and relative good-health, achieved higher initial antibody levels and better maintained them, yet also experienced significant declines in humoral immunity. Based on the rapid spread of the delta variant and reports of vaccine breakthrough in NH and among younger community populations, boosting NH residents may be warranted.

scholarly journals Interventions for Nursing Home Residents with Dysphagia—A Scoping Review

Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 55
Author(s):  
Dorte Melgaard ◽  
Albert Westergren ◽  
Conni Skrubbeltrang ◽  
David Smithard
Keyword(s):  
Nursing Home ◽  
Scoping Review ◽  
Oropharyngeal Dysphagia ◽  
Nursing Home Residents ◽  
Original Research ◽  
Publication Date ◽  
Next Of Kin ◽  
Study Designs ◽  
Underlying Diseases ◽  
Taste And Smell

Oropharyngeal dysphagia is common in nursing home residents. The objective of this scoping review was to summarize and disseminate the findings from the literature on interventions for dysphagia in nursing home residents. Searches were conducted in four databases. The criteria for including the studies were nursing home residents, dysphagia, interventions, original research, published in English, Danish, Norwegian, or Swedish with no restriction placed regarding publication date. Excluded were literature reviews, editorial comments, conference abstracts, protocols, papers not available in full text, and studies with a mixed population, for example, geriatric patients and nursing home residents and where the results were not separated between the groups. A total of 14 papers were included and analyzed. The included papers represented interventions focusing on feeding intervention, oral hygiene, caregiver algorithm, stimulation (taste and smell), teaching the residents what to eat, mobilization of the spine, exercises/training, and positioning. This scoping review identifies sparse knowledge about interventions affecting nursing home residents’ dysphagia. But the results indicate that multi-component interventions, including staff training, training of residents, and/or next of kin, might be successful. This scoping review clarifies that there is a need for well-designed studies that uncover which specific interventions have an effect in relation to nursing home residents with dysphagia and can serve as a guide for designing multi-component person-centered intervention studies. Future studies should implement high evidence study designs, define the measures of dysphagia, and quantify the severity of dysphagia, its underlying diseases, and comorbidities.

scholarly journals Antibody Response to 2-Dose Sars-Cov-2 mRNA Vaccine in Allogeneic Hematopoietic Cell Transplant Recipients

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 336-336
Author(s):  
Alexis Maillard ◽  
Rabah Redjoul ◽  
Marion Klemencie ◽  
Hélène Labussière ◽  
Amandine Le Bourgeois ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Antibody Response ◽  
Antibody Responses ◽  
Hematopoietic Cell ◽  
Time Interval ◽  
Cell Transplant ◽  
Transplant Recipients ◽  
Hematopoietic Cell Transplant ◽  
Allogeneic Hsct ◽  
The Past

Abstract INTRODUCTION Immunocompromised patients have been excluded from initial trials evaluating SARS-CoV-2 mRNA vaccines and there is a critical need to warrant vaccine efficacy in hematopoietic stem cell transplant (HSCT) recipients. In this study, we evaluated antibody responses to 2 doses mRNA SARS-CoV-2 vaccine in allogeneic HSCT recipients. METHODS We retrospectively enrolled successive hematopoietic cell transplant recipients across France who completed the 2-dose SARS-CoV-2 mRNA vaccine (BNT162b2 or mRNA-1273) between January 1 st and July 15 th 2021. All included patients had an available semi-quantitative antispike serologic testing after the second dose (from Roche, DiaSorin, Abbott or Siemens). We excluded patients with a prior COVID-19 confirmed by serology or PCR. For detectable antibody, we calculated the binding antibody units per milliliter (BAU/mL) according to the WHO International Standard by applying conversion factors given by the manufacturers (Kristiansen et al. , The Lancet 2021). Antibody response was categorized as "weak" or "good" with a threshold of 264 BAU/mL which has been associated to an estimate of 80% of mRNA vaccine-induced protection against symptomatic COVID-19 in immunocompetent patients (Feng S. et al., medRxiv 2021). We built a multivariate logistic regression model to assess factors independently associated with the absence of antibody response after the second dose of mRNA vaccination. RESULTS Overall, 620 allogeneic HSCT recipients from 12 hospitals across France were included in the analysis (60% male with a median age of 59 years old [IQR 47-66]), most with a myeloid (69%) or lymphoid (26%) malignancies. Donors were matched unrelated for 51%, HLA-identical sibling for 31% and haplo-identical for 18%. Thirty-one percent of HSCT recipients underwent a myeloablative conditioning, while 69% received a reduced intensity conditioning. The two doses of vaccines were given one month apart and the median time between transplantation and the initiation of vaccination was 29 months [IQR 14-58]. At a median of 33 [IQR 27-50] days after dose 2, an antibody response was detectable in 496 patients (80% [95CI: 77 to 83%]). Median [IQR] antibody levels was 243 BAU/mL [29.4-1391]. We classified detectable antibody responses as "weak" in 189 patients (30% [95CI 27 to 34%]) and as "good" in 306 (49% [95CI: 45 to 53%]). In the multivariate analysis including 533 patients (420 with detectable antibodies), factors associated with the absence of humoral responses were a time-interval from HSCT < 12 months (ajusted Odds-Ratio (aOR) 2.8 [95CI 1.6 to 4.8]), absolute lymphocyte count <1G/L (aOR 3.0 [95CI 1.7 to 5.0]), systemic immunosuppressive treatments within 3 months of vaccination (aOR 4.5 [95CI 2.7 to 7.5]), together with the use of rituximab within 6 months (aOR 15.1 [95CI 4.3 to 52.7]). In a subsequent multivariate analysis conducted a subset of 227 patients (170 with detectable antibodies) with available gammaglobulinemia as well as B and T lymphocytes counts, factors remaining associated with the absence of antibody response were only low B-lymphocytes count (aOR 5.5 [95CI 2.4 to 12.3]) and time-interval from HSCT < 12 months (aOR 3.3 [95CI 1.5 to 7.2]). CONCLUSION After 2 dose mRNA vaccination, the majority of allogeneic HSCT recipients developed an antibody response although a significant proportion of these responses may be insufficient. Studies are still needed to investigate the effect of a third vaccine dose in patients with a null or weak humoral response. Disclosures Loschi: Servier: Ended employment in the past 24 months, Honoraria; Novartis: Ended employment in the past 24 months, Honoraria; Gilead: Ended employment in the past 24 months, Honoraria; AbbVie: Ended employment in the past 24 months, Honoraria; CELGENE/BMS: Honoraria; MSD: Honoraria.

scholarly journals Antibody response after one and two doses of the BNT162b2 vaccine in nursing home residents: The CONsort-19 study

2021 ◽  
Author(s):  
Jean Bousquet ◽  
Hubert Blain ◽  
Edouard Tuaillon ◽  
Lucie Gamon ◽  
Amandine Pisoni ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Nursing Home ◽  
Antibody Response ◽  
Nursing Home Residents ◽  
Rt Pcr ◽  
Chain Reaction ◽  
S Protein ◽  
N Protein ◽  
Polymerase Chain ◽  
Low Levels

Methods: Twenty-two French nursing homes were included. COVID-19 had been diagnosed with real-time reverse-transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2. Blood S-protein IgG and nucleocapsid (N) IgG protein (N-protein IgG) were measured 21-24 days after the first jab (1,004 residents) and 6 weeks after the second (820 residents). Results: Among the 735 residents without prior COVID-19, 41.7% remained seronegative for S-protein IgG after the first jab vs 2.1% of the 270 residents with a previous positive RT-PCR (p<0.001). After the second jab, only 3% of the 586 residents without prior COVID-19 remained seronegative. However, 26.5% of them had low S-protein IgG levels (50-1050 UA/mL) vs 6.4% of the 222 residents with prior COVID-19. Residents with old infection (first wave), or seropositive for N-protein IgG at the time of vaccination, had the highest S-protein IgG levels. Residents with a prior COVID-19 infection had higher S-protein IgG levels after one dose than those without two jabs. Interpretation: A single vaccine jab is sufficient to reach immunity in residents with prior COVID-19. Most residents without prior COVID-19 are seropositive for S-protein IgG after the second jab, but around 30% have low levels of S-protein IgG. Whether residents with no or low post-vaccine immunity are at higher risk of symptomatic COVID-19 requires further analysis.

scholarly journals Vaccination strategy and anti - SARS-CoV-2 S titers in healthcare workers of the INT – IRCCS “Fondazione Pascale” Cancer Center (Naples, Italy)

2021 ◽  
Author(s):  
Ernesta Cavalcanti ◽  
Maria Antonietta Isgrò ◽  
Domenica Rea ◽  
Lucia Di Capua ◽  
Giusy Trillò ◽  
...  
Keyword(s):  
Immune Response ◽  
Immune Responses ◽  
Healthcare Workers ◽  
Geometric Mean ◽  
Vaccination Strategy ◽  
Antibody Responses ◽  
Cancer Center ◽  
Serum Samples ◽  
Humoral Immune ◽  
History Of

Abstract Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and the resulting disease, coronavirus disease 2019 (COVID-19), have spread to millions of people globally, requiring the development of billions of different vaccine doses. The SARS-CoV-2 spike mRNA vaccine (named BNT162b2/Pfizer), authorized by the FDA, has shown high efficacy in preventing SARS-CoV-2 infection after administration of two doses in individuals 16 years of age and older. In the present study, we retrospectively evaluated the differences in the SARS-CoV-2 humoral immune response after vaccine administration in the two different cohorts of workers at the INT - IRCCS “Fondazione Pascale” Cancer Center (Naples, Italy): previously exposed to SARS-CoV-2 subjects and not exposed to SARS-CoV-2 subjects.Methods: We determined specific anti-RBD (receptor-binding domain) titers against trimeric spike glycoprotein (S) of SARS-CoV-2 by Roche Elecsys Anti-SARS-CoV-2 S immunoassay in serum samples of 35 healthcare workers with a previous documented history of SARS-CoV-2 infection and 158 healthcare workers without, after 1 and 2 doses of vaccine, respectively. Moreover, geometric mean titers and relative fold changes (FC) were calculated.Results: Both previously exposed and not exposed to SARS-CoV-2 subjects developed significant immune responses to SARS-CoV-2 after the administration of 1 and 2 doses of vaccine, respectively. Anti-S antibody responses to the first dose of vaccine were significantly higher in previously SARS-CoV-2-exposed subjects in comparison to titers of not exposed subjects after the first as well as the second dose of vaccine. Fold changes for subjects previously exposed to SARS-CoV-2 was very modest, given the high basal antibody titer, as well as the upper limit of 2500.0 BAU/mL imposed by the Roche methods. Conversely, for naïve subjects, mean fold change following the first dose was low ( =1.6), reaching 3.8 FC in 72 subjects (45.6%) following the second dose.Conclusions: The results showed that, as early as the first dose, SARS-CoV-2-exposed individuals developed a remarkable and statistically significant immune response in comparison to those who did not contract the virus previously, suggesting the possibility of administering only one dose in previously SARS-CoV-2-exposed subjects. FC for previously exposed subjects should not be taken into account for the generally high pre-vaccination values. Conversely, FC for not exposed subjects, after the second dose, were = 3.8 in >45.0% of vaccinees, and ≤3.1 in 19.0%, the latter showing a potential susceptibility to further SARS-CoV-2 infection.

Very poor prognosis after a conservatively treated hip fracture in the most frail nursing home residents

2021 ◽  
pp. 1-3
Author(s):  
M.M.T.J. Broekman ◽  
J. de Vos ◽  
L. de Vijlder ◽  
M. Brundel
Keyword(s):  
Nursing Home ◽  
Hip Fracture ◽  
Median Survival ◽  
Primary Outcome ◽  
Nursing Home Residents ◽  
Inclusion Criteria ◽  
Severe Dementia ◽  
Exclusion Criteria ◽  
Group Methods ◽  
Almost All

Purpose: In very frail nursing home residents transport to the hospital for diagnostics in case of a suspected hip fracture might be considered too burdensome or not desirable. We aimed to elucidate the prognosis and disease course for this group. Methods: We performed a retrospective cohort study between 2017 and 2020 in a nursing home in the Netherlands. All patients with a suspected hip fracture were eligible. The main exclusion criteria was transport to the hospital for diagnostics. Our primary outcome is survival after one month. Results: 23 patients fulfilled the inclusion criteria. Median age was 84 years. Almost all patients had severe dementia. After one month 20 patients (87%) had died. Median survival was 5 days (interquartile range 3-8). Conclusion: In the most frail nursing home residents with a suspected hip fracture the prognosis is very poor with a median survival of only 5 days.

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