Effects of BNT162b2 mRNA Vaccination on COVID-19 Disease, Hospitalisation and Mortality in Nursing Homes and Healthcare Workers: A Prospective Cohort Study Including 28,594 Nursing Home Residents, 26,238 Nursing Home Staff, and 61,951 Healthcare Workers in Catalonia

2021 ◽  
Author(s):  
Carmen Cabezas ◽  
Ermengol Coma ◽  
Nuria Mora-Fernandez ◽  
Xintong Li ◽  
Montse Martinez-Marcos ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Nursing Homes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Nursing Home Residents ◽  
Nursing Home Staff

scholarly journals Associations of BNT162b2 vaccination with SARS-CoV-2 infection and hospital admission and death with covid-19 in nursing homes and healthcare workers in Catalonia: prospective cohort study

BMJ ◽  
2021 ◽  
pp. n1868
Author(s):  
Carmen Cabezas ◽  
Ermengol Coma ◽  
Nuria Mora-Fernandez ◽  
Xintong Li ◽  
Montse Martinez-Marcos ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Nursing Homes ◽  
Hospital Admission ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Nursing Home Residents ◽  
Nursing Home Staff ◽  
Hazard Ratios

Abstract Objective To determine associations of BNT162b2 vaccination with SARS-CoV-2 infection and hospital admission and death with covid-19 among nursing home residents, nursing home staff, and healthcare workers. Design Prospective cohort study. Setting Nursing homes and linked electronic medical record, test, and mortality data in Catalonia on 27 December 2020. Participants 28 456 nursing home residents, 26 170 nursing home staff, and 61 791 healthcare workers. Main outcome measures Participants were followed until the earliest outcome (confirmed SARS-CoV-2 infection, hospital admission or death with covid-19) or 26 May 2021. Vaccination status was introduced as a time varying exposure, with a 14 day run-in after the first dose. Mixed effects Cox models were fitted to estimate hazard ratios with index month as a fixed effect and adjusted for confounders including sociodemographics, comorbidity, and previous medicine use. Results Among the nursing home residents, SARS-CoV-2 infection was found in 2482, 411 were admitted to hospital with covid-19, and 450 died with covid-19 during the study period. In parallel, 1828 nursing home staff and 2968 healthcare workers were found to have SARS-CoV-2 infection, but fewer than five were admitted or died with covid-19. The adjusted hazard ratio for SARS-CoV-2 infection after two doses of vaccine was 0.09 (95% confidence interval 0.08 to 0.11) for nursing home residents, 0.20 (0.17 to 0.24) for nursing home staff, and 0.13 (0.11 to 0.16) for healthcare workers. Adjusted hazard ratios for hospital admission and mortality after two doses of vaccine were 0.05 (0.04 to 0.07) and 0.03 (0.02 to 0.04), respectively, for nursing home residents. Nursing home staff and healthcare workers recorded insufficient events for mortality analysis. Conclusions Vaccination was associated with 80-91% reduction in SARS-CoV-2 infection in all three cohorts and greater reductions in hospital admissions and mortality among nursing home residents for up to five months. More data are needed on longer term effects of covid-19 vaccines.

scholarly journals Cancer events in Belgian nursing home residents (NHR): An EORTC prospective cohort study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13066-e13066
Author(s):  
Hans Wildiers ◽  
Monique Elseviers ◽  
Murielle E. Mauer ◽  
Jonas de Wolf ◽  
Edith Bastiaens ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Skin Cancer ◽  
Nursing Homes ◽  
Head And Neck ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Nursing Home Residents ◽  
Clinical Suspicion ◽  
Local Staff

e13066 Background: A large prospective cohort study was designed to describe cancer events, referral patterns, anticancer treatments and outcome in NHR. Methods: The study was set up in 39 nursing homes from the Armonea network in Belgium, covering 4262 nursing home beds. Cancer events were defined as a new cancer event (new cancer or progressive disease of a previously known cancer) where a diagnostic/treatment decision had to be taken; and patients with strong clinical suspicion (physician’s judgement) of a new cancer event, but where the decision was made not to take further diagnostic/therapeutic steps. Cancer events in NHR were collected during a 1y-period in these 39 nursing homes. After training, each site’s local staff identified patients with cancer events in collaboration with the treating general practitioner (GP). NHR were included after informed consent, and relevant data, including a questionnaire for the GP at baseline, were recorded at least every 3 months up to 2 years. Results: The study was open from 3-2015 till 3-2016 in 37 nursing homes (and 2 pilot nursing homes started and stopped 6 months earlier). In only 9 NHR (median age 87y, range 72-92), cancer events were recorded during this period (incidence rate = 222/100,000 NHR per year). The 9 tumor cases were: one strong clinical suspicion of new prostate cancer, and one undefined cancer; a strong clinical suspicion of breast cancer progression; 3 newly diagnosed cancers (angiosarcoma of the breast, head and neck plus gingiva cancer, and one undefined) ; 3 cases with diagnosed progression of a previously known tumor (skin cancer, head and neck cancer plus skin cancer, bladder cancer). During follow-up, 6/9 NHR died, with a median overall survival of 5 Mo (range 2-16 Mo). Further details on diagnostic/therapeutic approach and outcome are pending. Conclusions: This study evaluated for the first time cancer events prospectively in a large nursing home population. Clinically relevant cancer events occur at a much lower frequency in NHR than expected from cancer incidence data in the general older population, supporting several previous retrospective observations that cancer events are much less frequent and problematic in very frail older persons than previously expected. Clinical trial information: NCT01910376.

Double-swab 5% versus single-swab 10% iodophor for reducing methicillin-resistant Staphylococcus aureus with routine chlorhexidine bathing

2021 ◽  
pp. 1-3
Author(s):  
Lauren T. Heim ◽  
Loren G. Miller ◽  
Raveena D. Singh ◽  
James A. McKinnell ◽  
Tabitha D. Catuna ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Nursing Home ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Nursing Home Residents ◽  
Nasal Carriage ◽  
Methicillin Resistant ◽  
Chlorhexidine Bathing

Abstract In a prospective cohort study, we compared a 2-swabs-per-nostril 5% iodophor regimen with a 1-swab-per-nostril 10% iodophor regimen on methicillin-resistant Staphylococcus aureus carriage in nursing-home residents. Compared with baseline, both single-swab and double-swab regimens resulted in an identical 40% reduction in nasal carriage and 60% reduction in any carriage, skin or nasal.

scholarly journals Cancer events in Belgian nursing home residents: An EORTC prospective cohort study

2019 ◽  
Vol 10 (5) ◽  
pp. 805-810 ◽  
Author(s):  
Hans Wildiers ◽  
Murielle Mauer ◽  
Monique Elseviers ◽  
Jonas De Wolf ◽  
Sigrid Hatse ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Nursing Home Residents

scholarly journals Initiation of advance care planning in newly admitted nursing home residents in Flanders, Belgium: A prospective cohort study

2018 ◽  
Vol 19 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Kristel Paque ◽  
Ivana Ivanova ◽  
Monique Elseviers ◽  
Robert Vander Stichele ◽  
Tinne Dilles ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Prospective Cohort Study ◽  
Advance Care Planning ◽  
Prospective Cohort ◽  
Nursing Home Residents ◽  
Care Planning ◽  
Advance Care

scholarly journals COVID-19 vaccine impact on rates of SARS-CoV-2 cases and post vaccination strain sequences among healthcare workers at an urban academic medical center: a prospective cohort study

2021 ◽  
Author(s):  
Tara C. Bouton ◽  
Sara Lodi ◽  
Jacquelyn Turcinovic ◽  
Sarah E. Weber ◽  
Emily Quinn ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Positive Impact ◽  
Medical Center ◽  
Academic Medical Center ◽  
Post Vaccination ◽  
Unvaccinated Control ◽  
Rate Ratios

AbstractBackgroundCOVID-19 vaccine trials and post-implementation data suggest vaccination decreases SARS-CoV-2 infections. We examine COVID-19 vaccination’s impact on SARS-CoV-2 case rates and viral diversity among healthcare workers (HCW) during a high community prevalence period.MethodsA prospective cohort study from Boston Medical Center (BMC)’s HCW vaccination program, where staff received two doses of BNT162b2 or mRNA-1273. We included PCR-confirmed SARS-CoV-2 cases among HCWs from December 09, 2020 to February 23, 2021. Weekly SARS-CoV-2 rates per 100,000 person-day overall and by time from first injection (1-14 and >14 days) were compared with surrounding community rates. Viral genomes were sequenced from SARS CoV-2 positive samples.ResultsSARS-CoV-2 cases occurred in 1.4% (96/7109) of HCWs given at least a first dose and 0.3% (17/5913) of HCWs given both vaccine doses. Adjusted SARS-CoV-2 infection rate ratios were 0.73 (95% CI 0.53-1.00) 1-14 days and 0.18 (0.10-0.32) >14 days from first dose. HCW SARS-CoV-2 cases >14 days from initial dose compared to within 14 days were more often older (46 versus 38 years, p=0.007), Latinx (10% versus 8%, p=0.03), and asymptomatic (48% versus 11%, p=0.0002). SARS-CoV-2 rates among HCWs fell below those of the surrounding community, with a 18% versus 11% weekly decrease respectively (p=0.14). Comparison of 48 SARS-CoV-2 genomes sequenced from post-first dose cases did not indicate selection pressure towards known spike-antibody escape mutations.ConclusionsOur results indicate a positive impact of COVID-19 vaccines on SARS-CoV-2 case rates. Post-vaccination isolates did not show unusual genetic diversity or selection for mutations of concern.Main PointCases of SARS-CoV-2 among health care workers dropped rapidly with COVID-19 vaccination. Sequencing 48 breakthrough infections (overwhelmingly in 14 days after 1st dose) showed no clear sign of any differences in spike protein compared with time-matched, unvaccinated control sequences.

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