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

Oliver Stirrup*, Madhumita Shrotri, Natalie L Adams, Maria Krutikov, Borscha Azmi, Igor Monakhov, Gokhan Tut, Paul Moss, Andrew Hayward, Andrew Copas, Laura Shallcross

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

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.

Original languageEnglish
Article numberafad141
Number of pages6
JournalAge and Ageing
Volume52
Issue number8
Early online date12 Aug 2023
DOIs
Publication statusPublished - Aug 2023

Bibliographical note

Funding:
This work is independent research funded by the Department of Health and Social Care (COVID-19 surveillance studies). MK is funded by a Wellcome Trust Clinical PhD Fellowship (222907/Z/21/Z). LS is funded by a National Institute for Health Research Clinician Scientist Award (CS-2016-007). AH is supported by Health Data Research UK (LOND1), which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust. The funders did not have a role in the design, execution, analysis and interpretation of data, or writing of this study.

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

Keywords

  • Aged
  • Humans
  • COVID-19/mortality
  • Long-Term Care
  • Prospective Studies
  • SARS-CoV-2
  • Skilled Nursing Facilities
  • COVID-19 Vaccines/administration & dosage
  • Vaccine Efficacy
  • England/epidemiology

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