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

doi:10.1093/ageing/afad141

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 journal › Article › peer-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 language	English
Article number	afad141
Number of pages	6
Journal	Age and Ageing
Volume	52
Issue number	8
Early online date	12 Aug 2023
DOIs	https://doi.org/10.1093/ageing/afad141
Publication status	Published - 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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Stirrup, O., Shrotri, M., Adams, N. L., Krutikov, M., Azmi, B., Monakhov, I., Tut, G., Moss, P., Hayward, A., Copas, A., & Shallcross, L. (2023). Effectiveness of successive booster vaccine doses against SARS-CoV-2 related mortality in residents of long-term care facilities in the VIVALDI study. Age and Ageing, 52(8), Article afad141. https://doi.org/10.1093/ageing/afad141

@article{92693e72d15b4f01b8a5ca4e495f619c,

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

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.",

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",

author = "Oliver Stirrup and Madhumita Shrotri and Adams, {Natalie L} and Maria Krutikov and Borscha Azmi and Igor Monakhov and Gokhan Tut and Paul Moss and Andrew Hayward and Andrew Copas and Laura Shallcross",

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: {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society.",

year = "2023",

month = aug,

doi = "10.1093/ageing/afad141",

language = "English",

volume = "52",

journal = "Age and Ageing",

issn = "0002-0729",

publisher = "SIPRI/Oxford University Press",

number = "8",

}

TY - JOUR

T1 - Effectiveness of successive booster vaccine doses against SARS-CoV-2 related mortality in residents of long-term care facilities in the VIVALDI study

AU - Stirrup, Oliver

AU - Shrotri, Madhumita

AU - Adams, Natalie L

AU - Krutikov, Maria

AU - Azmi, Borscha

AU - Monakhov, Igor

AU - Tut, Gokhan

AU - Moss, Paul

AU - Hayward, Andrew

AU - Copas, Andrew

AU - Shallcross, Laura

N1 - 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.

PY - 2023/8

Y1 - 2023/8

N2 - 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.

AB - 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.

KW - Aged

KW - Humans

KW - COVID-19/mortality

KW - Long-Term Care

KW - Prospective Studies

KW - SARS-CoV-2

KW - Skilled Nursing Facilities

KW - COVID-19 Vaccines/administration & dosage

KW - Vaccine Efficacy

KW - England/epidemiology

U2 - 10.1093/ageing/afad141

DO - 10.1093/ageing/afad141

M3 - Article

C2 - 37595069

SN - 0002-0729

VL - 52

JO - Age and Ageing

JF - Age and Ageing

IS - 8

M1 - afad141

ER -

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

Abstract

Bibliographical note

Keywords

UN SDGs

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