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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
Age and Ageing, Volume: 51, Issue: 1
Swansea University Authors:
Joe Hollinghurst, Laura North, Ashley Akbari , Michael Gravenor
, Ronan Lyons
, Rich Fry
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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...
Published in: | Age and Ageing |
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ISSN: | 0002-0729 1468-2834 |
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Oxford University Press (OUP)
2022
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URI: | https://cronfa.swan.ac.uk/Record/cronfa58868 |
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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 |
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Journal article |
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Age and Ageing |
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51 |
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2022 |
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Swansea University |
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0002-0729 1468-2834 |
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10.1093/ageing/afab223 |
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Oxford University Press (OUP) |
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Faculty of Medicine, Health and Life Sciences |
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Faculty of Medicine, Health and Life Sciences |
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Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine |
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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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1763754056903294976 |
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11.021648 |