lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

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

28 Pages Posted: 9 Apr 2021

See all articles by Carmen Cabezas

Carmen Cabezas

Generalitat de Catalunya - Department of Health

Ermengol Coma

Generalitat de Catalunya - Direcció assistencial d’Atenció Primària i a la Comunitat

Nuria Mora-Fernandez

Generalitat de Catalunya - Direcció assistencial d’Atenció Primària i a la Comunitat

Xintong Li

University of Oxford - Centre for Statistics in Medicine

Montse Martinez-Marcos

Generalitat de Catalunya - Department of Health

Francesc Fina-Aviles

Institut Català de la Salut - Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP)

Mireia Fabregas

Generalitat de Catalunya - Direcció assistencial d’Atenció Primària i a la Comunitat

Eduardo Hermosilla

Universitat Autonoma de Barcelona - Idiap Jordi Gol

Angel Jover

Generalitat de Catalunya - Direcció assistencial d’Atenció Primària i a la Comunitat

Juan Carlos Contel

Generalitat de Catalunya - Chronic Care Program

Yolanda Lejardi

Generalitat de Catalunya - Direcció assistencial d’Atenció Primària i a la Comunitat

Belen Enfedaque

Generalitat de Catalunya - Direcció assistencial d’Atenció Primària i a la Comunitat

Josep Maria Argimon

Generalitat de Catalunya - Department of Health

Manuel Medina-Peralta

Institut Català de la Salut - Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP)

Daniel Prieto-Alhambra

Erasmus University Rotterdam (EUR) - Erasmus Medical Center (MC)

More...

Abstract

Background: Spain began vaccinating priority groups against COVID-19 with BNT162b2 in late December 2020. We report associations of vaccination with COVID-19 infection, hospitalisation, and mortality among nursing home residents, nursing home staff, and healthcare workers. 

Methods: We analysed three cohorts of all nursing home residents, nursing home staff, and healthcare workers in Catalonia on 27 December 2020. Data were obtained from linked primary care, RT-PCR and lateral flow test, hospital, and mortality records. Those with a pre-study COVID-19 diagnosis or no linked electronic medical records were excluded. Two doses of BNT162b2 were administered 3 weeks apart. Participants were followed until the earliest of an outcome (confirmed COVID-19 infection, hospitalisation, and mortality) or 5 March 2021. Participants could contribute data to the unvaccinated, one-dose, and two-dose groups. Analyses were conducted using time-varying Cox regression. Multivariable adjustment for imbalances in socio-demographics, comorbidity, and polypharmacy. 

Findings: We included 28,594 nursing home residents, 26,238 nursing home staff, and 61,951 healthcare workers, of whom 2,405, 1,584, and 2,672 received COVID-19 diagnoses; 383, 35, and 76 were hospitalised; and 409, 0, and 1 died. The adjusted hazard ratio (HR) (95% confidence interval) for COVID-19 infection after two-dose vaccination was 0·08 (0·07-0·09) for nursing home residents, 0·12 (0·10-0·15) for nursing home staff, and 0·05 (0·04-0·07) for healthcare workers. The adjusted HRs for hospitalisation and mortality after two-dose vaccination were 0·03 (0·02-0·05) and 0·02 (0·01-0·03), respectively, for nursing home residents. Nursing home staff and healthcare workers recorded insufficient events for mortality analysis. Interpretation Vaccination was associated with 85%-96% reduction in SARS-CoV-2 infection in all three cohorts, and bigger reductions in hospitalisations and mortality amongst nursing home residents for up to two months. More data are needed on the long-term effects of COVID-19 vaccines. 

Funding: Partially supported by National Institute of Health Research UK, We do not have any other funding acknowledgements.

Declaration of Interest: None to declare.

Ethical Approval: The study was approved by the Clinical Research Ethics Committee of the IDIAP Jordi Gol with reference number 21/045-PCV.

Keywords: care home, COVID19 vaccine, effectiveness

Suggested Citation

Cabezas, Carmen and Coma, Ermengol and Mora-Fernandez, Nuria and Li, Xintong and Martinez-Marcos, Montse and Fina-Aviles, Francesc and Fabregas, Mireia and Hermosilla, Eduardo and Jover, Angel and Contel, Juan Carlos and Lejardi, Yolanda and Enfedaque, Belen and Argimon, Josep Maria and Medina-Peralta, Manuel and Prieto-Alhambra, Daniel, 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. Available at SSRN: https://ssrn.com/abstract=3815682 or http://dx.doi.org/10.2139/ssrn.3815682

Carmen Cabezas

Generalitat de Catalunya - Department of Health ( email )

Barcelona
Spain

Ermengol Coma

Generalitat de Catalunya - Direcció assistencial d’Atenció Primària i a la Comunitat

Spain

Nuria Mora-Fernandez

Generalitat de Catalunya - Direcció assistencial d’Atenció Primària i a la Comunitat ( email )

Spain

Xintong Li

University of Oxford - Centre for Statistics in Medicine

Oxford
United Kingdom

Montse Martinez-Marcos

Generalitat de Catalunya - Department of Health ( email )

Barcelona
Spain

Francesc Fina-Aviles

Institut Català de la Salut - Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP) ( email )

Barcelona
Spain

Mireia Fabregas

Generalitat de Catalunya - Direcció assistencial d’Atenció Primària i a la Comunitat ( email )

Spain

Eduardo Hermosilla

Universitat Autonoma de Barcelona - Idiap Jordi Gol

Angel Jover

Generalitat de Catalunya - Direcció assistencial d’Atenció Primària i a la Comunitat ( email )

Spain

Juan Carlos Contel

Generalitat de Catalunya - Chronic Care Program

Spain

Yolanda Lejardi

Generalitat de Catalunya - Direcció assistencial d’Atenció Primària i a la Comunitat ( email )

Spain

Belen Enfedaque

Generalitat de Catalunya - Direcció assistencial d’Atenció Primària i a la Comunitat ( email )

Spain

Josep Maria Argimon

Generalitat de Catalunya - Department of Health

Spain

Manuel Medina-Peralta

Institut Català de la Salut - Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP)

Barcelona
Spain

Daniel Prieto-Alhambra (Contact Author)

Erasmus University Rotterdam (EUR) - Erasmus Medical Center (MC) ( email )