Effectiveness of a COVID-19 Additional Primary or Booster Vaccine Dose in Preventing SARS-CoV-2 Infection Among Nursing Home Residents During Widespread Circulation of the Omicron Variant — United States, February 14–March 27, 2022
Namrata Prasad, Gordana Derado, Srinivas Nanduri, Hannah E. Reses, Heather Dubendris, Emily Wong, Minn Soe, Qunna Li, Philip Dollard, Suparna Bagchi, Jonathan R. Edwards, Nong Shang, Dan Budnitz, Jeneita M. Bell, Jennifer R. Verani, Andrea L. Benin, Ruth Link‐Gelles, John A. Jernigan, Tamara Pilishvili
Abstract
Nursing home residents have experienced disproportionally high levels of COVID-19-associated morbidity and mortality and were prioritized for early COVID-19 vaccination (1). Following reported declines in vaccine-induced immunity after primary series vaccination, defined as receipt of 2 primary doses of an mRNA vaccine (BNT162b2 [Pfizer-BioNTech] or mRNA-1273 [Moderna]) or 1 primary dose of Ad26.COV2 (Johnson & Johnson [Janssen]) vaccine (2), CDC recommended that all persons aged 12 years receive a COVID-19 booster vaccine dose.* Moderately to severely immunocompromised persons, a group that includes many nursing home residents, are also recommended to receive an additional primary COVID-19 vaccine dose. Data on vaccine effectiveness (VE) of an additional primary or booster dose against infection with SARS-CoV-2 (the virus that causes COVID-19) among nursing home residents are limited, especially against the highly transmissible B.1.1.529 and BA.2 (Omicron) variants. Weekly COVID-19 surveillance and vaccination coverage data among nursing home residents, reported by skilled nursing facilities (SNFs) to CDC's National Healthcare Safety Network (NHSN) during February 14-March 27, 2022, when the Omicron variant accounted for >99% of sequenced isolates, were analyzed to estimate relative * During September-October, 2021, CDC recommended use of a single COVID-19 vaccine booster dose for all persons aged 18 years, 6 months after receipt of a primary mRNA vaccination series or 2 months after receipt of a primary Janssen vaccine dose. During January, 2022, CDC updated booster recommendations, shortening the interval from 6 months to 5 months for receiving an mRNA booster dose after a primary mRNA vaccination series. In January, 2022, CDC also expanded eligibility of booster doses, recommending that adolescents aged 12-17 years receive a booster dose 5 months after a primary Pfizer-BioNTech vaccination series. https://www.cdc.gov/vaccines/covid-19/ clinical-considerations/covid- 19-vaccines-us.html (Accessed March 27, 2022). https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/ immuno.html (Accessed March 27, 2022). CDC's NHSN provides health care facilities, such as skilled nursing and longterm care facilities with a platform for reporting outcomes and process measures. COVID-19 related vaccination and surveillance data are reported to NHSN through the long-term care facilities COVID-19 Module. https://www.cdc. gov/nhsn/ltc/covid19/index.html