Continued need for non-pharmaceutical interventions after COVID-19 vaccination in long-term-care facilities

Jay Love,David L Swerdlow,Kimberly M Shea,Frederick J Angulo,Lindsay T Keegan,Damon J A Toth,John M Mclaughlin,Matthew H Samore

doi:10.1038/s41598-021-97612-w

Jay Love, David L Swerdlow + Show 6 more

Open Access

https://doi.org/10.1038/s41598-021-97612-w

Copy DOI

Journal: Scientific Reports	Publication Date: Sep 10, 2021
Citations: 28	License type: open-access

Affiliation: Pfizer (United States), University of Utah

Abstract

Long-term care facilities (LTCFs) bear disproportionate burden of COVID-19 and are prioritized for vaccine deployment. LTCF outbreaks could continue occurring during vaccine rollout due to incomplete population coverage, and the effect of vaccines on viral transmission are currently unknown. Declining adherence to non-pharmaceutical interventions (NPIs) against within-facility transmission could therefore limit the effectiveness of vaccination. We built a stochastic model to simulate outbreaks in LTCF populations with differing vaccination coverage and NPI adherence to evaluate their interacting effects. Vaccination combined with strong NPI adherence produced the least morbidity and mortality. Healthcare worker vaccination improved outcomes in unvaccinated LTCF residents but was less impactful with declining NPI adherence. To prevent further illness and deaths, there is a continued need for NPIs in LTCFs during vaccine rollout.

Highlights

Long-term care facilities (LTCFs) bear disproportionate burden of COVID-19 and are prioritized for vaccine deployment
We found that all disease outcomes were highest in the absence of a vaccine and lowest within LTCFs when vaccine deployment was paired with strong adherence to non-pharmaceutical interventions (NPIs) (Scenario 1; 37% fewer infections, 61% fewer severe infections and hospitalizations, and 62% fewer deaths than baseline; Fig. 1)
If those unvaccinated individuals are more prone to severe disease outcomes, as are residents in LTCFs when compared to healthcare workers, population-level morbidity and mortality may not experience the expected decline associated with vaccination

Summary

Introduction

Long-term care facilities (LTCFs) bear disproportionate burden of COVID-19 and are prioritized for vaccine deployment. We simulated three scenarios for levels of NPI adherence, quantified by possible facility-specific rates of transmission-relevant resident-to-resident contact.

Results

Conclusion