COVID‐19 and vaccination programme in one residential home

Abstract

BackgroundApproximately 410 000 people live in care homes (CH) or residential settings in the UK, with the majority of this population being above the age of 85, making this group fall in the category of higher risk of more severe COVID‐19 symptoms and death. CH have been disproportionately affected by COVID‐19, people living and working in these settings have a higher risk of exposure to infection and higher risk of severe disease and mortality. CH residents and staff were prioritised for the vaccination programme in the UK due to increased risk of outbreaks, morbidity and mortality.MethodOne Residential home reported a COVID‐19 outbreak following the vaccination programme. Most staff vaccinated between 16‐18 December 2020, and most residents vaccinated on 30/12/2020. Residents were on isolation from 22/12/2020 prior to vaccination. The first positive COVID‐19 case was on 27th December. Staff and residents were scored according to the World Health Organisation (WHO) Ordinal Scale for Clinical Improvement (OSCI), table 1.ResultOf staff vaccinated, 20,83% (n=5) tested positive for COVID‐19. Nine staff members (27.28%) didn't have the vaccine, with 7 of these (77.78%) developing more limiting symptoms (OSCI score 2), compared to 8.33% (n=2) of those who had the vaccine. With 100% of residents vaccinated, 21 residents (65,63%) developed COVID‐19 symptoms, and 31.25% (n=10) developing more limiting COVID‐19 symptoms or death. Nineteen residents have a diagnosis of dementia and 63.16% (n=12) developed COVID‐19 symptoms and 50% (n=6) of those with dementia died, whilst those without dementia did not have any deaths reported.ConclusionAlthough this reflects the experience of a single CH, it is of relevance in suggesting substantial protection for staff who have been vaccinated, even though there was only 11 days between vaccination and the start of the outbreak.The experience in this CH starkly emphasizes the poor outcomes of COVID‐19 for residents, especially those with dementia, and unfortunately suggests that there are no benefits from vaccination as a secondary prevention approach once an outbreak has started. Ongoing evaluation will be important to optimize the delivery of the vaccination programme in CH settings, and to optimize staff take up of the vaccine.