Direct and Indirect Effectiveness of mRNA Vaccination against Severe Acute Respiratory Syndrome Coronavirus 2 in Long-Term Care Facilities, Spain

• Main Authors: Susana Monge, Carmen Olmedo, Belén Alejos, María Fé Lapeña, María José Sierra, Aurora Limia
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2021-10-01
• Series: Emerging Infectious Diseases
• Subjects: COVID-19; coronavirus disease; SARS-CoV-2; severe acute respiratory syndrome coronavirus 2; viruses; respiratory infections
• Online Access: https://wwwnc.cdc.gov/eid/article/27/10/21-1184_article

We conducted a registries-based cohort study of long-term care facility residents >65 years of age offered vaccination against severe acute respiratory syndrome coronavirus 2 before March 10, 2021, in Spain. Risk for infection in vaccinated and nonvaccinated persons was compared with risk in the same persons in a period before the vaccination campaign, adjusted by daily-varying incidence and reproduction number. We selected 299,209 persons; 99.0% had >1 dose, 92.6% had 2 doses, and 99.8% of vaccines were Pfizer/BioNTech (BNT162b2). For vaccinated persons with no previous infection, vaccine effectiveness was 81.8% (95% CI 81.0%–82.7%), and 11.6 (95% CI 11.3–11.9) cases were prevented per 10,000 vaccinated/day. In those with previous infection, effectiveness was 56.8% (95% CI 47.1%–67.7%). In nonvaccinated residents with no previous infection, risk decreased by up to 81.4% (95% CI 73.3%–90.3%). Our results confirm vaccine effectiveness in this population and suggest indirect protection in nonvaccinated persons.