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Investigation of a Severe Acute Respiratory Syndrome Coronavirus 2 Delta (B.1.617.2) Variant Outbreak Among Residents of a Skilled Nursing Facility and Vaccine Effectiveness Analysis: Maricopa County, Arizona, June-July 2021.
Dale, Ariella P; Almendares, Olivia; Howard, Brandon J; Burnett, Eleanor; Prasai, Siru; Arons, Melissa; Collins, Jennifer; Duffy, Nadezdha; Pandit, Urvashi; Brady, Shane; White, Jessica R; Garrett, Brenna; Kirking, Hannah L; Sunenshine, Rebecca; Tate, Jacqueline E; Scott, Sarah E.
  • Dale AP; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA.
  • Almendares O; Maricopa County Department of Public Health, Phoenix, Arizona, USA.
  • Howard BJ; Arizona Department of Health Services, Phoenix, Arizona, USA.
  • Burnett E; Centers for Disease Control and Prevention COVID-19 Response, Atlanta, GeorgiaUSA.
  • Prasai S; Maricopa County Department of Public Health, Phoenix, Arizona, USA.
  • Arons M; Centers for Disease Control and Prevention COVID-19 Response, Atlanta, GeorgiaUSA.
  • Collins J; Maricopa County Department of Public Health, Phoenix, Arizona, USA.
  • Duffy N; Centers for Disease Control and Prevention COVID-19 Response, Atlanta, GeorgiaUSA.
  • Pandit U; Maricopa County Department of Public Health, Phoenix, Arizona, USA.
  • Brady S; Centers for Disease Control and Prevention COVID-19 Response, Atlanta, GeorgiaUSA.
  • White JR; Maricopa County Department of Public Health, Phoenix, Arizona, USA.
  • Garrett B; Arizona Department of Health Services, Phoenix, Arizona, USA.
  • Kirking HL; Maricopa County Department of Public Health, Phoenix, Arizona, USA.
  • Sunenshine R; Arizona Department of Health Services, Phoenix, Arizona, USA.
  • Tate JE; Centers for Disease Control and Prevention COVID-19 Response, Atlanta, GeorgiaUSA.
  • Scott SE; Maricopa County Department of Public Health, Phoenix, Arizona, USA.
Clin Infect Dis ; 75(1): e20-e26, 2022 08 24.
Article in English | MEDLINE | ID: covidwho-1853000
ABSTRACT

BACKGROUND:

Short-term rehabilitation units present unique infection control challenges because of high turnover and medically complex residents. In June 2021, the Maricopa County Department of Public Health was notified of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta outbreak in a skilled nursing facility short-term rehabilitation unit. We describe the outbreak and assess vaccine effectiveness (VE).

METHODS:

Facility electronic medical records were reviewed for residents who spent > 1 night on the affected unit between June 10 and July 23, 2021, to collect demographics, SARS-CoV-2 test results, underlying medical conditions, vaccination status, and clinical outcomes. Coronavirus disease 2019 VE estimates using Cox proportional hazards models were calculated.

RESULTS:

Forty (37%) of 109 short-stay rehabilitation unit residents who met inclusion criteria tested positive for SARS-CoV-2. SARS-CoV-2-positive case-patients were mostly male (58%) and White (78%) with a median age of 65 (range, 27-92) years; 11 (27%) were immunocompromised. Of residents, 39% (10 cases, 32 noncases) received 2 doses and 9% (4 cases, 6 noncases) received 1 dose of messenger RNA (mRNA) vaccine. Among nonimmunocompromised residents, adjusted 2-dose primary-series mRNA VE against symptomatic infection was 80% (95% confidence interval, 15-95). More cases were hospitalized (33%) or died (38%) than noncases (10% hospitalized; 16% died).

CONCLUSIONS:

In this large SARS-CoV-2 Delta outbreak in a high-turnover short-term rehabilitation unit, a low vaccination rate and medically complex resident population were noted alongside severe outcomes. VE of 2-dose primary-series mRNA vaccine against symptomatic infection was the highest in nonimmunocompromised residents. Health departments can use vaccine coverage data to prioritize facilities for assistance in preventing outbreaks.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines / Variants Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines / Variants Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article