Frailty Reduces Vaccine Effectiveness Against SARS-CoV-2 Infection: A Test-Negative Case Control Study Using National VA Data.
J Nutr Health Aging
; 27(2): 81-88, 2023.
Article
in English
| MEDLINE | ID: covidwho-2245646
ABSTRACT
OBJECTIVES:
To assess the variation of vaccine effectiveness against SARS-CoV-2 infection during the Delta wave according to frailty status among U.S. veterans.DESIGN:
Test-negative case-control study of SARS-CoV-2 mRNA vaccine effectiveness.SETTING:
Veterans Health Administration (VHA) medical centers.PARTICIPANTS:
Veterans 19 years and older who had at least one COVID-19/Flu like symptoms and received a SARS-CoV-2 PCR or antigen test at VHA medical centers between July 25 to September 30, 2021. INTERVENTION mRNA vaccination. MEASUREMENTS New SARS-CoV-2 infection. Vaccine effectiveness was defined as 1-odds of vaccination in cases/odds of vaccination in controls, where cases were patients who had a COVID-19 test and tested positive for SARS-CoV-2, and controls were those who tested negative. Frailty was measured using the VA frailty index, categorized as robust (0-<0.1), pre-frail (≥0.1-<0.21) and frail (≥0.21).RESULTS:
A total of 58,604 patients (age58.9±17.0, median61, IQR45-72; 87.5%men; 68.1%white; 1.3%African American, 8.3%Hispanic) were included in the study. Of these, 27,733 (47.3%) were robust, 16,276 (27.8%) were prefrail, and 14,595 (24.9%) were frail. mRNA vaccine effectiveness against the Delta variant symptomatic infection was lower in patients with frailty, 62.8 %(95%CI59.8-65.7), versus prefrail 73.9%(95%CI72.0-75.7), and robust, 77.0 %(95%CI75.7-78.3).CONCLUSIONS:
This test-negative case control study showed that mRNA vaccine effectiveness against infection declined in veterans with frailty. Frailty status is a factor to consider when designing, developing, and evaluating COVID-19 vaccines.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Frailty
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Vaccines
/
Variants
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
J Nutr Health Aging
Journal subject:
Nutritional Sciences
/
Geriatrics
Year:
2023
Document Type:
Article
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