The BNT162b2 vaccine is associated with lower new COVID-19 cases in nursing home residents and staff

Abstract

Background/Objectives: The effectiveness of the BNT162b2 vaccine on preventing the spread of COVID-19 and deaths in nursing homes (NH) is unknown. Design: We used zero-inflated negative binomial mixed effects regressions to model the associations of time since the vaccine clinic ending the week of December 27, 2020 (cohort 1), January 3, 2021 (cohort 2), or January 10, 2021 (cohort 3) controlling for county rate of COVID-19, bed size, urban location, racial and ethnic census, and level of registered nurses with resident cases and deaths of COVID-19 and staff cases of COVID-19. Setting and Participants: All 2501 NHs who held a vaccine clinic from the first 17 states to initiate clinics as part of the Pharmacy Partnership for Long-Term Care Program. Main Outcome(s) and Measure(s): Adjusted Incidence Rate Ratio (IRR) for time in 3, 4, 5, and 6 weeks after the first vaccine clinic for resident cases and deaths of COVID-19 and staff cases of COVID-19. Results: Resident and staff cases trended downward in all three cohorts following the vaccine clinics. Time following the first clinic at 5 and 6 weeks was consistently associated with fewer resident cases (IRR: 0.68 [95% CI: 0.54–0.84], IRR: 0.64 [95% CI: 0.48–0.86], respectively); resident deaths (IRR: 0.59 [95% CI: 0.45–0.77], IRR: 0.45 [95% CI: 0.31–0.65], respectively); and staff cases (IRR: 0.64 [95% CI: 0.56–0.73], IRR: 0.51 [95% CI: 0.42–0.62], respectively). Other factors associated with fewer resident and staff cases included facilities with less than 50 certified beds and high nurse staffing per resident day (>0.987). Contrary to prior research, higher Hispanic non-white resident census was associated with fewer resident cases (IRR: 0.42, 95% CI: 0.31–0.56) and deaths (IRR: 0.18, 95% CI: 0.12–0.27). Conclusions: The BNT162b2 vaccine is associated with decreased spread of SARS-CoV-2 in both residents and staff as well as decreased deaths among residents.