MMWR Morb Mortal Wkly Rep. 2021 Mar 19;70(11):396-401. doi: 10.15585/mmwr.mm7011e3.
Residents of long-term care facilities (LTCFs), particularly those in skilled nursing facilities (SNFs), have experienced disproportionately high levels of COVID-19-associated morbidity and mortality and were prioritized for early COVID-19 vaccination (1,2). However, this group was not included in COVID-19 vaccine clinical trials, and limited postauthorization vaccine effectiveness (VE) data are available for this critical population (3). It is not known how well COVID-19 vaccines protect SNF residents, who typically are more medically frail, are older, and have more underlying medical conditions than the general population (1). In addition, immunogenicity of the Pfizer-BioNTech vaccine was found to be lower in adults aged 65-85 years than in younger adults (4). Through the CDC Pharmacy Partnership for Long-Term Care Program, SNF residents and staff members in Connecticut began receiving the Pfizer-BioNTech COVID-19 vaccine on December 18, 2020 (5). Administration of the vaccine was conducted during several on-site pharmacy clinics. In late January 2021, the Connecticut Department of Public Health (CT DPH) identified two SNFs experiencing COVID-19 outbreaks among residents and staff members that occurred after each facility's first vaccination clinic. CT DPH, in partnership with CDC, performed electronic chart review in these facilities to obtain information on resident vaccination status and infection with SARS-CoV-2, the virus that causes COVID-19. Partial vaccination, defined as the period from >14 days after the first dose through 7 days after the second dose, had an estimated effectiveness of 63% (95% confidence interval [CI] = 33%-79%) against SARS-CoV-2 infection (regardless of symptoms) among residents within these SNFs. This is similar to estimated effectiveness for a single dose of the Pfizer-BioNTech COVID-19 vaccine in adults across a range of age groups in noncongregate settings (6) and suggests that to optimize vaccine impact among this population, high coverage with the complete 2-dose series should be recommended for SNF residents and staff members.
长期护理机构（LTCF）的居民，尤其是在熟练护理机构（SNF）中的居民，经历了不成比例的高 COVID-19 相关发病率和死亡率，并且优先进行了早期 COVID-19 疫苗接种（1，2）。然而，该人群并未被纳入 COVID-19 疫苗临床试验，并且针对这一关键人群，可用的疫苗接种后疫苗有效性（VE）数据有限（3）。目前尚不清楚 COVID-19 疫苗对 SNF 居民的保护效果如何，这些居民通常身体更脆弱，年龄更大，并且比一般人群有更多的潜在医疗条件（1）。此外，与年轻成年人相比，辉瑞-BioNTech 疫苗在 65-85 岁成年人中的免疫原性较低（4）。通过 CDC 药房合作计划为长期护理机构，康涅狄格州的 SNF 居民和工作人员于 2020 年 12 月 18 日开始接种辉瑞-BioNTech COVID-19 疫苗（5）。疫苗接种是在几个现场药房诊所进行的。2021 年 1 月下旬，康涅狄格州公共卫生部（CT DPH）发现了两家 SNF，这些机构的居民和工作人员在每家机构的第一次疫苗接种诊所之后都出现了 COVID-19 疫情。CT DPH 与 CDC 合作，对这些机构进行了电子病历审查，以获取有关居民疫苗接种状况和感染 SARS-CoV-2（引起 COVID-19 的病毒）的信息。部分接种的定义为从第一剂接种后超过 14 天到第二剂接种后 7 天，估计对这些 SNF 中居民的 SARS-CoV-2 感染（无论症状如何）的有效性为 63%（95%置信区间[CI] = 33%-79%）。这与在非聚集环境中，针对不同年龄组的成年人使用辉瑞-BioNTech COVID-19 疫苗单剂接种的估计有效性相似（6），这表明为了优化该人群的疫苗效果，应建议 SNF 居民和工作人员充分接种两剂完整疫苗系列。
