MMWR Morb Mortal Wkly Rep. 2021 Apr 30;70(17):639-643. doi: 10.15585/mmwr.mm7017e2.
Although COVID-19 mRNA vaccines demonstrated high efficacy in clinical trials (1), they were not 100% efficacious. Thus, some infections postvaccination are expected. Limited data are available on effectiveness in skilled nursing facilities (SNFs) and against emerging variants. The Kentucky Department for Public Health (KDPH) and a local health department investigated a COVID-19 outbreak in a SNF that occurred after all residents and health care personnel (HCP) had been offered vaccination. Among 83 residents and 116 HCP, 75 (90.4%) and 61 (52.6%), respectively, received 2 vaccine doses. Twenty-six residents and 20 HCP received positive test results for SARS-CoV-2, the virus that causes COVID-19, including 18 residents and four HCP who had received their second vaccine dose >14 days before the outbreak began. An R.1 lineage variant was detected with whole genome sequencing (WGS). Although the R.1 variant has multiple spike protein mutations, vaccinated residents and HCP were 87% less likely to have symptomatic COVID-19 compared with those who were unvaccinated. Vaccination of SNF populations, including HCP, is critical to reduce the risk for SARS-CoV-2 introduction, transmission, and severe outcomes in SNFs. An ongoing focus on infection prevention and control practices is also essential.
尽管 COVID-19 mRNA 疫苗在临床试验中表现出了很高的疗效（1），但它们并非 100%有效。因此，预计接种疫苗后仍会发生一些感染。有关在熟练护理设施（SNFs）中的有效性和针对新兴变异株的数据有限。肯塔基州公共卫生部（KDPH）和当地卫生部门调查了一起发生在所有居民和医护人员（HCP）都接种疫苗后的 SNF 中的 COVID-19 疫情。在 83 名居民和 116 名 HCP 中，分别有 75 名（90.4%）和 61 名（52.6%）接种了 2 剂疫苗。26 名居民和 20 名 HCP 的 SARS-CoV-2 检测结果呈阳性，SARS-CoV-2 是导致 COVID-19 的病毒，其中包括 18 名居民和 4 名 HCP，他们在疫情爆发前 14 天以上接种了第二剂疫苗。通过全基因组测序（WGS）检测到了 R.1 谱系变异株。尽管 R.1 变异株具有多个刺突蛋白突变，但与未接种疫苗的居民和 HCP 相比，接种疫苗的居民和 HCP 出现有症状 COVID-19 的可能性降低了 87%。对 SNF 人群（包括 HCP）进行疫苗接种对于降低 SNF 中 SARS-CoV-2 的引入、传播和严重后果的风险至关重要。持续关注感染预防和控制措施也至关重要。
