Malignac Mathilde, Besseiche Adrien, Cloppet-Fontaine Anaïs, Sadeg Mohand Ouali, Jafarbay Jamileh, Gourdon Mathilde, Trivalle Christophe, Jeandel Claude, Vidal Jean-Sébastien, Hanon Olivier
Université de Paris, EA 4468, APHP, Hôpital Broca, Paris, France.
Gérontopôle d'Ile-de-France, Paris, France.
BMC Geriatr. 2024 Dec 23;24(1):1032. doi: 10.1186/s12877-024-05609-7.
Older age and associated comorbid conditions increase the risk of severe form of COVID-19 and death. The SARS-CoV-2 vaccination campaign began in France in December 2020 targeting institutionalized older population before having been evaluated in this population. The objective of our study was to assess the tolerability of vaccination 21 days (D21) and 90 days after the first vaccination (D90) in institutionalized old people. Secondary objective was to assess its effectiveness (mortality, hospitalization and occurrence of COVID) at D21 and D90.
People living in nursing homes or in long-term hospitalization facilities in France were included 12-2020-06-2021. They were divided into SARS-CoV-2 vaccinated and unvaccinated groups. Vaccine tolerability was prospectively assessed by the occurrence of health events at D21 and D90 (local and systemic side effects, geriatric syndromes, cardiovascular events). Vaccine efficacy was assessed by the occurrence of COVID-19 and serious adverse events (unscheduled hospitalization and all-cause mortality).
The mean age of the 2595 participants was 86 years, 83% received COVID-19 vaccine. There were no significant difference between the vaccinated and unvaccinated for systemic or local adverse events at D21 and D90. At D90, vaccinated participants had significantly fewer SARS-CoV-2 infections (odds ratio (95% confidence interval) = 0.35 (0.22-0.58)), fewer deaths or hospitalizations (0.50 (0.31-0.81)), fewer cardiovascular events (0.28 (0.12-0.64)) and fewer pressure ulcers (0.38 (0.17-0.88)).
In this prospective cohort study, COVID-19 vaccine in a very old institutionalized geriatric population had a reassuring safety profile and a protective effect on COVID-19, hospitalizations and deaths, cardiovascular events and pressure ulcers.
高龄及相关合并症会增加感染重症 COVID-19 和死亡的风险。2020 年 12 月，法国启动了针对机构养老人群的 SARS-CoV-2 疫苗接种计划，而在此之前该人群尚未经过疫苗评估。我们研究的目的是评估机构养老老人在首次接种疫苗后 21 天（D21）和 90 天（D90）时疫苗的耐受性。次要目的是评估其在 D21 和 D90 时的有效性（死亡率、住院率和 COVID 感染情况）。
纳入 2020 年 6 月至 2021 年 12 月期间居住在法国养老院或长期住院机构的人员。他们被分为接种 SARS-CoV-2 疫苗组和未接种疫苗组。通过 D21 和 D90 时健康事件的发生情况（局部和全身副作用、老年综合征、心血管事件）前瞻性评估疫苗耐受性。通过 COVID-19 和严重不良事件（非计划住院和全因死亡率）的发生情况评估疫苗效力。
2595 名参与者的平均年龄为 86 岁，83%的人接种了 COVID-19 疫苗。在 D21 和 D90 时，接种疫苗组和未接种疫苗组在全身或局部不良事件方面无显著差异。在 D90 时，接种疫苗的参与者感染 SARS-CoV-2 的人数显著减少（比值比（95%置信区间）=0.35（0.22 - 0.58）），死亡或住院人数减少（0.50（0.31 - 0.81）），心血管事件减少（0.28（0.12 - 0.64）），压疮减少（0.38（0.17 - 0.88））。
在这项前瞻性队列研究中，在高龄机构养老人群中接种 COVID-19 疫苗具有令人放心的安全性，并且对 COVID-19、住院和死亡、心血管事件及压疮具有保护作用。
