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Epidemiology of COVID-19 outbreaks in aged care facilities during postvaccine period: a systematic review and meta-analysis.
- Source :
-
BMJ open [BMJ Open] 2024 Mar 14; Vol. 14 (3), pp. e073555. Date of Electronic Publication: 2024 Mar 14. - Publication Year :
- 2024
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Abstract
- Objective: We aimed to define the epidemiology of COVID-19 outbreaks in aged care facilities (ACFs) during the postvaccine period, including vaccine effectiveness (VE) for this high-risk group.<br />Design: Systematic review and meta-analysis.<br />Data Sources: Ovid Medline, Ovid Embase, Scopus, Web of Science and Cochrane databases were searched through 1 September 2023.<br />Eligibility Criteria: Any original observational studies and trials reporting data on COVID-19 outbreaks among the partially/fully vaccinated residents from ACFs during or after the worldwide implementation of vaccine roll-out.<br />Data Extraction and Synthesis: We estimated the attack rate, case fatality rate, mortality rate and VE during postvaccine period. Random effect model was adopted for meta-analysis. Quality assessment on all included studies was performed using the Meta Quality Appraisal Tool.<br />Results: 38 articles were included from 12 countries reporting 79 outbreaks with 1708 confirmed cases of COVID-19 from 78 ACFs. The pooled attack rate was 28% (95% CI 20% to 37%) among the fully vaccinated residents. Two-thirds (62.5%) of the index cases were unvaccinated healthcare professionals (eg, physicians, nurses) and caregivers. Unvaccinated residents had a significantly higher rates (12%) (95% CI 7% to 19%) of mortality compared with the vaccinated residents (2%) (95% CI% 1 to 4%) and the post-COVID-19 vaccine estimates for case fatality rate (13% vs 23%) and hospitalisation rate (17% vs 37%) were substantially lower. VE in preventing disease among residents in ACFs was 73% (95% CI 49% to 86). Overall, the included studies were heterogeneous in nature, however, the risk of bias was low to moderate.<br />Conclusions: Our study reaffirmed the impact of vaccination as a key public health measure to minimise the burden of COVID-19 in ACFs. Facilities with higher crowding indexes should be prioritised for vaccination and should advocate for higher vaccination targets among staff and residents as a critical intervention strategy to minimise disease burden in this vulnerable population.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Humans
Aged
Homes for the Aged statistics & numerical data
Vaccination statistics & numerical data
Vaccine Efficacy
Nursing Homes statistics & numerical data
COVID-19 epidemiology
COVID-19 prevention & control
COVID-19 mortality
COVID-19 Vaccines administration & dosage
SARS-CoV-2
Disease Outbreaks prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 2044-6055
- Volume :
- 14
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- BMJ open
- Publication Type :
- Academic Journal
- Accession number :
- 38485480
- Full Text :
- https://doi.org/10.1136/bmjopen-2023-073555