<b><i>Background:</i></b> Older adults living in long-term care facilities (LTCFs) are at increased risk for severe outcomes from COVID-19 and were identified as a priority group in COVID-19 vaccination strategies. Emerging evidence suggests vaccine effectiveness in LTCF populations, but data about median and long-term durability of immune response after vaccination are still limited. <b><i>Objectives:</i></b> In this study, we assessed the humoral response to BNT162b2 mRNA COVID-19 vaccine 3 months after the second dose, in a cohort of 495 residents aged ≥65 years from 11 LTCF in Granada, Spain. <b><i>Method:</i></b> Between April 19 and April 30, 2021, we measured anti-SARS-CoV-2 Spike IgG to evaluate the humoral vaccination response. Antibody titers were reported in binding antibody units (BAU/mL). Bivariate and multivariate logistic regression models were performed to investigate the impact of age, sex, underlying health conditions, and prior COVID-19 infection on the antibody levels. <b><i>Results:</i></b> Over 96% of the participants developed an adequate humoral response. We detected higher antibody titers in previously infected individuals, compared with those previously uninfected (<i>B</i>: 1,150.059 BAU/mL, <i>p</i> < 0.001). Moreover, we found a significant inverse association between age and antibody levels (<i>B</i>: −7.943 BAU/mL, <i>p</i> < 0.05). This negative age-dependent response was more noticeable among residents over 85 years old. In contrast, baseline health conditions and cognitive status were not associated with different antibody levels. <b><i>Conclusions:</i></b> These findings support monitoring COVID-19 vaccination response trend in older adults, in order to optimize future disease prevention and control strategies in this vulnerable population.
BackgroundThe incidence and geographical distribution of arboviruses is constantly increasing. The epidemiological patterns of the proliferation of viruses and their vectors (Aedes aegypti and Aedes albopictus) are associated with socio-environmental determinants, and are closely related to human habits, especially at the household level. The aim of this work is to analyze the influence of socio-environmental determinants on the knowledge and practices related to arboviruses and their transmission, among the residents of three communities on the southern border of Mexico.MethodologyBetween June 2017 and August 2018, our investigation covered a set of 149 households from three communities of Tapachula (Chiapas) and Villahermosa (Tabasco). We first conducted household surveys about knowledge and practices on arbovirosis. Then, we carried out direct observations of risk factors for vector proliferation at the domestic level, before and after exposing a part of the population to a cycle of community engagement prevention activities. Through semi-structured interviews, we also focused on the detection of environmental risk situations for vector breeding at the community level.Key resultsWe found that most dwellings had an adequate knowledge about the origin and transmission of arboviruses, but only a minority of them also implemented appropriate practices. Higher education levels were associated with better prevention scores. The observations made after the cycle of community activities in Chiapas revealed a decrease in the accumulation of unprotected water deposits. A higher percentage of domestic risk practices were detected in association with significant deficiencies in sanitation and water supply services. Furthermore, the perception of greater risk and difficulty in complying with preventive measures was detected among the population.DiscussionKnowledge does not necessarily lead to adequate prevention practices. A better understanding of all these dimensions and their interactions is required. In addition to the educational level, intermediate social determinants (such as water supply and environmental sanitation) influence the persistence of behaviors that are risk factors for the proliferation of arbovirosis. The achievement of an effective and sustainable vector management is required to address these related aspects.Author summaryDengue, Chikungunya and Zika are arboviral diseases, transmitted by Aedes mosquitoes. As a result of a continuous increase in the geographical spread and burden of disease, arbovirosis have become a priority issue for global health.The proliferation of viruses and their vectors are influenced by a complex interaction of environmental and social determinants. Thus, the design of effective and sustainable prevention and control measures requires an understanding of all these different aspects.The aim of our work is to explore the effects of social and environmental factors on the knowledge and practices related to Dengue, Chikungunya and Zika and their transmission, among the residents of three communities on the southern border of Mexico, currently an endemic area. Our study draws on the application of a program combining the implementation of new technologies for vector management with a participatory and holistic multidisciplinary approach.Between June 2017 and August 2018, we used different surveys and methodological approaches to explore knowledge and practices on arbovirosis, as well as to identify risk factors for vector proliferation. We found that intermediate social determinants (such as occasional water supply and infrequent waste collections) influence the persistence of behaviors that are risk factors for the proliferation of arbovirosis.Public health interventions for arbovirosis prevention must be accompanied by intersectoral work that includes the improvement of these related aspects, according to the multifactorial etiology of arboviruses.
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