Mass COVID-19 vaccination of residents in geriatric facilities by emergency medical services: the Israeli experience

Alpert, Evan Avraham; Herbst, Raphael; Abramovich, Itamar; Strugo, Refael; Jaffe, Eli

doi:10.1016/s2666-7568(21)00058-1

Cited by 6 publications

(7 citation statements)

References 8 publications

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“…Several papers addressed the efficacy of different SARS-CoV-2 vaccines either through Phase II and III of clinical trials [ 21 – 23 ] or field investigations [ 9 – 11 ]. Few of them detailed data regarding elderly and persons living in LTCF [ 12 – 15 ] and outbreaks after the first and second dose were reported [ 24 – 26 ].…”

Section: Discussionmentioning

confidence: 99%

Sero-survey on long-term care facility residents reveals increased risk of sub-optimal antibody response to BNT162b2: implications for breakthrough prevention

et al. 2022

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Background The impact of coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) on residents of long-term care facilities (LTCFs) has been dramatic on global scale as older age and comorbidities pose an increased risk of severe disease and death. Methods Aim of this study was to evaluate SARS-CoV-2 Spike-specific IgG (S-IgG) antibody titers in 478 residents and 649 health care workers of a large Italian long-term care facility two months after complete vaccination with BNT162b2. Associations among resident-related factors and predictors of humoral response were investigated. Results By stratifying levels of humoral responses, we found that 62.1%, 21.6%, 12.1% and 4.2% of residents had high (>1,000 BAU/ml), medium (101-1,000), low (1-100) and null (<1 BAU/mL) S-IgG titers, respectively. Residents with documented previous COVID-19 and those with SARS-CoV-2 nucleocapsid-specific IgG (N-IgG) positive serology showed higher level of serological response, while significant associations were observed for cancer with suboptimal response (p = 0.005) and the administration of corticosteroid for suboptimal response (p = 0.028) and a null one (p = 0.039). According to multivariate logistic regression, predictors of an increased risk of null response were advanced age (Odd ratio, OR: 2.630; Confidence interval, CI: 1.13-6.14; p = 0.025), corticosteroid therapy (OR: 4.964; CI: 1.06-23.52; p = 0.042) and diabetes mellitus (OR:3.415; CI:1.08-10.8; p = 0.037). In contrast, previous diagnosis of COVID-19 was strongly associated with a reduced risk of null response to vaccination (OR:0.126; CI:0.02-0.23; p < 0.001). Conclusions SARS-CoV-2 specific antibodies in elderly individuals should be consider when deciding the need of a third dose of vaccine for prevention of reinfections in LTCFs despite the maintenance of barrier measures.

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Section: Discussionmentioning

confidence: 99%

Sero-survey on long-term care facility residents reveals increased risk of sub-optimal antibody response to BNT162b2: implications for breakthrough prevention

et al. 2022

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“…Several papers addressed the efficacy of different SARS-CoV-2 vaccines either through Phase II and III of clinical trials [18][19][20] or field investigations [9][10][11]. Few of them detailed data regarding elderly and persons living in nurse facility [12][13][14][15] and outbreaks after the first and second dose were reported [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

“…Several reports indicate that vaccination of old age is showing to protect from severe disease, and risk of death by conferring a degree of humoral immunity [9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Sero-survey on Long-term Care Facility Residents Reveals Increased Risk of Sub-optimal Antibody Response to BNT162B2: Implications for Breakthrough Prevention

Caimi¹,

Franzetti²,

Velleca³

et al. 2021

Preprint

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Background: The impact of coronavirus disease 2019 caused by Severe Acute Respiratory Syndrome Coronavirus 2 on hosts of Long Term Care Facilities (LTCFs) has been dramatic at global scale as aging and comorbitities pose individuals at increased risk of severe disease and death. Methods: Aim of this study was to evaluate SARS-CoV-2 S-IgG antibodies titers in 478 residents and 649 health care workers of the largest Italian nurse facility two months after the complete vaccination with BNT162B2. Associations among host-related factors and predictors of humoral response were investigated. Results: By stratifying levels of humoral responses, we found that 62.1%, 21.6%, 12.1% and 4.2% of hosts has high (>1,000 BAU/ml), medium (101-1,000), low (1-100) and null (<1 BAU/mL) S-IgG titers, respectively. Hosts with previous COVID-19 and those with SARS-CoV-2 N-IgG positive serology showed higher level of serological response (p<0.001 and p<0.001, respectively), while the administration of corticosteroid or cancer diminished all levels of specific antibodies (p=0.019 and p=0.004). Significant associations were observed for these parameters in those with suboptimal response (p<0.001, p<0.001, p=0.028 and p=0.005) and with a null one (p=0.005, p<0.001 and p=0.039). Predictors of an increased risk of null response were advanced age, corticosteroid therapy and diabetes mellitus (p=0.025, p=0.017 and p=0.037). In contrast, previous diagnosis of COVID-19 resulted strongly associated with a reduced risk of null response to vaccination (p<0.001). Conclusions: SARS-CoV-2 specific antibodies in elderly individuals need to be measured to consider a third dose of vaccine after mass vaccination for prevention of reinfections in LTCFs despite the maintenance of barrier measures.

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“…A limitation of this study may be that it examined trends but not specific motivation patterns. Understanding trends may allow devoting EMS resources to other activities such as home or drive-through testing, 24 vaccinations, 25 or even educational actions. 26 The retrospective nature of the analysis makes it difficult to assess associated bias and/or confounding factors.…”

Section: Discussionmentioning

confidence: 99%

Responses of a Pre-hospital Emergency Medical Service During Military Conflict Versus COVID-19: A Retrospective Comparative Cohort Study

et al. 2021

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Background Decreases in routine healthcare practices have been shown to occur during disasters. However, research regarding the impacts of natural disasters, pandemics, or military conflicts on emergency medical services (EMS) is scarce. Objectives This study assessed the impact of a military conflict versus the coronavirus disease 2019 (COVID-19) pandemic on a national EMS organization in terms of responses to overall daily emergencies, medical illnesses, motor vehicle collisions, and other injuries. Methods This retrospective comparative cohort study assessed daily routine emergency ambulance calls to Magen David Adom (MDA), Israel’s national EMS organization. This included overall emergency calls as well as those related to medical illnesses, motor vehicle collisions (MVCs), and other injuries. All data were obtained from the MDA command and control database. During the military conflict Operation Protective Edge (2014), the civilian population was subjected to intensive rocket attacks for 24 days, followed by 26 days of a progressive withdrawal of operations and then to a post-conflict period. During the first wave of the COVID-19 pandemic (March-April 2020), the population was subjected to 32 days of total lockdown, followed by 27 days of progressive relief of confinement, and then to a post-lockdown period. Results The total number of emergency calls in this study was 330,430. During the conflict, the mean number of daily calls decreased, followed by an increase during Relief and Post-Conflict with higher values in Post-Conflict than in Pre-Conflict. During the COVID-19 pandemic, there was a decrease in the mean daily number of calls during Lockdown. It remained low during Relief and increased during Post-Lockdown. However, it remained lower in Post-Lockdown than during Pre-Lockdown. Calls related to medical illnesses decreased during the conflict and during the lockdown. The post-conflict period was characterized by a similar baseline call magnitude but not during the post-lockdown period. Decreases in calls for MVC and other injuries were significant during the lockdown but not during the military conflict. Post-lockdown was accompanied by return to baseline call volumes for MVC, whereas calls for other injuries increased above baseline both after the lockdown and military conflict. Conclusion This study shows decreasing trends in routine daily calls for EMS during both Operation Protective Edge and COVID-19. However, different patterns of needs for EMS were evidenced for medical illnesses, MVC, or calls concerning other injuries. These results are instrumental for managing the operational demands of EMS during military conflicts and pandemics.

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Mass COVID-19 vaccination of residents in geriatric facilities by emergency medical services: the Israeli experience

Cited by 6 publications

References 8 publications

Sero-survey on long-term care facility residents reveals increased risk of sub-optimal antibody response to BNT162b2: implications for breakthrough prevention

Sero-survey on long-term care facility residents reveals increased risk of sub-optimal antibody response to BNT162b2: implications for breakthrough prevention

Sero-survey on Long-term Care Facility Residents Reveals Increased Risk of Sub-optimal Antibody Response to BNT162B2: Implications for Breakthrough Prevention

Responses of a Pre-hospital Emergency Medical Service During Military Conflict Versus COVID-19: A Retrospective Comparative Cohort Study

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