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Investigation of an Outbreak of COVID-19 in a French Nursing Home With Most Residents Vaccinated

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To identify the key insights or developments described in this article
1 Credit CME

There is great hope that vaccination against SARS-CoV-2 will decrease the burden of COVID-19 on nursing home (NH) residents, who have been significantly affected by this pandemic. The efficacy and effectiveness of COVID-19 vaccines are not well known in this population. Recent immunogenic studies have found decreased titers of postvaccine neutralizing antibodies against SARS-CoV-2 among NH residents, suggesting the potential for diminished effectiveness in this population.1,2 We report an outbreak of COVID-19 in a French nursing home where most residents had been fully vaccinated with the BNT162b2 vaccine.

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Article Information

Accepted for Publication: July 12, 2021.

Published: September 13, 2021. doi:10.1001/jamanetworkopen.2021.25294

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Burugorri-Pierre C et al. JAMA Network Open.

Corresponding Author: Joël Belmin, MD, PhD, Service de Gériatrie, Hôpital Charles Foix, Assistance Publique–Hopitaux de Paris, 7 avenue de la République, 94200 Ivry-sur-Seine, France (j.belmin@aphp.fr).

Author Contributions: Dr Burugorri-Pierre had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Lafuente-Lafuente, Oasi, Donadio, Belmin.

Acquisition, analysis, or interpretation of data: Burugorri-Pierre, Lafuente-Lafuente, Lecorche, Pariel, Belmin.

Drafting of the manuscript: Burugorri-Pierre, Belmin.

Critical revision of the manuscript for important intellectual content: Lafuente-Lafuente, Oasi, Lecorche, Pariel, Donadio, Belmin.

Statistical analysis: Burugorri-Pierre, Lafuente-Lafuente, Lecorche.

Administrative, technical, or material support: Belmin.

Supervision: Lafuente-Lafuente, Belmin.

Conflict of Interest Disclosures: Dr Belmin reported receiving personal fees from Novartis, Pfizer, and Sanofi outside the submitted work. No other disclosures were reported.

Additional Contributions: Bénédicte Roquebert, PhD (Cerba Laboratory), contributed to viral genome sequencing, and Laurence Jacquenod, MA (Sorbonne Université), provided technical help with the Figure. These individuals were not compensated for this work.

References
1.
Van Praet  JT , Vandecasteele  S , De Roo  A , De Vriese  AS , Reynders  M . Humoral and cellular immunogenicity of the BNT162b2 mRNA COVID-19 vaccine in nursing home residents.  Clin Infect Dis. Published online ahead of print April 7, 2021;ciab300. doi:10.1093/cid/ciab300PubMed
2.
Brockman  MA , Mwimanzi  F , Sang  Y ,  et al.  Weak humoral immune reactivity among residents of long-term care facilities following one dose of the BNT162b2 mRNA COVID-19 vaccine.   medRxiv. Preprint posted online March24, 2021:2021.03.17.21253773. doi:10.1101/2021.03.17.21253773Google Scholar
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Cavanaugh  AM , Fortier  S , Lewis  P ,  et al.  COVID-19 outbreak associated with a SARS-CoV-2 R.1 lineage variant in a skilled nursing facility after vaccination program—Kentucky, March 2021.   MMWR Morb Mortal Wkly Rep. 2021;70(17):639-643. doi:10.15585/mmwr.mm7017e2PubMedGoogle ScholarCrossref
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Fulop  T , Pawelec  G , Castle  S , Loeb  M .  Immunosenescence and vaccination in nursing home residents.   Clin Infect Dis. 2009;48(4):443-448. doi:10.1086/596475PubMedGoogle ScholarCrossref
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Lelic  A , Verschoor  CP , Lau  VW ,  et al.  Immunogenicity of varicella vaccine and immunologic predictors of response in a cohort of elderly nursing home residents.   J Infect Dis. 2016;214(12):1905-1910. doi:10.1093/infdis/jiw462PubMedGoogle ScholarCrossref
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Williams  RE , Sena  AC , Moorman  AC ,  et al.  Hepatitis B vaccination of susceptible elderly residents of long term care facilities during a hepatitis B outbreak.   Vaccine. 2012;30(21):3147-3150. doi:10.1016/j.vaccine.2012.02.078PubMedGoogle ScholarCrossref
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