COVID-19 Outbreak Associated with a SARS-CoV-2 R.1 Lineage Variants in a Skilled Nursing Facility After Vaccination Program — Kentucky, March 2021

Details

• Personal Author:
  Cavanaugh, Alyson M. ; Fortier, Sarah ; Lewis, Patricia ; Arora, Vaneet ; Johnson, Matt ; George, Karim ; Tobias, Joshua ; Lunn, Stephanie ; Miller, Taylor ; Thoroughman, Douglas ; Spicer, Kevin B.
• Corporate Authors:
  Centers for Disease Control and Prevention (U.S.)Epidemic Intelligence Service. ; Kentucky. Department for Public Health. ; Center for State, Tribal, Local, and Territorial Support (U.S.)Division of Performance Improvement and Field Services, Center for State, Tribal, Local, and Territorial Support. ; National Center for Emerging and Zoonotic Infectious Diseases (U.S.)Division of Healthcare Quality Promotion.
• Description:
  What is already known about this topic? COVID-19 vaccines have demonstrated high efficacy in clinical trials. Limited data are available on effectiveness in skilled nursing facilities (SNFs) and against emerging Variantss.
  
  What is added by this report? In a COVID-19 outbreak at a Kentucky SNF involving a newly introduced Variants to the region, unvaccinated residents and health care personnel (HCP) had 3.0 and 4.1 times the risk of infection as did vaccinated residents and HCP. Vaccine was 86.5% protective against symptomatic illness among residents and 87.1% protective among HCP.
  
  What are the implications for public health practice? Vaccination of SNF residents and HCP is essential to reduce the risk for symptomatic COVID-19, as is continued focus on infection Prevention and control practices.
  
  Although COVID-19 mRNA vaccines demonstrated high efficacy in clinical trials (1), they were not 100% efficacious. Thus, some infections postvaccination are expected. Limited data are available on effectiveness in skilled nursing facilities (SNFs) and against emerging Variantss. The Kentucky Department for Public Health (KDPH) and a local health department investigated a COVID-19 outbreak in a SNF that occurred after all residents and health care personnel (HCP) had been offered vaccination. Among 83 residents and 116 HCP, 75 (90.4%) and 61 (52.6%), respectively, received 2 vaccine doses. Twenty-six residents and 20 HCP received positive test results for SARS-CoV-2, the Virus that causes COVID-19, including 18 residents and four HCP who had received their second vaccine dose >14 days before the outbreak began. An R.1 lineage Variants was detected with whole genome sequencing (WGS). Although the R.1 Variants has multiple spike protein mutations, vaccinated residents and HCP were 87% less likely to have symptomatic COVID-19 compared with those who were unvaccinated. Vaccination of SNF populations, including HCP, is critical to reduce the risk for SARS-CoV-2 introduction, Transmission, and severe outcomes in SNFs. An ongoing focus on infection Prevention and control practices is also essential.
  
  Suggested citation for this article: 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. ePub: 21 April 2021.
  
  mm7017e2.htm?s_cid=mm7017e2_w
  
  mm7017e2-H.pdf
  
  
• Subjects:
  CoronaVirus Infections/Prevention & Control COVID-19 Vaccines/Immunology COVID-19/Prevention & Control Health Personnel Nursing Staff SARS-CoV-2/Genetics Skilled Nursing Facilities
• Source:
  MMWR: Morbidity and Mortality Weekly Report 2021; v. 70 Early Release
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Document Type:
  Journal Article
• Place as Subject:
  Kentucky
• Pages in Document:
  5 pdf pages
• Volume:
  70
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:062e576ebed06446d0344e5d9cb2da252df98badbd9998f339c0e70ab0af7da67e87cb9cfdd591d0c926c58aec5c79387a11f456e9ae2ee198a3640acb0ee549
• Download URL:
  https://stacks.cdc.gov/view/cdc/105347/cdc_105347_DS1.pdf
• File Type:
  [PDF - 147.28 KB ]