Breakthrough SARS-CoV-2 infections found to be low among vaccinated nursing home residents

Reviewed by Emily Henderson, B.Sc.Apr 3 2023

A new study published in the Journal of American Medical Directors (JAMDA) found that the risk of severe COVID-19 illness among nursing home residents with complete vaccination are low. The study found that residents aged 85 and older with certain comorbidities like heart disease and kidney disease were more vulnerable but that the risk of breakthrough COVID among fully vaccinated residents was less than 10%.

Examining data of 23,172 fully vaccinated residents from 984 nursing homes from March through November 2021, the study, entitled "Resident Factors Associated with Breakthrough SARS-COV-2 Infections," found that just 5% developed an incident of breakthrough infection (BTI) of COVID-19 irrespective of variant during the time frame.

The study also found that less than 10% of vaccinated residents with a breakthrough infection required hospitalization or died within 30 days (8.6%). Residents with severe infection were more likely to be aged 85 years and older and to have certain comorbidities, like heart disease and kidney disease.

The goal of the study was to examine how often breakthrough infections and severe illness occur among nursing home residents who have received the COVID-19 vaccination series."

Sarah D. Berry, M.D., M.P.H., Study's Co-Author, Associate Director, Musculoskeletal Research Center and Associate Scientist, Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife

"Despite changes in the COVID-19 virus, the risk of severe infection in vaccinated older adults in nursing homes is low. Given that the pandemic continues and testing policies have relaxed, this data provides prognostic information for nursing home facilities faced with continued outbreaks," Dr. Berry added.

The study's findings are significant, Dr. Berry said, because "rates of BTI and serious illness may vary with other variants, but risk factors for serious illness are likely similar and may help providers predict who will get sick during future outbreaks."

The Brown University, NYU and the University of Michigan collaborated in this retrospective cohort study.

Ana Montoya, MD, M.P.H., C.M.D., Clinical Assistant Professor, Geriatric and Palliative Medicine, Medical Director, Sub-Acute Service and Medical Director, Glacier Hills Care and Rehabilitation Center, University of Michigan School of Medicine, was the first author of the study. Other authors included: Vincent Mor, Ph.D., Professor of Health Services, Policy & Practice and the Florence Pirce Grant University Professor, Brown University School of Public Health; Elizabeth (Betsy) White, APRN, Ph.D., Assistant Professor of Health Services, Policy, and Practice, Brown University School of Public Health; and Jasmine L. Travers, AGPCNP-BC, CCRN, Ph.D. R.N., Assistant Professor of Nursing, NYU Rory Meyers College of Nursing.

Funding came from grants from NIA/NIH (3U54 AG063546).