Emerging Infectious Diseases (Apr 2023)

Outbreaks of SARS-CoV-2 Infections in Nursing Homes during Periods of Delta and Omicron Predominance, United States, July 2021–March 2022

  • W. Wyatt Wilson,
  • Amelia A. Keaton,
  • Lucas G. Ochoa,
  • Kelly M. Hatfield,
  • Paige Gable,
  • Kelly A. Walblay,
  • Richard A. Teran,
  • Meghan Shea,
  • Urooj Khan,
  • Ginger Stringer,
  • Meenalochani Ganesan,
  • Jordan Gilbert,
  • Joanne G. Colletti,
  • Erin M. Grogan,
  • Carly Calabrese,
  • Andrew Hennenfent,
  • Rebecca Perlmutter,
  • Katherine A. Janiszewski,
  • Christina Brandeburg,
  • Ishrat Kamal-Ahmed,
  • Kyle Strand,
  • Matthew Donahue,
  • M. Salman Ashraf,
  • Emily Berns,
  • Jennifer MacFarquhar,
  • Meghan L. Linder,
  • Dat J. Tran,
  • Patricia Kopp,
  • Rebecca M. Walker,
  • Rebekah Ess,
  • James Baggs,
  • John A. Jernigan,
  • Alex Kallen,
  • Jennifer C. Hunter

DOI
https://doi.org/10.3201/eid2904.221605
Journal volume & issue
Vol. 29, no. 4
pp. 761 – 770

Abstract

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SARS-CoV-2 infections among vaccinated nursing home residents increased after the Omicron variant emerged. Data on booster dose effectiveness in this population are limited. During July 2021–March 2022, nursing home outbreaks in 11 US jurisdictions involving >3 infections within 14 days among residents who had received at least the primary COVID-19 vaccine(s) were monitored. Among 2,188 nursing homes, 1,247 outbreaks were reported in the periods of Delta (n = 356, 29%), mixed Delta/Omicron (n = 354, 28%), and Omicron (n = 536, 43%) predominance. During the Omicron-predominant period, the risk for infection within 14 days of an outbreak start was lower among boosted residents than among residents who had received the primary vaccine series alone (risk ratio [RR] 0.25, 95% CI 0.19–0.33). Once infected, boosted residents were at lower risk for all-cause hospitalization (RR 0.48, 95% CI 0.40–0.49) and death (RR 0.45, 95% CI 0.34–0.59) than primary vaccine–only residents.

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