June 29, 2021
Publications / Articles
Mor contributes to publication providing evidence of COVID-19 vaccine effectiveness in a real-world nursing home setting
April 16, 2021
Vince Mor, PhD, IMPACT multiple principal investigator, contributes to publication providing evidence of COVID-19 vaccine effectiveness in a real-world setting of vulnerable nursing homes.
Abstract
Objective
To compare rates of incident SARS-CoV-2 infection and 30-day hospitalization or death among residents with confirmed infection in nursing homes with earlier versus later SARS-CoV-2 vaccine clinics.
Design
Matched pairs analysis of nursing homes that had their initial vaccine clinics between December 18, 2020, and January 2, 2021, versus between January 3, 2021, and January 18, 2021. Matched facilities had their initial vaccine clinics between 12 and 16 days apart.
Setting and Participants
Two hundred and eighty nursing homes in 21 states owned and operated by the largest long-term care provider in the United States.
Measurements
Incident SARS-CoV-2 infections per 100 at-risk residents per week; hospital transfers and/or deaths per 100 residents with confirmed SARS-CoV-2 infection per day, averaged over a week.
Results
The early vaccinated group included 136 facilities with 12,157 residents; the late vaccinated group included 144 facilities with 13,221 residents. After 1 week, early vaccinated facilities had a predicted 2.5 fewer incident SARS-CoV-2 infections per 100 at-risk residents per week (95% CI: 1.2–4.0) compared with what would have been expected based on the experience of the late vaccinated facilities. The rates remained significantly lower for several weeks. Cumulatively over 5 weeks, the predicted reduction in new infections was 5.2 cases per 100 at-risk residents (95% CI: 3.2–7.3). By 5 to 8 weeks post-vaccine clinic, early vaccinated facilities had a predicted 1.1 to 3.8 fewer hospitalizations and/or deaths per 100 infected residents per day, averaged by week than expected based on late vaccinated facilities' experience for a cumulative on average difference of 5 events per 100 infected residents per day.
Conclusions
The SARS-CoV-2 vaccines seem to have accelerated the rate of decline of incident infections, morbidity, and mortality in this large multi-state nursing home population.
Hey and Taljaard co-authors on review of pragmatic clinical trials
March 28, 2021
IMPACT Collaboratory members Spencer Hey, PhD and Monica Taljaard, PhD are among the authors of a review of pragmatic clinical trials recently published online in the Journal of Clinical Epidemiology and covered in a blog post from the US GRADE network. The first author of the study is Stuart G. Nicholls, PhD, of the Ottawa Hospital Research Institute.
The researchers identified 4,337 eligible trials in their review of data collected from MEDLINE, Web of Science, ClinicalTrials.gov and full text between January 2014 and April 2019. They found diversity in research areas, but only 22% of the trials identified were labeled as pragmatic in the title, abstract or full text of the document. In addition, the authors estimated one-fifth of trials under-accrued by at least 15%. They concluded that there is a need to improve reporting of pragmatic trials and quality of trial registry data. Under accrual remains a challenge in pragmatic RCTs despite calls for more streamlined recruitment approaches.
The US GRADE Network blog developed an infographic to share the findings of the review.
