High coverage COVID-19 mRNA vaccination rapidly controls SARS-CoV-2 transmission in long-term care facilities

Residents of Long-Term Care Facilities (LTCFs) represent a major share of COVID-19 deaths worldwide. Measuring the vaccine effectiveness among the most vulnerable in these settings is essential to monitor and improve mitigation strategies. We evaluate the early effect of the administration of BNT162b2-mRNA vaccine to individuals older than 64 years residing in LTCFs in Catalonia, Spain. We monitor all the SARS-CoV-2 documented infections and deaths among LTCFs residents once more than 70% of them were fully vaccinated (February–March 2021). We develop a modeling framework based on the relationship between community and LTCFs transmission during the pre-vaccination period (July–December 2020). We compute the total reduction in SARS-CoV-2 documented infections and deaths among residents of LTCFs over time, as well as the reduction in the detected transmission for all the LTCFs. We compare the true observations with the counterfactual predictions. We estimate that once more than 70% of the LTCFs population are fully vaccinated, 74% (58–81%, 90% CI) of COVID-19 deaths and 75% (36–86%, 90% CI) of all expected documented infections among LTCFs residents are prevented. Further, detectable transmission among LTCFs residents is reduced up to 90% (76–93%, 90% CI) relative to that expected given transmission in the community. Our findings provide evidence that high-coverage vaccination is the most effective intervention to prevent SARS-CoV-2 transmission and death among LTCFs residents. Widespread vaccination could be a feasible avenue to control the COVID-19 pandemic conditional on key factors such as vaccine escape, roll out and coverage. A large number of COVID-19 infections and deaths have occurred in older adults who reside in long-term care facilities (LTCFs). In this study, we determine whether high rates of vaccinations among older adult residents of LTCFs in Catalonia (Spain) reduced transmission of SARS-CoV-2—the virus that causes COVID-19—and prevented infections and deaths after most vaccinations were complete. We use statistical modeling to compare the expected number of infections and deaths in LTCFs if vaccination would not have occurred to those actually observed after vaccinating more than 70% of residents. We estimate that 3 out of 4 SARS-CoV-2 infections and deaths were prevented due to vaccination, and that SARS-CoV-2 transmission in LTCFs was reduced by 90%. Our study shows that high-coverage vaccination is a highly effective way to prevent SARS-CoV-2 transmission and death among vulnerable populations De Salazar et al. quantify the impact of BNT162b2 mRNA vaccination on COVID-19 transmission and deaths in residents of long-term care facilities in Catalonia, Spain using statistical modelling. They find that high vaccination coverage results in a substantial reduction in transmission amongst residents, preventing around 3 in 4 documented infections and COVID-19-related deaths.