According to one of the latest reports from the Centers for Disease Control and Prevention (CDC), a so-called R.1 coronavirus lineage variant was discovered during an outbreak at a Kentucky nursing home, where nearly all residents were vaccinated. Health departments noted that coronavirus infections showed up in a quarter of vaccinated residents, raising concerns about the impact of the vaccine.
The unnamed, skilled nursing facility offered all residents and staff vaccinations from January, with 90.4% of the 83 residents taking a vaccine and just over half of the staff also accepting doses.
An investigation by the Kentucky Department of Public Health revealed that an unvaccinated, infected staffer initiated the outbreak in early March, ultimately resulting in 46 COVID-19 cases. Of the total, 26 residents were infected, including 18 fully vaccinated individuals, and 20 staff members, including four vaccinated individuals.
The report suggested that unvaccinated individuals were at a 3 to 4.1 times greater risk of infection compared to those who accepted injections.
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The recently approved coronavirus vaccines are safe and highly effective, but they are not 100% effective, the CDC notes, and the agency says breakthrough cases or infections are expected in fully vaccinated individuals. However, vaccine efficacy was found to be lower than in real-world vaccine rollout in Israel, although the CDC warns against comparing results due to small sample size, increased risk, and testing regardless of symptoms in the Kentucky nursing home .
According to the CDC report, the vaccine was 86.5% protective in suppressing symptomatic illness for residents and 87.1% protective in staff. The vaccine was more effective in preventing bad outcomes; the reported efficacy of the vaccine against hospital admissions was more than 94% for residents; no executives were hospitalized.
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The R.1 lineage variant is not listed on the CDC compiled variants of interest or of concern, although it does contain several mutations seen in other variants that have previously been shown to spread faster and resist antibody treatments.
Although vaccination was associated with a reduced risk of infection and symptomatic disease, 25.4% of the vaccinated residents and 7.1% of the vaccinated caregivers were infected, supporting concerns about possible reduced protective immunity against R.1 “reads the report. “In addition, four possible reinfections were identified, providing some evidence of limited or declining natural immunity to this variant.”
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Three residents died, one of whom was vaccinated, and the four possible reinfections were identified in most unvaccinated people. All possible cases of reinfection related to symptomatic illness, and one resident was hospitalized and died.
The CDC is pushing for the use of COVID-19 vaccination among health care providers who work in skilled nursing facilities to protect residents and prevent virus transmission. The report had its limitations, such as possible differences in health status for staff members who accepted vaccine versus those who didn’t, which could skew results who didn’t check for the underlying health issues. It is also possible that antigen testing has overlooked some asymptomatic cases, which, if true, would affect the efficacy of the vaccine.