Although evidence is preliminary, vaccines have been effective in decreasing cases of SARSCoV-2 infections (COVID-19) and deaths among long-term care (LTC) residents by 89% and 96% respectively (Brown et al., 2021).
Estimated vaccine uptake among LTC staff in ON has been estimated at 68% as of March 5, 2021. The estimated relative reduction in COVID-19 cases among LTC staff is 79% (Brown et al., 2021).
Vaccination against COVID-19 protects in varying degrees against symptomatic infection and can be expected to have some effect on COVID-19 transmission; however, the extent of the impact on transmission is not fully quantified. In 3 separate small studies, all utilizing Pfizer Bio N Tech™ vaccine, the following results were observed: vaccine efficacy among partially vaccinated residents (n=463) was 63% (Britton et al., 2021), nasopharyngeal viral load was significantly decreased following a single dose (n = 10) (mean -2.4 log10 calculated by Ct value) (McEllistrem et al., 2021) and an immunogenic response was demonstrated following full vaccination (N= 134) as measured by antibody titres (15274 AU/mL) with no associated difference by age, gender, frailty or comorbidity (Salmeron Rios et al., 2021).
It is recommended that both vaccinated and unvaccinated persons in LTC continue to follow infection control measures such as masking, physical distancing, and hand/respiratory hygiene as long as there is community transmission of COVID-19 (European CDC 2021; ON Ministry of Health 2021; AB Ministry of Health 2021; Health Protection Surveillance Ireland, 2021; CDC Mar 5, 2021; WHO 2021; Brown et al., 2021; Centre for Health Policy Evaluation in LTC, 2021; Love et al., 2021; Jaklevic et al., 2020).
Within Canada 5 provinces have currently prioritized designated family care givers for vaccination to facilitate their presence in LTC (British Columbia, Newfoundland, Nova Scotia, Ontario and Prince Edward Island; NIA 2021).
Family and friends provide critical support to residents of LTC homes as partners in care and as visitors, playing an important role in their overall health and well-being (NIA, 2021; Levere et al., 2021; CFHI and CPSI, 2021; WHO, 2021; Ranhoff et al., 2021). Emerging evidence shows that cessation of visiting has had a significantly negative impact on the well-being physical, emotional, and cognitive well-being of LTC residents and on the well-being of their families (WHO, 2021; Levere et al., 2021; Suarez-Gonzalez et al., 2021; NIA, 2021; Dhama et al., 2021).
Policy changes pertaining to COVID-19 should be informed by all impacts on the health and well-being of LTC residents and their families and friends, beyond the direct effects of morbidity and mortality due to COVID-19 (Levere et al., 2021; Suarez-Gonzalez et al., 2021; WHO, 2021; Dhama et al., 2021; NIA, 2021). Policy guidelines for healthcare decision makers have focused attention on the harms of stringent visitor policies and the need to reintegrate family/designated caregivers for every resident (CFHI and CPSI, 2021; NIA, 2021; WHO, 2021; ON Ministry of Health, 2021, BCDC 2021).
Available data to inform policy on the impact of strict visitation policies and social isolation in LTC is limited and ongoing data collection is required (Suarez-Gonzales et al., 2021; WHO, 2021; Levere et al., 2021 ).
Prioritization of family/designated caregivers in vaccine roll out policies is intended to address the balance of a more comprehensive definition of resident safety and well-being inclusive of quality of life and well-being with morbidity and mortality of COVID-19 (NIA, 2021; WHO, 2021; CFHI and CPS, 2021). Policies prioritizing family/designated caregivers may also reduce the enormous burden placed on LTC staff during the remainder of the pandemic (NIA, 2021).
Ward, H; Tupper, S; Boden, C; Dalidowicz, M; Mueller, M. What impact does COVID-19 vaccination have on visitation policies and transmission rates in LTC? 2021 Mar 29; Document no.: LTC012501 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 44 p. (CEST rapid review report)