How the Timing of Annual COVID-19 Vaccination of Nursing Home Residents and Staff Affects Its Value

How the Timing of Annual COVID-19 Vaccination of Nursing Home Residents and Staff Affects Its Value

To evaluate the epidemiologic, clinical, and economic value of an annual nursing home (NH) COVID-19 vaccine campaign and the impact of when vaccination starts. Agent-based model representing a typical NH. NH residents and staff. We used the model representing an NH with 100 residents, its staff, the...

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Published in:Journal of the American Medical Directors Association Vol. 25; no. 4; pp. 639 - 646.e5
Main Authors: Bartsch, Sarah M., Weatherwax, Colleen, Wasserman, Michael R., Chin, Kevin L., Martinez, Marie F., Velmurugan, Kavya, Singh, Raveena D., John, Danielle C., Heneghan, Jessie L., Gussin, Gabrielle M., Scannell, Sheryl A., Tsintsifas, Alexandra C., O'Shea, Kelly J., Dibbs, Alexis M., Leff, Bruce, Huang, Susan S., Lee, Bruce Y.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-04-2024
Subjects:
annual vaccination
cost-effectiveness
COVID-19
economic
Nursing homes
SARS-CoV-2
COVID-19
Nursing homes
cost-effectiveness
SARS-CoV-2
annual vaccination
economic
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Summary:To evaluate the epidemiologic, clinical, and economic value of an annual nursing home (NH) COVID-19 vaccine campaign and the impact of when vaccination starts. Agent-based model representing a typical NH. NH residents and staff. We used the model representing an NH with 100 residents, its staff, their interactions, COVID-19 spread, and its health and economic outcomes to evaluate the epidemiologic, clinical, and economic value of varying schedules of annual COVID-19 vaccine campaigns. Across a range of scenarios with a 60% vaccine efficacy that wanes starting 4 months after protection onset, vaccination was cost saving or cost-effective when initiated in the late summer or early fall. Annual vaccination averted 102 to 105 COVID-19 cases when 30-day vaccination campaigns began between July and October (varying with vaccination start), decreasing to 97 and 85 cases when starting in November and December, respectively. Starting vaccination between July and December saved $3340 to $4363 and $64,375 to $77,548 from the Centers for Medicare & Medicaid Services and societal perspectives, respectively (varying with vaccination start). Vaccination's value did not change when varying the COVID-19 peak between December and February. The ideal vaccine campaign timing was not affected by reducing COVID-19 levels in the community, or varying transmission probability, preexisting immunity, or COVID-19 severity. However, if vaccine efficacy wanes more quickly (over 1 month), earlier vaccination in July resulted in more cases compared with vaccinating later in October. Annual vaccination of NH staff and residents averted the most cases when initiated in the late summer through early fall, at least 2 months before the COVID-19 winter peak but remained cost saving or cost-effective when it starts in the same month as the peak. This supports tethering COVID vaccination to seasonal influenza campaigns (typically in September-October) for providing protection against SARS-CoV-2 winter surges in NHs.
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ISSN:1525-8610
1538-9375
DOI:10.1016/j.jamda.2024.02.005