To what extent does COVID-19 vaccination protect older people in care homes? Some new evidence from Brazil and Argentina.
Peter Lloyd-Sherlock, Lucas Sempe and Karla Giacomin
On 11 May the Brazilian media reported that there had been a large outbreak of new COVID-19 cases among older people in a residential care facility in the state of Minas Gerais [https://g1.globo.com/mg/sul-de-minas/noticia/2021/05/11/asilo-confirma-infeccao-de-33-idosos-pela-covid-19-em-lavras-todos-haviam-sido-vacinados.ghtml]. It was reported that 33 of the care home’s 46 residents and one member of staff had so far been tested positive for the virus. All of these individuals had already been vaccinated. The point of entry into the care home remains unknown and the care home insists it had followed all the required infection control protocols.
The same day similar reports appeared relating to a care home in Argentina, where 20 older residents and three members of staff had been tested positive for the virus [https://el-periodico.com.ar/contenido/124558/a-una-semana-del-brote-en-el-geriatrico-los-abuelos-siguen-bien-remarco-vicente].
At first sight, this seems worrying news, calling into question the efficacy of these vaccines. However, the most telling point is that all the infected residents and staff in both care homes appeared to be well and none had, as yet, presented COVID-19 symptoms. In other words, the vaccine had not prevented infection, but had (so far) prevented serious illness among this high-risk population group.
These experiences show the importance of vaccinating all care home residents and staff, and of continuing regular testing afterwards. This is not always a simple task, since many care homes in Latin America operate informally and are not registered with local government agencies [https://corona-older.com/2020/11/24/an-emergency-strategy-for-managing-covid-19-in-long-term-care-facilities-in-low-and-middle-income-countries-the-ciat-framework-version-2/]. In other words, these facilities are effectively invisible to public health authorities. The COVID-19 pandemic has demonstrated the urgent need to improve regulation of care homes in the region.