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Seed funding to a project about pandemic response and preparedness


Adam Mitchell is one of five recipients of this year´s EpiHealth seed money.

Worldwide, the COVID-19 pandemic caused disproportionately higher morbidity and mortality in older adults, particularly in nursing homes for older adults. In Swedish nursing homes, COVID-19 was associated with a large excess in mortality after controlling for an extensive number of risk factors, suggesting that reducing transmission of COVID-19 would prevent a considerable number of deaths. 

Vaccination one method

Vaccination is one such method of transmission reduction and achieving a high rate of vaccination in individuals residing and working in nursing homes as well as in the entire population is critical to reduce morbidity and mortality. Higher staffing ratios were helpful in containing outbreaks in nursing homes, however higher staff traffic between nursing homes and in and out of areas with high COVID-19 prevalence was associated with more cases and deaths in nursing homes. To combat this, staff and residents in nursing homes were among the first to be eligible for vaccination.        

Regional differences in vaccination

By combining different health and population registers, the aim of Adam Mitchell´s project is to assess the extent to which COVID-19 vaccination among nursing home staff was associated with preventing Covid-19 cases, severe health outcomes and deaths among nursing home residents in all Sweden. He also aim to assess regional differences in vaccination uptake within nursing homes among residents, staff and close relatives of residents to assess whether socioeconomic differences persist in this setting. We will also extend this to influenza and RS vaccination in specific regions (Skåne) with the later goal of extending this all Sweden.                                             

This work will provide evidence on how preventive measures could decrease the burden of infectious diseases among older adults living in nursing homes. It will improve knowledge around pandemic response and preparedness while improving and generating surveillance infrastructure in the form of relevant register data in nursing home settings. 

Causal effects of increasing staff COVID-19 vaccination 

With this infrastructure we would have the possibility to estimate causal effects of increasing staff COVID-19 vaccination in nursing homes on nursing home resident COVID-19 outcomes and also extend to influenza and other infectious diseases. This project could have long term societal benefits, aiding policy makers identify specific groups for targeted vaccine campaigns and helping to improve health among older people living in nursing homes.