Objective To determine associations of BNT162b2 vaccination with SARS-CoV-2 infection and hospital admission and death with covid-19 among nursing home residents, nursing home staff, and healthcare workers. Design Prospective cohort study. Setting Nursing homes and linked electronic medical record, test, and mortality data in Catalonia on 27 December 2020. Participants 28 456 nursing home residents, 26 170 nursing home staff, and 61 791 healthcare workers. Main outcome measures Participants were followed until the earliest outcome (confirmed SARS-CoV-2 infection, hospital admission or death with covid-19) or 26 May 2021. Vaccination status was introduced as a time varying exposure, with a 14 day run-in after the first dose. Mixed effects Cox models were fitted to estimate hazard ratios with index month as a fixed effect and adjusted for confounders including sociodemographics, comorbidity, and previous medicine use. Results Among the nursing home residents, SARS-CoV-2 infection was found in 2482, 411 were admitted to hospital with covid-19, and 450 died with covid-19 during the study period. In parallel, 1828 nursing home staff and 2968 healthcare workers were found to have SARS-CoV-2 infection, but fewer than five were admitted or died with covid-19. The adjusted hazard ratio for SARS-CoV-2 infection after two doses of vaccine was 0.09 (95% confidence interval 0.08 to 0.11) for nursing home residents, 0.20 (0.17 to 0.24) for nursing home staff, and 0.13 (0.11 to 0.16) for healthcare workers. Adjusted hazard ratios for hospital admission and mortality after two doses of vaccine were 0.05 (0.04 to 0.07) and 0.03 (0.02 to 0.04), respectively, for nursing home residents. Nursing home staff and healthcare workers recorded insufficient events for mortality analysis. Conclusions Vaccination was associated with 80-91% reduction in SARS-CoV-2 infection in all three cohorts and greater reductions in hospital admissions and mortality among nursing home residents for up to five months. More data are needed on longer term effects of covid-19 vaccines. No patient level data can be shared owing to local information governance and data protection regulations. Aggregated data are available and reported in the supplement.

中文翻译：

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加泰罗尼亚疗养院和医护人员中 BNT162b2 疫苗接种与 SARS-CoV-2 感染以及因 covid-19 住院和死亡的关联：前瞻性队列研究

目的 确定疗养院居民、疗养院工作人员和医护人员中 BNT162b2 疫苗接种与 SARS-CoV-2 感染、covid-19 住院和死亡之间的关联。设计前瞻性队列研究。2020 年 12 月 27 日在加泰罗尼亚设置疗养院和相关电子病历、测试和死亡率数据。参与者包括 28 456 名疗养院居民、26 170 名疗养院工作人员和 61 791 名医护人员。主要结局指标 对参与者进行随访，直到最早的结局（确认 SARS-CoV-2 感染、入院或因 covid-19 死亡）或 2021 年 5 月 26 日。疫苗接种状态被引入为随时间变化的暴露，有 14 天的磨合在第一剂之后。混合效应 Cox 模型被拟合以估计风险比，指数月作为固定效应，并针对混杂因素进行调整，包括社会人口统计学、合并症和既往药物使用。结果在研究期间，疗养院居民中 2482 人感染了 SARS-CoV-2，411 人因 covid-19 入院，450 人死于 covid-19。同时，发现 1828 名疗养院工作人员和 2968 名医护人员感染了 SARS-CoV-2，但只有不到 5 人因 covid-19 入院或死亡。两剂疫苗接种后调整后的 SARS-CoV-2 感染风险比为：疗养院居民 0.09（95% 置信区间 0.08 至 0.11）、疗养院工作人员 0.20（0.17 至 0.24）和 0.13（0.11 至 0.16）对于医护人员。对于疗养院居民，两剂疫苗后住院和死亡率的调整风险比分别为 0.05（0.04 至 0.07）和 0.03（0.02 至 0.04）。疗养院工作人员和医护人员记录的事件不足以进行死亡率分析。结论 疫苗接种与所有三个队列中 SARS-CoV-2 感染减少 80-91% 以及在长达五个月的疗养院居民中住院人数和死亡率的更大减少相关。需要更多关于 covid-19 疫苗长期影响的数据。由于当地信息治理和数据保护法规，无法共享患者级别的数据。汇总数据可用，并在补充资料中报告。疗养院工作人员和医护人员记录的事件不足以进行死亡率分析。结论 疫苗接种与所有三个队列中 SARS-CoV-2 感染减少 80-91% 以及在长达五个月的疗养院居民中住院人数和死亡率的更大减少相关。需要更多关于 covid-19 疫苗长期影响的数据。由于当地信息治理和数据保护法规，无法共享患者级别的数据。汇总数据可用，并在补充资料中报告。疗养院工作人员和医护人员记录的事件不足以进行死亡率分析。结论 疫苗接种与所有三个队列中 SARS-CoV-2 感染减少 80-91% 以及在长达五个月的疗养院居民中住院人数和死亡率的更大减少相关。需要更多关于 covid-19 疫苗长期影响的数据。由于当地信息治理和数据保护法规，无法共享患者级别的数据。汇总数据可用，并在补充资料中报告。需要更多关于 covid-19 疫苗长期影响的数据。由于当地信息治理和数据保护法规，无法共享患者级别的数据。汇总数据可用，并在补充资料中报告。需要更多关于 covid-19 疫苗长期影响的数据。由于当地信息治理和数据保护法规，无法共享患者级别的数据。汇总数据可用，并在补充资料中报告。