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We collected data from 10 EU/EEA countries on 240 COVID-19 outbreaks occurring from July−October 2021 in long-term care facilities with high vaccination coverage. Among 17,268 residents, 3,832 (22.2%) COVID-19 cases were reported. Median attack rate was 18.9% (country range: 2.8–52.4%), 17.4% of cases were hospitalised, 10.2% died. In fully vaccinated residents, adjusted relative risk for COVID-19 increased with outbreak attack rate. Findings highlight the importance of early outbreak detection and rapid containment through effective infection prevention and control measures.


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  1. European Centre for Disease Prevention and Control (ECDC). Rapid Risk Assessment: COVID-19 outbreaks in long-term care facilities in the EU/EEA in the context of current vaccination coverage. Stockholm: ECDC; 26 Jul 2021. Available from: https://www.ecdc.europa.eu/en/publications-data/rapid-risk-assessment-covid-19-outbreaks-long-term-care-facilities-eueea
  2. European Centre for Disease prevention and Control (ECDC). Data collection on COVID-19 outbreaks in closed settings with a completed vaccination programme: long-term care facilities, version 2.0. Stockholm: ECDC;3 Sep 2021. Available from: https://www.ecdc.europa.eu/en/publications-data/data-collection-covid-19-outbreaks-closed-settings-completed-vaccination
  3. European Centre for Disease Prevention and Control (ECDC). Case definition for coronavirus disease 2019 (COVID-19), as of 3 December 2020. Stockholm: ECDC; 3 Dec 2020. Available from: https://www.ecdc.europa.eu/en/covid-19/surveillance/case-definition
  4. Kaslow DC. Force of infection: a determinant of vaccine efficacy? NPJ Vaccines. 2021;6(1):51.  https://doi.org/10.1038/s41541-021-00316-5  PMID: 33846340 
  5. Nanduri S, Pilishvili T, Derado G, Soe MM, Dollard P, Wu H, et al. Effectiveness of Pfizer-BioNTech and Moderna Vaccines in Preventing SARS-CoV-2 Infection Among Nursing Home Residents Before and During Widespread Circulation of the SARS-CoV-2 B.1.617.2 (Delta) Variant - National Healthcare Safety Network, March 1-August 1, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(34):1163-6.  https://doi.org/10.15585/mmwr.mm7034e3  PMID: 34437519 
  6. Falsey AR, Frenck RW Jr, Walsh EE, Kitchin N, Absalon J, Gurtman A, et al. SARS-CoV-2 Neutralization with BNT162b2 Vaccine Dose 3. N Engl J Med. 2021;385(17):1627-9.  https://doi.org/10.1056/NEJMc2113468  PMID: 34525276 
  7. Bar-On YM, Goldberg Y, Mandel M, Bodenheimer O, Freedman L, Kalkstein N, et al. Protection of BNT162b2 Vaccine Booster against Covid-19 in Israel. N Engl J Med. 2021;385(15):1393-400.  https://doi.org/10.1056/NEJMoa2114255  PMID: 34525275 
  8. Andrews N, Stowe J, Kirsebom F, Gower C, Ramsay M, Bernal JL. Effectiveness of BNT162b2 (Comirnaty, Pfizer-BioNTech) COVID-19 booster vaccine against covid-19 related symptoms in England: test negative case-control study. Pre-print. medRxiv. 15 Nov 2021. Available from: https://www.medrxiv.org/content/10.1101/2021.11.15.21266341v1
  9. European Centre for Disease Prevention and Control (ECDC). Interim public health considerations for the provision of additional COVID-19 vaccine doses. Stockholm: ECDC;1 Sep 2021. Available from: https://www.ecdc.europa.eu/en/publications-data/covid-19-public-health-considerations-additional-vaccine-doses
  10. European Centre for Disease Prevention and Control (ECDC). Overview of the implementation of COVID-19 vaccination strategies and deployment plans in the EU/EEA. Stockholm: ECDC;11 Nov 2021. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-overview-of-the-implementation-of-vaccination-strategies-and-deployment-plans-11-november-2021.pdf

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