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Even Partial COVID-19 lence of underlying medical conditions,” the Protects Nursing Home Residents authors wrote. A CDC analysis has shown that a single dose Waning COVID-19 cases as more resi- of the Pfizer-BioNTech COVID-19 dents and staff received second vaccina- protected medically vulnerable nursing tions made it impossible to assess vaccine ef- home residents as well as it did general adult fectiveness after 2 doses. Evidence from populations that were evaluated in other ef- previous studies demonstrated greater pro- ficacy and effectiveness studies. tection among older adults after a second The analysis helps fill a data gap about dose, suggesting that completing the 2-dose vaccine effectiveness in this high-risk regimen may be particularly important to group—generally older, frail adults with un- protect long-term care facility residents, the derlying health conditions—who were left authors suggested. out of COVID-19 vaccine trials. Excluding older adults from the trials raised questions Vaccine Dramatically Reduces HPV about how well nursing home residents Among Young Women would respond to vaccination. Widespread vaccination of young women By analyzing the Pfizer-BioNTech vac- against human papillomavirus (HPV) has led cine’sperformanceduringalateJanuaryout- to a greater than 80% reduction in infec- the 4 HPV strains most likely to cause dis- break at 2 Connecticut skilled nursing facili- tions with the 4 strains most often associ- ease. Newer versions that protect against 9 ties, investigators from the CDC and the ated with disease, according to a CDC study. strains became available in 2015. Connecticut Department of Public Health Although most HPV are be- According to National Health and Nutri- provided real-world data about this vulner- nign and resolve quickly, HPV vaccination tionExaminationSurveydata,infectionrates able population. A review of 463 residents’ has been recommended since 2006 for pre- among females aged 14 to 19 years with charts showed that the vaccine was 63% ef- teen girls starting at age 11 or 12 years to pre- strains targeted by the quadrivalent vac- fective during the period that stretched from vent cervical, oral, or anal and geni- cine fell from 11.5% during the 3 years be- 14 days after their first shot until 7 days af- tal or anal resulting from persistent fore HPV began to 1.1% during ter their second. infection. Catch-up vaccination is recom- 2015 to 2018. In addition, infections with the “Even during a large disease outbreak in mended for teens and young women up to other 5 strains decreased from 8.4% in the a long-term care setting, the Pfizer-BioNTech age 26 years. prevaccine era to 2.3% in 2015 to 2018. vaccine provided protection against SARS- Vaccination has also been recommended Among women in their early 20s, infection CoV-2 infection, including in older adults for boys aged 11 or 12 years since 2011. Ini- with quadrivalent vaccine-preventable aged 65 years [or older] with a high preva- tially,quadrivalentvaccinesprotectedagainst strainsdecreasedfrom18.5%duringthepre- vaccine years to 3.3% during 2015 to 2018. No decrease in prevalence was reported af- ter 2015 for the other 5 strains. Lower rates of sexual activity among fe- males aged 14 to 19 years after HPV vaccine became available may also have contrib- uted to decreased infections in their age group, the authors noted. Sexual activity rates in the older age group remained stable. Significant decreases in infection rates among unvaccinated girls and young women whoweresexuallyactiveindicateaherdeffect from widespread HPV vaccination between theprevaccineeraand2015to2018.Infections with the quadrivalent vaccine–preventable strains fell by 87% among females aged 14 to 19 years and by 65% among women aged 20 to 24 years. − Bridget M. Kuehn, MSJ Note: Source references are available through

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1826 JAMA May 11, 2021 Volume 325, Number 18 (Reprinted) jama.com

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