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               <mods:identifier type="citation">Emerg Infect Dis. 2021 Oct;27(10):2595-2603.</mods:identifier>
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               <mods:abstract>We conducted a registries-based cohort study of long-term care facility residents >65 years of age offered vaccination against severe acute respiratory syndrome coronavirus 2 before March 10, 2021, in Spain. Risk for infection in vaccinated and nonvaccinated persons was compared with risk in the same persons in a period before the vaccination campaign, adjusted by daily-varying incidence and reproduction number. We selected 299,209 persons; 99.0% had >1 dose, 92.6% had 2 doses, and 99.8% of vaccines were Pfizer/BioNTech (BNT162b2). For vaccinated persons with no previous infection, vaccine effectiveness was 81.8% (95% CI 81.0%-82.7%), and 11.6 (95% CI 11.3-11.9) cases were prevented per 10,000 vaccinated/day. In those with previous infection, effectiveness was 56.8% (95% CI 47.1%-67.7%). In nonvaccinated residents with no previous infection, risk decreased by up to 81.4% (95% CI 73.3%-90.3%). Our results confirm vaccine effectiveness in this population and suggest indirect protection in nonvaccinated persons.</mods:abstract>
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                  <mods:topic>COVID-19</mods:topic>
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                  <mods:topic>SARS-CoV-2</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Spain</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Coronavirus disease</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Elderly</mods:topic>
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                  <mods:topic>Indirect effects</mods:topic>
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                  <mods:topic>Long-term care facilities</mods:topic>
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                  <mods:topic>Respiratory infections</mods:topic>
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               <mods:subject>
                  <mods:topic>Severe acute respiratory syndrome coronavirus 2</mods:topic>
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                  <mods:topic>Transmissibility</mods:topic>
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                  <mods:topic>Vaccination</mods:topic>
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                  <mods:topic>Zoonoses</mods:topic>
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                  <mods:title>Direct and Indirect Effectiveness of mRNA Vaccination against Severe Acute Respiratory Syndrome Coronavirus 2 in Long-Term Care Facilities, Spain</mods:title>
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