Supplementary Material

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Background: No studies have so far explored differences in frailty between groups of individuals who are vaccinated/unvaccinated against COVID-19.  Therefore, this study aimed to investigate frailty progression in community-dwelling individuals requiring care/support who were using outpatient rehabilitation services during the start phase of vaccination programs against COVID-19.

Methods: A longitudinal survey using the Frailty Screening Index was administered in April 2020, September 2020, and June 2021 to 74 older adults (43 males, 31 females; age, 78.2 ± 7.2; mean ± standard deviation) requiring long-term care/support and using outpatient rehabilitation services. Participants
were divided into the vaccinated (those who had received COVID-19 vaccinations; 41 participants) and unvaccinated (those who had not been vaccinated; 33 participants) groups. The Frailty Screening Index and frailty rating (robust, pre-frailty/frailty) at each of the three periods were analyzed using the Cochran's Q test. The resulting items and ratings with significant differences underwent post-hoc testing with the Bonferroni correction.

Results: Concerning the frailty rating (robust, pre-frailty/frailty), pre-frailty/frailty increased significantly only in the unvaccinated group. Its post hoc tests showed that pre-frailty/frailty increased significantly from April 2020 to June 2021 and from September 2020 to June 2021.

Conclusions: We find a difference in frailty progression between groups of vaccinated and unvaccinated community-dwelling older adults requiring  care/support who were using outpatient rehabilitation services at the beginning of coronavirus vaccination programs during the COVID-19 pandemic.