Mark W Tenforde1, Wesley H Self2, Yuwei Zhu2, Eric A Naioti1, Manjusha Gaglani3,4, Adit A Ginde5, Kelly Jensen5, H Keipp Talbot2, Jonathan D Casey2, Nicholas M Mohr6, Anne Zepeski6, Tresa McNeal3,4, Shekhar Ghamande3,4, Kevin W Gibbs7, D Clark Files7, David N Hager8, Arber Shehu8, Matthew E Prekker9, Heidi L Erickson9, Michelle N Gong10, Amira Mohamed10, Nicholas J Johnson11, Vasisht Srinivasan11, Jay S Steingrub12, Ithan D Peltan13, Samuel M Brown13, Emily T Martin14, Arnold S Monto14, Akram Khan15, Catherine L Hough15, Laurence W Busse16, Caitlin Ten Lohuis16, Abhijit Duggal17, Jennifer G Wilson18, Nida Qadir19, Steven Y Chang19, Christopher Mallow20, Carolina Rivas20, Hilary M Babcock21, Jennie H Kwon21, Matthew C Exline22, Mena M Botros22, Adam S Lauring23, Nathan I Shapiro24, Natasha Halasa2, James D Chappell2, Carlos G Grijalva2, Todd W Rice2, Ian D Jones2, William B Stubblefield2, Adrienne Baughman2, Kelsey N Womack2, Jillian P Rhoads2, Christopher J Lindsell2, Kimberly W Hart2, Caitlin Turbyfill1, Samantha Olson1, Nancy Murray1, Katherine Adams1, Manish M Patel1.
Abstract
BACKGROUND: COVID-19 mRNA vaccines were authorized in the United States in December 2020. Although vaccine effectiveness (VE) against mild infection declines markedly after several months, limited understanding exists on the long-term durability of protection against COVID-19-associated hospitalization.
METHODS: Case control analysis of adults (≥18 years) hospitalized at 21 hospitals in 18 states March 11 - December 15, 2021, including COVID-19 case patients and RT-PCR-negative controls. We included adults who were unvaccinated or vaccinated with two doses of a mRNA vaccine before the date of illness onset. VE over time was assessed using logistic regression comparing odds of vaccination in cases versus controls, adjusting for confounders. Models included dichotomous time (<180 vs ≥180 days since dose two) and continuous time modeled using restricted cubic splines.
RESULTS: 10,078 patients were included, 4906 cases (23% vaccinated) and 5172 controls (62% vaccinated). Median age was 60 years (IQR 46-70), 56% were non-Hispanic White, and 81% had ≥1 medical condition. Among immunocompetent adults, VE <180 days was 90% (95%CI: 88-91) vs 82% (95%CI: 79-85) at ≥180 days (p < 0.001). VE declined for Pfizer-BioNTech (88% to 79%, p < 0.001) and Moderna (93% to 87%, p < 0.001) products, for younger adults (18-64 years) [91% to 87%, p = 0.005], and for adults ≥65 years of age (87% to 78%, p < 0.001). In models using restricted cubic splines, similar changes were observed.
CONCLUSION: In a period largely pre-dating Omicron variant circulation, effectiveness of two mRNA doses against COVID-19-associated hospitalization was largely sustained through 9 months. © Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2022.
BACKGROUND: COVID-19 mRNA vaccines were authorized in the United States in December 2020. Although vaccine effectiveness (VE) against mild infection declines markedly after several months, limited understanding exists on the long-term durability of protection against COVID-19-associated hospitalization.
METHODS: Case control analysis of adults (≥18 years) hospitalized at 21 hospitals in 18 states March 11 - December 15, 2021, including COVID-19 case patients and RT-PCR-negative controls. We included adults who were unvaccinated or vaccinated with two doses of a mRNA vaccine before the date of illness onset. VE over time was assessed using logistic regression comparing odds of vaccination in cases versus controls, adjusting for confounders. Models included dichotomous time (<180 vs ≥180 days since dose two) and continuous time modeled using restricted cubic splines.
RESULTS: 10,078 patients were included, 4906 cases (23% vaccinated) and 5172 controls (62% vaccinated). Median age was 60 years (IQR 46-70), 56% were non-Hispanic White, and 81% had ≥1 medical condition. Among immunocompetent adults, VE <180 days was 90% (95%CI: 88-91) vs 82% (95%CI: 79-85) at ≥180 days (p < 0.001). VE declined for Pfizer-BioNTech (88% to 79%, p < 0.001) and Moderna (93% to 87%, p < 0.001) products, for younger adults (18-64 years) [91% to 87%, p = 0.005], and for adults ≥65 years of age (87% to 78%, p < 0.001). In models using restricted cubic splines, similar changes were observed.
CONCLUSION: In a period largely pre-dating Omicron variant circulation, effectiveness of two mRNA doses against COVID-19-associated hospitalization was largely sustained through 9 months. © Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2022.
Entities:
Keywords:
COVID-19; duration of protection; mRNA; vaccine effectiveness; waning
Year: 2022
PMID： 35580849 PMCID： PMC9129194 DOI： 10.1093/cid/ciac381
Source DB: PubMed Journal: Clin Infect Dis ISSN： 1058-4838 Impact factor: 20.999