Effectiveness of Severe Acute Respiratory Syndrome Coronavirus 2 Messenger RNA Vaccines for Preventing Coronavirus Disease 2019 Hospitalizations in the United States. (6th August 2021)

• Record Type: Journal Article
• Authors: Tenforde, Mark W; Patel, Manish M; Ginde, Adit A; Douin, David J; Talbot, H Keipp; Casey, Jonathan D; Mohr, Nicholas M; Zepeski, Anne; Gaglani, Manjusha; McNeal, Tresa; Ghamande, Shekhar; Shapiro, Nathan I; Gibbs, Kevin W; Files, D Clark; Hager, David N; Shehu, Arber; Prekker, Matthew E; Erickson, Heidi L; Exline, Matthew C; Gong, Michelle N; Mohamed, Amira; Henning, Daniel J; Steingrub, Jay S; Peltan, Ithan D; Brown, Samuel M; Martin, Emily T; Monto, Arnold S; Khan, Akram; Hough, Catherine L; Busse, Laurence W; ten Lohuis, Caitlin C; Duggal, Abhijit; Wilson, Jennifer G; Gordon, Alexandra June; Qadir, Nida; Chang, Steven Y; Mallow, Christopher; Gershengorn, Hayley B; Babcock, Hilary M; Kwon, Jennie H; Halasa, Natasha; Chappell, James D; Lauring, Adam S; Grijalva, Carlos G; Rice, Todd W; Jones, Ian D; Stubblefield, William B; Baughman, Adrienne; Womack, Kelsey N; Lindsell, Christopher J; Hart, Kimberly W; Zhu, Yuwei; Olson, Samantha M; Stephenson, Meagan; Schrag, Stephanie J; Kobayashi, Miwako; Verani, Jennifer R; Self, Wesley H;
• Is Part Of: Clinical infectious diseases. Volume 74:Number 9(2022)
• Page Start: 1515
• Page End: 1524
• Publication Date: 2021-08-06
• Subjects: COVID-19 -- vaccine effectiveness -- mRNA vaccines -- hospitalized -- immunocompromised; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciab687
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination coverage increases in the United States, there is a need to understand the real-world effectiveness against severe coronavirus disease 2019 (COVID-19) and among people at increased risk for poor outcomes. Methods: In a multicenter case-control analysis of US adults hospitalized March 11–May 5, 2021, we evaluated vaccine effectiveness to prevent COVID-19 hospitalizations by comparing odds of prior vaccination with a messenger RNA (mRNA) vaccine (Pfizer-BioNTech or Moderna) between cases hospitalized with COVID-19 and hospital-based controls who tested negative for SARS-CoV-2. Results: Among 1212 participants, including 593 cases and 619 controls, median age was 58 years, 22.8% were Black, 13.9% were Hispanic, and 21.0% had immunosuppression. SARS-CoV-2 lineage B0.1.1.7 (Alpha) was the most common variant (67.9% of viruses with lineage determined). Full vaccination (receipt of 2 vaccine doses ≥14 days before illness onset) had been received by 8.2% of cases and 36.4% of controls. Overall vaccine effectiveness was 87.1% (95% confidence interval [CI], 80.7–91.3). Vaccine effectiveness was similar for Pfizer-BioNTech and Moderna vaccines, and highest in adults aged 18–49 years (97.4%; 95% CI, 79.3–9.7). Among 45 patients with vaccine-breakthrough COVID hospitalizations, 44 (97.8%) were ≥50 years old and 20 (44.4%) had immunosuppression. Vaccine effectiveness was lower among patients with immunosuppression (62.9%; 95% CI, 20.8–82.6) than without immunosuppression (91.3%; 95% CI, 85.6–94.8). Conclusion: During March–May 2021, SARS-CoV-2 mRNA vaccines were highly effective for preventing COVID-19 hospitalizations among US adults. SARS-CoV-2 vaccination was beneficial for patients with immunosuppression, but effectiveness was lower in the immunosuppressed population. Abstract : From March to May 2021, full vaccination using authorized mRNA products was associated with 87.1% (95% CI, 80.7–91.3) protection against COVID-19 hospitalization among US adults. Vaccine effectiveness was lower in adults with versus without immunosuppression (62.9% versus 91.3%).