Effectiveness of 2-Dose Vaccination with mRNA COVID-19 Vaccines Against COVID-19–Associated Hospitalizations Among Immunocompromised Adults — Nine States, January–September 2021

Embí, Peter J.; Levy, Matthew E.; Naleway, Allison L.; Patel, Palak; Gaglani, Manjusha; Natarajan, Karthik; Dascomb, Kristin; Ong, Toan C.; Klein, Nicola P.; Liao, I‐Chia; Grannis, Shaun J.; Han, Jungmi; Stenehjem, Edward; Dunne, Margaret M.; Lewis, Ned; Irving, Stephanie A.; Rao, Suchitra; McEvoy, Charlene; Bozio, Catherine H; Murthy, Kempapura; Dixon, Brian E.; Grisel, Nancy; Yang, Deying; Goddard, Kristin; Kharbanda, Anupam B.; Reynolds, Sue; Raiyani, Chandni; Fadel, William F.; Arndorfer, Julie; Rowley, Elizabeth; Fireman, Bruce; Ferdinands, Jill; Valvi, Nimish R; Ball, Sarah; Zerbo, Ousseny; Griggs, Eric P.; Mitchell, Patrick K.; Porter, Rachael M.; Kiduko, Salome A.; Blanton, Lenee; Zhuang, Yan; Steffens, Andrea; Reese, Sarah E.; Olson, Natalie; Williams, Jeremiah; Dickerson, Monica; McMorrow, Meredith; Schrag, Stephanie J.; Verani, Jennifer R.; Fry, Alicia M.; Azziz‐Baumgartner, Eduardo; Barron, Michelle A.; Thompson, Mark G.; DeSilva, Malini B.

doi:10.15585/mmwr.mm7044e3

Cited by 151 publications

(156 citation statements)

References 9 publications

(16 reference statements)

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“… 78 Data from the VISION Network compared VE against COVID-19 associated hospitalization after receipt of a 2-dose vaccination series in 20,101 immuncompromised adults and 69,116 immunocompetent adults. 79 VE was found to be lower in the immunocompromised patients (77%) compared with the immunocompetent patients (90%) irrespective of age, delta variant predominance, and mRNA vaccine product. 79 VE point estimates demonstrated a VE of 79% in those with solid malignancy, 74% with hematologic malignancy, 81% with a rheumatologic or inflammatory disorder, 73% with an intrinsic immune or immunodeficiency, 59% in solid organ or stem cell transplant recipients.…”

Section: Clinical Data Of Mrna Therapeutics For Sars Cov-2mentioning

confidence: 84%

“… 79 VE was found to be lower in the immunocompromised patients (77%) compared with the immunocompetent patients (90%) irrespective of age, delta variant predominance, and mRNA vaccine product. 79 VE point estimates demonstrated a VE of 79% in those with solid malignancy, 74% with hematologic malignancy, 81% with a rheumatologic or inflammatory disorder, 73% with an intrinsic immune or immunodeficiency, 59% in solid organ or stem cell transplant recipients. Generally, the VE point estimates were higher for those who received 2 doses of Moderna compared with Pfizer-BioNTech except in those with a rheumatologic or inflammatory disorder (they were the same).…”

Section: Clinical Data Of Mrna Therapeutics For Sars Cov-2mentioning

confidence: 84%

“…Generally, the VE point estimates were higher for those who received 2 doses of Moderna compared with Pfizer-BioNTech except in those with a rheumatologic or inflammatory disorder (they were the same). 79 On August 12, 2021, the FDA amended the EUA for the Pfizer-BioNTech and Moderna COVID-19 vaccines, which allowed moderately to severely imunocompromised individuals to receive an additional dose of COVID-19 vaccination for a 3 total dose primary vaccine series. One day later the CDC issued a statement supporting the FDA's amendment.…”

Section: Clinical Data Of Mrna Therapeutics For Sars Cov-2mentioning

confidence: 99%

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Messenger ribonucleic acid vaccines for severe acute respiratory syndrome coronavirus-2 – a review

Akamine

Sahly

2022

Translational Research

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The mRNA therapeutics have been studied since the 1970s and the currently available mRNA vaccines against COVID-19 are the culmination of decades of scientific research. The mRNA vaccines BNT162b2 and mRNA-1273 have played a key role in our global response to the COVID-19 pandemic as they have demonstrated significant advantages over conventional vaccines and have proven to be highly effective against COVID-19 associated hospitalization and severe illness in large clinical trials and studies using real-world data.

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Section: Clinical Data Of Mrna Therapeutics For Sars Cov-2mentioning

confidence: 84%

Section: Clinical Data Of Mrna Therapeutics For Sars Cov-2mentioning

confidence: 84%

Section: Clinical Data Of Mrna Therapeutics For Sars Cov-2mentioning

confidence: 99%

See 1 more Smart Citation

Messenger ribonucleic acid vaccines for severe acute respiratory syndrome coronavirus-2 – a review

Akamine

Sahly

2022

Translational Research

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“…Second, since we estimated the VE based on only short-term durations, we could not evaluate the long term VE or need for a third vaccine dose. One recent study published after our systematic search ended evaluated the long term VE among those immunocompromised and reported the effectiveness of mRNA vaccination against COVID-19 hospitalization was lower (77%) among immunocompromised individuals than among immunocompetent individuals (90%) over nine months ( 10 ). There is a need for longer-term observational studies to assess sustained immune response and VE.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies evaluated the humoral immune response among these patients ( 8 ). Studies suggested that immunocompromised patients who received COVID-19 vaccines might not develop high neutralizing antibody titers or be as protected against severe COVID-19 outcomes as are immunocompetent patients ( 9 , 10 ). Vaccine responsiveness in patients who were receiving an immunosuppressor drug therapy exhibited impaired serological immune responses ( 9 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

Short-term effectiveness of COVID-19 vaccines in immunocompromised patients: A systematic literature review and meta-analysis

Marra

Kobayashi

Suzuki

et al. 2022

Journal of Infection

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Objectives : We aimed to assess the short-term effectiveness of COVID-19 vaccines among immunocompromised patients to prevent laboratory-confirmed symptomatic COVID-19 infection. Methods: Systematic review and meta-analysis. We calculated the pooled diagnostic odds ratio [DOR] (95% CI) for COVID-19 infection between immunocompromised patients and healthy people or those with stable chronic medical conditions. VE was estimated as 100% x (1-DOR). We also investigated the rates of developing anti-SARS-CoV-2 spike protein IgG between the 2 groups. Results: Twenty studies evaluating COVID-19 vaccine response, and four studies evaluating VE were included in the meta-analysis. The pooled DOR for symptomatic COVID-19 infection in immunocompromised patients was 0.296 (95% CI: 0.108-0.811) with an estimated VE of 70.4% (95% CI: 18.9%- 89.2%). When stratified by diagnosis, IgG antibody levels were much higher in the control group compared to immunocompromised patients with solid organ transplant (pOR 232.3; 95% Cl: 66.98-806.03), malignant diseases (pOR 42.0, 95% Cl: 11.68-151.03), and inflammatory rheumatic diseases (pOR 19.06; 95% Cl: 5.00-72.62). Conclusions: We found COVID-19 mRNA vaccines were effective against symptomatic COVID-19 among the immunocompromised patients but had lower VE compared to the controls. Further research is needed to understand the discordance between antibody production and protection against symptomatic COVID-19 infection.

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Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants

Accorsi

Britton

Fleming-Dutra

et al. 2022

JAMA

Self Cite

573

521

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IMPORTANCEAssessing COVID-19 vaccine performance against the rapidly spreading SARS-CoV-2 Omicron variant is critical to inform public health guidance.OBJECTIVE To estimate the association between receipt of 3 doses of Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273 vaccine and symptomatic SARS-CoV-2 infection, stratified by variant (Omicron and Delta). DESIGN, SETTING, AND PARTICIPANTSA test-negative case-control analysis among adults 18 years or older with COVID-like illness tested December 10, 2021, through January 1, 2022, by a national pharmacy-based testing program (4666 COVID-19 testing sites across 49 US states).EXPOSURES Three doses of mRNA COVID-19 vaccine (third dose Ն14 days before test and Ն6 months after second dose) vs unvaccinated and vs 2 doses 6 months or more before test (ie, eligible for a booster dose). MAIN OUTCOMES AND MEASURESAssociation between symptomatic SARS-CoV-2 infection (stratified by Omicron or Delta variants defined using S-gene target failure) and vaccination (3 doses vs unvaccinated and 3 doses vs 2 doses). Associations were measured with multivariable multinomial regression. Among cases, a secondary outcome was median cycle threshold values (inversely proportional to the amount of target nucleic acid present) for 3 viral genes, stratified by variant and vaccination status.RESULTS Overall, 23 391 cases (13 098 Omicron; 10 293 Delta) and 46 764 controls were included (mean age, 40.3 [SD, 15.6] years; 42 050 [60.1%] women). Prior receipt of 3 mRNA vaccine doses was reported for 18.6% (n = 2441) of Omicron cases, 6.6% (n = 679) of Delta cases, and 39.7% (n = 18 587) of controls; prior receipt of 2 mRNA vaccine doses was reported for 55.3% (n = 7245), 44.4% (n = 4570), and 41.6% (n = 19 456), respectively; and being unvaccinated was reported for 26.0% (n = 3412), 49.0% (n = 5044), and 18.6% (n = 8721), respectively. The adjusted odds ratio for 3 doses vs unvaccinated was 0.33 (95% CI, 0.31-0.35) for Omicron and 0.065 (95% CI, 0.059-0.071) for Delta; for 3 vaccine doses vs 2 doses the adjusted odds ratio was 0.34 (95% CI, 0.32-0.36) for Omicron and 0.16 (95% CI, 0.14-0.17) for Delta. Median cycle threshold values were significantly higher in cases with 3 doses vs 2 doses for both Omicron and Delta (

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Effectiveness of 2-Dose Vaccination with mRNA COVID-19 Vaccines Against COVID-19–Associated Hospitalizations Among Immunocompromised Adults — Nine States, January–September 2021

Cited by 151 publications

References 9 publications

Messenger ribonucleic acid vaccines for severe acute respiratory syndrome coronavirus-2 – a review

Messenger ribonucleic acid vaccines for severe acute respiratory syndrome coronavirus-2 – a review

Short-term effectiveness of COVID-19 vaccines in immunocompromised patients: A systematic literature review and meta-analysis

Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants

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