Effectiveness of Monovalent mRNA Vaccines Against COVID-19–Associated Hospitalization Among Immunocompetent Adults During BA.1/BA.2 and BA.4/BA.5 Predominant Periods of SARS-CoV-2 Omicron Variant in the United States — IVY Network, 18 States, December 26, 2021–August 31, 2022

Surie, Diya; Bonnell, Levi; Adams, Katherine; Gaglani, Manjusha; Ginde, Adit A.; Douin, David J.; Talbot, H. Keipp; Casey, Jonathan D; Mohr, Nicholas M.; Zepeski, Anne; McNeal, Tresa; Ghamande, Shekhar; Gibbs, Kevin W.; Files, D. Clark; Hager, David N.; Shehu, Arber; Frosch, Anne E.; Erickson, Heidi L.; Gong, Michelle N.; Mohamed, Amira; Johnson, Nicholas J.; Srinivasan, Vasisht; Steingrub, Jay S.; Peltan, Ithan D.; Brown, Samuel M.; Martin, Emily T.; Khan, Akram; Bender, William; Duggal, Abhijit; Wilson, Jennifer G.; Qadir, Nida; Chang, Steven Y.; Mallow, Christopher; Rivas, Carolina; Kwon, Jennie H.; Exline, Matthew C.; Lauring, Adam S.; Shapiro, Nathan I.; Halasa, Natasha; Chappell, James D.; Grijalva, Carlos G; Rice, Todd W.; Stubblefield, William B; Baughman, Adrienne; Womack, Kelsey N.; Hart, Kimberly W.; Swan, Sydney A.; Zhu, Yuwei; DeCuir, Jennifer; Tenforde, Mark W; Patel, Manish; McMorrow, Meredith; Self, Wesley H.; Calhoun, Nicole; Herrick, Judy; Hoffman, Eric; McKillop, Amanda; Murthy, Kempapura; Smith, Michael; Zayed, Martha; Souza, Lesley De; Kozikowski, Lori-Ann; Ouellette, Scott; Ashok, Kiran; Gole, Susan; King, Alexander H.; Mehkri, Omar; Poynter, Bryan; Lohuis, Caitlin Ten; Stanley, Nicholas; Caspers, Sean; Hendrickson, Audrey; Kaus, Olivia; Taghizadeh, Leyla; Tordsen, Walker; Aston, Valerie; Bowers, Robert R.; Jorgensen, Jeffrey L.; King, Jennifer; Ali, Harith; Rothman, Richard E.; Chen, Jen-Ting; Nair, R.; Allada, Gopal; Briceno, Genesis; Giovanni, Shewit P.; Hubel, Kinsley; Martínez, Jesús; Oh, Minn; Pak, Jonathan; Peña, José; Gordon, Alexandra Jun; Levitt, Joe; Pérez, Cynthia M.; Roque, Jonasel; Visweswaran, Anita; Karow, Sarah; Khan, Maryiam; Klingler, Austin; Pannu, Sarah; Smith, David J.; Schwartz, Elizabeth; Snyder, Connor; So, Madison; So, Preston; Swoope, Gabrielle; Weigand, Michael; Carricato, Michael; Chambers, Ian; Driver, Conner; Goff, Jennifer; Huynh, David; Jensen, Kelly; Chandrasekaran, Sukantha; Frankel, Trevor; Garner, Omai B.; Fairfield, Catherine; Landers, Shannon R.; Nassar, Paul; Williams, Cameron; Gershengorn, Hayley B.; Bielak, Ramsay; Blair, Christopher; Fitzsimmons, William J.; Fong, Rebecca; Gilbert, Julie; McSpadden, EJ; Thomas, Lara J.; Truscon, Rachel; Valvano, Weronika Damek; Anderson, Layla A.; Crider, Christine D.; Paulson, Thomas C.; Steinbock, Kyle A.; Blair, Marica; Ezzell, Lauren J.; Hargrave, Samarian J.; Kampe, Christy; Johnson, Jakea; Luther, Jennifer L.; McHenry, Rendie; Peterson, Bryan P. M.; Pulido, Claudia Guevara; Short, Laura L.; Whitsett, Margaret E.; Hicks, Madeline; Landreth, Leigha; LaRose, Mary; Parks, Lisa; Babcock, Hilary M.; Hink, Tiffany; Jolani, Kevin; McDonald, David W.; O'Neal, Caroline; Parikh, Bijal A.; Parrish, Katie Adams; Samuels, Carleigh

doi:10.15585/mmwr.mm7142a3

Cited by 48 publications

(38 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…23 A study among Kaiser Permanente members found that VE of third and fourth doses against BA.4/BA.5-related hospitalizations was lower compared to BA.1/BA.2-related hospitalizations, whereas another study among individuals admitted to IVY Network hospitals saw this difference for a third dose but not for 2 or 4 doses. 24,25 The IVY Network study reported 3-dose VE of 79% (95%CI, 74-84%) and 60% (95%CI, 12-81%), respectively, during the BA.1/BA.2-predominant versus BA.4/BA.5-predominant periods 7-120 days after vaccination. 25 Potential explanations for lower VE during the period of BA.4/BA.5-predominance compared to BA.1/BA.2-predominance include longer intervals between booster dose receipt and outcomes, increased incidence of undocumented infections, and increased BA.4/BA.5 immune evasion.…”

Section: Discussionmentioning

confidence: 99%

“…24,25 The IVY Network study reported 3-dose VE of 79% (95%CI, 74-84%) and 60% (95%CI, 12-81%), respectively, during the BA.1/BA.2-predominant versus BA.4/BA.5-predominant periods 7-120 days after vaccination. 25 Potential explanations for lower VE during the period of BA.4/BA.5-predominance compared to BA.1/BA.2-predominance include longer intervals between booster dose receipt and outcomes, increased incidence of undocumented infections, and increased BA.4/BA.5 immune evasion. 17 In our study, differences in the median numbers of days since booster receipt between the BA.1/BA.2-predominant versus BA.4/BA.5-predominant periods were always <30 days, so longer post-booster follow-up during the BA.4/BA.5-predominant period was unlikely to be a major contributor to the large observed differences in VE.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness of mRNA COVID-19 vaccine booster doses against Omicron severe outcomes

Grewal

Nguyen

Buchan

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: To inform planning for further booster doses of COVID-19 vaccines, we estimated the effectiveness of monovalent mRNA vaccines against Omicron-associated severe outcomes in adults over time. Methods: We used a test-negative design and multivariable logistic regression to estimate vaccine effectiveness (VE; 2, 3, or 4 doses compared to unvaccinated individuals) and marginal effectiveness (3 or 4 doses compared to 2 doses) against Omicron-associated hospitalization or death among community-dwelling adults aged ≥50 years who were tested for SARS-CoV-2 between January 2, 2022 and October 1, 2022 in Ontario, Canada, stratified by age group and time since vaccination. We also compared VE during periods of Omicron BA.1/BA.2 and BA.4/BA.5 sublineage predominance. Results: We included 11,160 cases of Omicron-associated severe outcomes and 62,880 test-negative symptomatic controls. Depending on the age group, compared to unvaccinated individuals, VE was 91-98% 7-59 days after a third dose, waned to 76-87% after ≥240 days, was restored to 92-97% 7-59 days after a fourth dose, and waned to 86-89% after ≥120 days. Trends in marginal effectiveness were consistent with VE estimates. VE was lower during the BA.4/BA.5-predominant period compared to the BA.1/BA.2-predominant period based on the same intervals since vaccination. Conclusion: Our findings suggest that 1 or 2 booster doses of monovalent mRNA COVID-19 vaccines initially restored very strong protection against Omicron-associated severe outcomes in all age groups, but VE subsequently declined over time with some age-related differences, and particularly so during a period of BA.4/BA.5 predominance.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of mRNA COVID-19 vaccine booster doses against Omicron severe outcomes

Grewal

Nguyen

Buchan

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Studies in the US and UK also showed significant VE (60–70%) against BA.4/5-related hospitalization within 3–5 months after the last vaccination (third or fourth dose of the mRNA vaccine). 56 57 58 However, a study reported that significant VE could not be expected 6 months after the third dose or 3 months after the fourth dose of BNT162b2. 58 A study in South Africa conducted an elapsed time-stratified analysis for VE after the third dose of BNT162b2 against BA.4/5-related hospitalization, which showed a decrease in VE over time: 47.7% 3–4 months after the second dose, 26.3% 5–6 months after the second dose, 68.8% 1–2 months after the third dose, and 46.8% 3–4 months after the third dose.…”

Section: Vaccine Effectiveness Against the Omicron Ba4/5 Subvariantsmentioning

confidence: 99%

COVID-19 Vaccination in Korea: Past, Present, and the Way Forward

et al. 2022

View full text Add to dashboard Cite

Since its first emergence in late 2019, severe acute respiratory syndrome coronavirus-2 has claimed more than 6.5 million lives worldwide and continues to infect hundreds of thousands of people daily. To combat this once-in-a-century disaster, several vaccines have been developed at unprecedented speeds. Novel vaccine platforms (messenger ribonucleic acid vaccines and adenoviral vector vaccines) have played a major role in the current pandemic. In Korea, six vaccines, including a domestically developed recombinant vaccine, have been approved. As in other countries, vaccines have been proven to be safe and highly effective in Korea. However, rare serious adverse events and breakthrough infections have undermined public trust in the vaccines, even while the benefits of vaccination far outweigh the risks. The rise of the omicron variant and the subsequent increase in excess mortality demonstrated that while vaccines are a key component of the pandemic response, it alone can fail without non-pharmaceutical interventions like masking and social distancing. The pandemic of coronavirus disease has revealed both the strengths and weaknesses of our healthcare system and pandemic preparedness. When the next pandemic arrives, improved risk communication and vaccine development should be prioritized. To enable timely vaccine development, it is essential to make strategic and sufficient investments in vaccine research and development.

show abstract

Smart Thermometer–Based Participatory Surveillance to Discern the Role of Children in Household Viral Transmission During the COVID-19 Pandemic

Tseng

Olson

Bloch³

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceChildren’s role in spreading virus during the COVID-19 pandemic is yet to be elucidated, and measuring household transmission traditionally requires contact tracing.ObjectiveTo discern children’s role in household viral transmission during the pandemic when enveloped viruses were at historic lows and the predominance of viral illnesses were attributed to COVID-19.Design, Setting, and ParticipantsThis cohort study of a voluntary US cohort tracked data from participatory surveillance using commercially available thermometers with a companion smartphone app from October 2019 to October 2022. Eligible participants were individuals with temperature measurements in households with multiple members between October 2019 and October 2022 who opted into data sharing.Main Outcomes and MeasuresProportion of household transmissions with a pediatric index case and changes in transmissions during school breaks were assessed using app and thermometer data.ResultsA total of 862 577 individuals from 320 073 households with multiple participants (462 000 female [53.6%] and 463 368 adults [53.7%]) were included. The number of febrile episodes forecast new COVID-19 cases. Within-household transmission was inferred in 54 506 (15.4%) febrile episodes and increased from the fourth pandemic period, March to July 2021 (3263 of 32 294 [10.1%]) to the Omicron BA.1/BA.2 wave (16 516 of 94 316 [17.5%]; P &lt; .001). Among 38 787 transmissions in 166 170 households with adults and children, a median (IQR) 70.4% (61.4%-77.6%) had a pediatric index case; proportions fluctuated weekly from 36.9% to 84.6%. A pediatric index case was 0.6 to 0.8 times less frequent during typical school breaks. The winter break decrease was from 68.4% (95% CI, 57.1%-77.8%) to 41.7% (95% CI, 34.3%-49.5%) at the end of 2020 (P &lt; .001). At the beginning of 2022, it dropped from 80.3% (95% CI, 75.1%-84.6%) to 54.5% (95% CI, 51.3%-57.7%) (P &lt; .001). During summer breaks, rates dropped from 81.4% (95% CI, 74.0%-87.1%) to 62.5% (95% CI, 56.3%-68.3%) by August 2021 (P = .02) and from 83.8% (95% CI, 79.2%-87.5) to 62.8% (95% CI, 57.1%-68.1%) by July 2022 (P &lt; .001). These patterns persisted over 2 school years.Conclusions and RelevanceIn this cohort study using participatory surveillance to measure within-household transmission at a national scale, we discerned an important role for children in the spread of viral infection within households during the COVID-19 pandemic, heightened when schools were in session, supporting a role for school attendance in COVID-19 spread.

show abstract

Effectiveness of Monovalent mRNA Vaccines Against COVID-19–Associated Hospitalization Among Immunocompetent Adults During BA.1/BA.2 and BA.4/BA.5 Predominant Periods of SARS-CoV-2 Omicron Variant in the United States — IVY Network, 18 States, December 26, 2021–August 31, 2022

Cited by 48 publications

References 7 publications

Effectiveness of mRNA COVID-19 vaccine booster doses against Omicron severe outcomes

Effectiveness of mRNA COVID-19 vaccine booster doses against Omicron severe outcomes

COVID-19 Vaccination in Korea: Past, Present, and the Way Forward

Smart Thermometer–Based Participatory Surveillance to Discern the Role of Children in Household Viral Transmission During the COVID-19 Pandemic

Contact Info

Product

Resources

About