New COVID-19 Cases and Hospitalizations Among Adults, by Vaccination Status — New York, May 3–July 25, 2021

Rosenberg, Eli S.; Holtgräve, David R.; Dorabawila, Vajeera; Conroy, MaryBeth; Greene, Danielle; Lutterloh, Emily; Backenson, Bryon; Hoefer, Dina; Morne, Johanne E.; Bauer, Ursula E.; Zucker, Howard A.

doi:10.15585/mmwr.mm7037a7

Cited by 101 publications

(84 citation statements)

References 6 publications

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“…Because the unit of observation was an admission rather than person (approximately 9% of admissions estimated non-unique on persons), an aggregate rates approach was used, as done elsewhere. 10,11 For each product and age group, the incidence rates of new admissions per population, and exact Poisson 95% CI, were estimated overall by time cohort monthly, given data sparseness at the week-level. Incidence rate-ratios (IRR) and exact binomial 95% CI compared each vaccinated cohort to the respective age-specific unvaccinated cohort, with VE estimated as 1-IRR.…”

Section: Statistical Approachmentioning

confidence: 99%

“…Four databases were linked to construct a surveillance-based cohort of adults aged ≥18 years residing in NYS. 10 The Citywide Immunization Registry (CIR) and the NYS Immunization Information System (NYSIIS) are used to collect and store all COVID-19 provider vaccination data for persons residing in New York City and the rest of the state, respectively (excluding settings that report directly to the federal system such as veterans, military, and first nations tribal healthcare facilities). The Electronic Clinical Laboratory Reporting System (ECLRS) collects all reportable COVID-19 test results (nucleic acid amplification test [NAAT] or antigen) in NYS.…”

Section: Data Sourcesmentioning

confidence: 99%

“…Our estimates of VE may be influenced by unmeasured confounding due to behavioral, medical, or exposure differences between fully-vaccinated and unvaccinated adults. 10,11 This potential bias comes in exchange for large sample sizes and outcome numbers that exceed those of other nations' studies and of smaller, more controlled designs. 6,7,13,14 Our findings are further strengthened by broad age representation across time-cohorts and the consistency of changes in calendar time.…”

Section: Limitationsmentioning

confidence: 99%

“…[6][7][8][9] U.S. population-based effectiveness studies in NYS and sentinel populations have documented declines in VE, particularly for persons ≥65 years, during the period in which the Delta variant became predominant and mitigation strategies and policies were relaxed. [10][11][12][13][14] The limitations of open cohort surveillance studies and limited numbers of events in more controlled studies make it difficult to isolate and quantify the extent to which VE declines can be attributed to immunologic waning, Delta variant, behavioral changes, or other causes, particularly across subgroups defined by age, product, and risks for infection or severe illness.…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 Vaccine Effectiveness by Product and Timing in New York State

Rosenberg

Dorabwila

Easton

et al. 2021

Preprint

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Background: US population-based data on COVID-19 vaccine effectiveness (VE) for the 3 currently FDA- authorized products is limited. Whether declines in VE are due to waning immunity, the Delta variant, or other causes, is debated. Methods: We conducted a prospective study of 8,834,604 New York adults, comparing vaccine cohorts defined by product, age, and month of full-vaccination to age-specific unvaccinated cohorts, by linking statewide testing, hospital, and vaccine registry databases. VE was estimated from May 1, 2021 for incident laboratory-confirmed COVID-19 cases (weekly life-table hazard rates through September 3) and hospitalizations (monthly incidence rates through August 31). Results: 155,092 COVID-19 cases and 14,862 hospitalizations occurred. Estimated VE for cases declined contemporaneously across age, products, and time-cohorts, from high levels beginning May 1 (1.8% Delta variant prevalence), to a nadir around July 10 (85.3% Delta), with limited changes thereafter (>95% Delta). Decreases were greatest for Pfizer-BioNTech (-24.6%, -19.1%, -14.1% for 18-49, 50-64 years, and ≥65 years, respectively), and similar for Moderna (-18.0%, -11.6%, -9.0%, respectively) and Janssen (-19.2%, -10.8, -10.9%, respectively). VE for hospitalization for adults 18-64 years was >86% across cohorts, without time trend. Among persons ≥65 years, VE declined from May to August for Pfizer-BioNTech (95.0% to 89.2%) and Moderna (97.2% to 94.1%). VE was lower for Janssen, without trend, ranging 85.5%-82.8%. Conclusions: Declines in VE for cases may have been primarily driven by factors other than waning. VE for hospitalizations remained high, with modest declines limited to Pfizer-BioNTech and Moderna recipients ≥65 years, supporting targeted booster dosing recommendations.

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Section: Statistical Approachmentioning

confidence: 99%

Section: Data Sourcesmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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COVID-19 Vaccine Effectiveness by Product and Timing in New York State

Rosenberg

Dorabwila

Easton

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

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“…From 3 May to 25 July 2021, the predominance of this VOC raised from 2% to 80% in this country. The overall age-adjusted effectiveness against new cases for all adults declined from 91.7% to 79.8%, whereas during the same period, the effectiveness against hospitalization remained steady, ranging from 91.9% to 95.3% [120]. This suggests limited protection with the current vaccines.…”

Section: Effectiveness Of Mrna Vaccines Against Variantsmentioning

confidence: 98%

Shooting at a Moving Target—Effectiveness and Emerging Challenges for SARS-CoV-2 Vaccine Development

et al. 2021

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Since late 2019 the newly emerged pandemic SARS-CoV-2, the causative agent of COVID‑19, has hit the world with recurring waves of infections necessitating the global implementation of non-pharmaceutical interventions, including strict social distancing rules, the wearing of masks and the isolation of infected individuals in order to restrict virus transmissions and prevent the breakdown of our healthcare systems. These measures are not only challenging on an economic level but also have a strong impact on social lifestyles. Using traditional and novel technologies, highly efficient vaccines against SARS-CoV-2 were developed and underwent rapid clinical evaluation and approval to accelerate the immunization of the world population, aiming to end the pandemic and return to normality. However, the emergence of virus variants with improved transmission, enhanced fitness and partial immune escape from the first generation of vaccines poses new challenges, which are currently being addressed by scientists and pharmaceutical companies all over the world. In this ongoing pandemic, the evaluation of SARS-CoV-2 vaccines underlies diverse unpredictable dynamics, posed by the first broad application of the mRNA vaccine technology and their compliance, the occurrence of unexpected side effects and the rapid emergence of variations in the viral antigen. However, despite these hurdles, we conclude that the available SARS-CoV-2 vaccines are very safe and efficiently protect from severe COVID-19 and are thereby the most powerful tools to prevent further harm to our healthcare systems, economics and individual lives. This review summarizes the unprecedented pathways of vaccine development and approval during the ongoing SARS-CoV-2 pandemic. We focus on the real-world effectiveness and unexpected positive and negative side effects of the available vaccines and summarize the timeline of the applied adaptations to the recommended vaccination strategies in the light of emerging virus variants. Finally, we highlight upcoming strategies to improve the next generations of SARS-CoV-2 vaccines.

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Model-Estimated Association Between Simulated US Elementary School–Related SARS-CoV-2 Transmission, Mitigation Interventions, and Vaccine Coverage Across Local Incidence Levels

Giardina¹,

Bilinski

Fitzpatrick

et al. 2022

JAMA Netw Open

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IMPORTANCE With recent surges in COVID-19 incidence and vaccine authorization for children aged 5 to 11 years, elementary schools face decisions about requirements for masking and other mitigation measures. These decisions require explicit determination of community objectives (eg, acceptable risk level for in-school SARS-CoV-2 transmission) and quantitative estimates of the consequences of changing mitigation measures. OBJECTIVETo estimate the association between adding or removing in-school mitigation measures (eg, masks) and COVID-19 outcomes within an elementary school community at varying student vaccination and local incidence rates. DESIGN, SETTING, AND PARTICIPANTS This decision analytic model used an agent-based modelto simulate SARS-CoV-2 transmission within a school community, with a simulated population of students, teachers and staff, and their household members (ie, immediate school community).Transmission was evaluated for a range of observed local COVID-19 incidence (0-50 cases per 100 000 residents per day, assuming 33% of all infections detected). The population used in the model reflected the mean size of a US elementary school, including 638 students and 60 educators and staff members in 6 grades with 5 classes per grade.EXPOSURES Variant infectiousness (representing wild-type virus, Alpha variant, and Delta variant), mitigation effectiveness (0%-100% reduction in the in-school secondary attack rate, representing increasingly intensive combinations of mitigations including masking and ventilation), and student vaccination levels were varied. MAIN OUTCOMES AND MEASURESThe main outcomes were (1) probability of at least 1 in-school transmission per month and (2) mean increase in total infections per month among the immediate school community associated with a reduction in mitigation; multiple decision thresholds were estimated for objectives associated with each outcome. Sensitivity analyses on adult vaccination uptake, vaccination effectiveness, and testing approaches (for selected scenarios) were conducted. RESULTSWith student vaccination coverage of 70% or less and moderate assumptions about mitigation effectiveness (eg, masking), mitigation could only be reduced when local case incidence was 14 or fewer cases per 100 000 residents per day to keep the mean additional cases associated with reducing mitigation to 5 or fewer cases per month. To keep the probability of any in-school transmission to less than 50% per month, the local case incidence would have to be 4 or fewer cases per 100 000 residents per day.

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New COVID-19 Cases and Hospitalizations Among Adults, by Vaccination Status — New York, May 3–July 25, 2021

Cited by 101 publications

References 6 publications

COVID-19 Vaccine Effectiveness by Product and Timing in New York State

COVID-19 Vaccine Effectiveness by Product and Timing in New York State

Shooting at a Moving Target—Effectiveness and Emerging Challenges for SARS-CoV-2 Vaccine Development

Model-Estimated Association Between Simulated US Elementary School–Related SARS-CoV-2 Transmission, Mitigation Interventions, and Vaccine Coverage Across Local Incidence Levels

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