Routine Surveillance and Vaccination on a University Campus During the Spread of the SARS-CoV-2 Omicron Variant

Meredith, Genevive R; Diel, Diego G.; Frazier, Peter I.; Henderson, Shane G.; Koretzky, Gary A.; Wan, Jiayue; Warnick, Lorin D.

doi:10.1001/jamanetworkopen.2022.12906

Cited by 11 publications

(14 citation statements)

References 3 publications

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“…In 2020, college campus re-openings were associated with increased transmission of SARS-CoV-2 (29). Because Omicron infections can break through vaccinations, college campuses may have increased the likelihood of persons in this age group being infected with SARS-CoV-2 (30). The age group effect for preschool children (0-4 years of age) may represent a reduced level of socialization for this group.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Vaccine Breakthrough by Omicron and Delta Variants, New York, USA

Keyel¹,

Russell²,

Plitnick³

et al. 2022

Emerg. Infect. Dis.

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the SARS-CoV-2 pandemic had claimed >6.4 million human lives globally, >1 million in the United States, and >70,000 in New York state (1). Virus evolution and adaptation have been observed in persistently infected immunocompromised persons (2) and animal reservoirs (3,4), leading to the potential for new, highly adapted variants.Novel variants of SARS-CoV-2 have shown increased rates of transmission and immune evasion (5,6). In particular, Omicron has evolved a suite of unique mutations, which have greatly increased its infectiousness (7), increased its ability to evade current vaccines (5,6), and decreased the effectiveness of convalescent plasma transfusions and monoclonal antibody treatments (8,9). To a lesser degree, the Delta variant showed some of these same patterns of increased infectiousness (10) and potential for immune evasion compared with earlier strains that preceded Delta (11).Prior literature has also shown differences in vaccine effectiveness for SARS-CoV-2 lineages associated with variation in vaccine type, time since vaccination, and patient age. Before emergence of the Delta and Omicron variants, data showed reduced neutralizing antibody protection for the Janssen vaccine (Johnson & Johnson, https://www.jnj.com) compared with the Pfizer (Pfizer-BioNTech, https://www.pfizer.com) and Moderna (https://www.modernatx.com) vaccines (12) and slightly stronger protection for Moderna compared with Pfizer vaccines ( 12). An effect of time since vaccination has been demonstrated for the Delta variant (11). Younger persons were found to be more likely to be infected with Omicron (13,14).To test the associations between vaccination status, vaccine type, and time since vaccination with lineage identity during the emergence of new variants of SARS-CoV-2, we conducted a matched case-control study. We performed analyses for the emergence of the Omicron and Delta variants in New York, USA. The study was waived by the New York State Department of Health (NYSDOH) Institutional Review Board for Human Subjects Research review. Methods Data Analysis Omicron Emergence AnalysisWe analyzed emergence of the SARS-CoV-2 Omicron variant from November 28, 2021, through January 24, 2022 (Figure 1). We matched persons infected with Omicron (case-patients) to persons infected with any other virus lineage (controls). Case-patients (n = 1,439) included infection with B.1.1.529 and all BA

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Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Vaccine Breakthrough by Omicron and Delta Variants, New York, USA

Keyel¹,

Russell²,

Plitnick³

et al. 2022

Emerg. Infect. Dis.

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“…Free PCR testing was available to any constituent of the university 7 days per week. Whole genome sequencing confirmed the presence of the Omicron variant (BA.1) in Cornell community COVID-19 surveillance samples collected on December 1, 2021; by December 11, 2021, Omicron was the predominant variant on the Ithaca campus [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

“…Seventh, gaps in time between a student’s last test and their departure from Ithaca (or the end of the study period, whichever came first) could lead to attrition bias. Eighth, although nearly 90% of positive samples tested for S-gene dropout during the study period exhibited this marker of the Omicron BA.1 variant [ 20 ], and sequencing confirmed the presence of the Omicron variant in all samples sequenced during this period, not all samples were tested for S-gene dropout, and sequencing of each PCR-positive case was not performed. Finally, not every individual who was boosted before or during the study period may have uploaded their vaccination record, which may have led to information bias towards the null.…”

Section: Limitations and Conclusionmentioning

confidence: 99%

“…We leveraged polymerase chain reaction (PCR) testing data derived from a SARS-CoV-2 surveillance program that required mandatory routine SARS-CoV-2 testing of students (through December 14, 2021) and departure tests before students left the Ithaca campus. During December 5 to December 31, 2021, there was an explosive increase in Omicron cases to the point where the Omicron variant (BA.1) became predominant at Cornell University’s Ithaca campus [ 20 ], and 1,926 SARS-CoV-2 infections were identified in a vaccinated population of students. We sought to estimate the effectiveness of COVID-19 boosters in reducing SARS-CoV-2 infections in the vaccinated population of students during this Omicron-predominant period.…”

Section: Introductionmentioning

confidence: 99%

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Booster vaccination protection against SARS-CoV-2 infections in young adults during an Omicron BA.1-predominant period: A retrospective cohort study

et al. 2023

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Background While booster vaccinations clearly reduce the risk of severe Coronavirus Disease 2019 (COVID-19) and death, the impact of boosters on Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections has not been fully characterized: Doing so requires understanding their impact on asymptomatic and mildly symptomatic infections that often go unreported but nevertheless play an important role in spreading SARS-CoV-2. We sought to estimate the impact of COVID-19 booster doses on SARS-CoV-2 infections in a vaccinated population of young adults during an Omicron BA.1-predominant period. Methods and findings We implemented a cohort study of young adults in a college environment (Cornell University’s Ithaca campus) from a period when Omicron BA.1 was the predominant SARS-CoV-2 variant on campus (December 5 to December 31, 2021). Participants included 15,800 university students who completed initial vaccination series with vaccines approved by the World Health Organization for emergency use, were enrolled in mandatory at-least-weekly surveillance polymerase chain reaction (PCR) testing, and had no positive SARS-CoV-2 PCR test within 90 days before the start of the study period. Robust multivariable Poisson regression with the main outcome of a positive SARS-CoV-2 PCR test was performed to compare those who completed their initial vaccination series and a booster dose to those without a booster dose. A total of 1,926 unique SARS-CoV-2 infections were identified in the study population. Controlling for sex, student group membership, date of completion of initial vaccination series, initial vaccine type, and temporal effect during the study period, our analysis estimates that receiving a booster dose further reduces the rate of having a PCR-detected SARS-CoV-2 infection relative to an initial vaccination series by 56% (95% confidence interval [42%, 67%], P < 0.001). While most individuals had recent booster administration before or during the study period (a limitation of our study), this result is robust to the assumed delay over which a booster dose becomes effective (varied from 1 day to 14 days). The mandatory active surveillance approach used in this study, under which 86% of the person-days in the study occurred, reduces the likelihood of outcome misclassification. Key limitations of our methodology are that we did not have an a priori protocol or statistical analysis plan because the analysis was initially done for institutional research purposes, and some analysis choices were made after observing the data. Conclusions We observed that boosters are effective, relative to completion of initial vaccination series, in further reducing the rate of SARS-CoV-2 infections in a college student population during a period when Omicron BA.1 was predominant; booster vaccinations for this age group may play an important role in reducing incidence of COVID-19.

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“…COVID-19 cases (Figure) 3. Isolation, case investigation, contact tracing, quarantine, and targeted supplemental testing limited the outbreak to 480 cases (August 23 to September 10: mean [SD] 22.9 [18.8] cases/d).…”

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confidence: 99%