Third BNT162b2 Vaccination Neutralization of SARS-CoV-2 Omicron Infection

Nemet, Ital; Kliker, Limor; Lustig, Yaniv; Zuckerman, Neta S.; Erster, Oran; Cohen, Carmit; Kreiss, Yitshak; Alroy‐Preis, Sharon; Regev‐Yochay, Gili; Mendelson, Ella; Mandelboim, Michal

doi:10.1056/nejmc2119358

Cited by 410 publications

(422 citation statements)

References 2 publications

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“…While our analysis cannot infer absolute vaccine effectiveness against the distinct variants, our findings suggest vaccine protection against infection with the Omicron variant may be lower than protection against infection with the Delta variant. This result is consistent with studies showing reduced neutralization efficiency of two and three doses of BNT162b2 vaccine against the Omicron variant (versus non-Omicron variants) [3,26]. Similarly, in multiple settings, vaccination with two doses showed slightly lower effectiveness against hospitalization with Omicron vs. Delta variant infections [6][7][8].…”

Section: Discussionsupporting

confidence: 89%

Clinical outcomes associated with Omicron (B.1.1.529) variant and BA.1/BA.1.1 or BA.2 subvariant infection in southern California

Lewnard

Hong

Patel

et al. 2022

Preprint

118

103

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Background: The Omicron (B.1.1.529) variant of SARS-CoV-2 has rapidly achieved global dissemination, accounting for most infections in the United States by December 2021. Risk of severe outcomes associated with Omicron infections, as compared to earlier SARS-CoV-2 variants, remains unclear. Methods: We analyzed clinical and epidemiologic data from cases testing positive for SARS-CoV-2 infection within the Kaiser Permanente Southern California healthcare system from November 30, 2021 to January 1, 2022, using S gene target failure (SGTF) as assessed by the ThermoFisher TaqPath ComboKit assay as a proxy for Omicron infection. We fit Cox proportional hazards models to compare time to any hospital admission and hospital admissions associated with new-onset respiratory symptoms, intensive care unit (ICU) admission, mechanical ventilation, and mortality among cases with Omicron and Delta (non-SGTF) variant infections. We fit parametric competing risk models to compare lengths of hospital stay among admitted cases with Omicron and Delta variant infections. Results: Our analyses included 52,297 cases with SGTF (Omicron) and 16,982 cases with non-SGTF (Delta [B.1.617.2]) infections, respectively. Hospital admissions occurred among 235 (0.5%) and 222 (1.3%) of cases with Omicron and Delta variant infections, respectively. Among cases first tested in outpatient settings, the adjusted hazard ratios for any subsequent hospital admission and symptomatic hospital admission associated with Omicron variant infection were 0.48 (0.36-0.64) and 0.47 (0.35-0.62), respectively. Rates of ICU admission and mortality after an outpatient positive test were 0.26 (0.10-0.73) and 0.09 (0.01-0.75) fold as high among cases with Omicron variant infection as compared to cases with Delta variant infection. Zero cases with Omicron variant infection received mechanical ventilation, as compared to 11 cases with Delta variant infections throughout the period of follow-up (two-sided p<0.001). Median duration of hospital stay was 3.4 (2.8-4.1) days shorter for hospitalized cases with Omicron variant infections as compared to hospitalized patients with Delta variant infections, reflecting a 69.6% (64.0-74.5%) reduction in hospital length of stay. Conclusions: During a period with mixed Delta and Omicron variant circulation, SARS-CoV-2 infections with presumed Omicron variant infection were associated with substantially reduced risk of severe clinical endpoints and shorter durations of hospital stay.

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Section: Discussionsupporting

confidence: 89%

Clinical outcomes associated with Omicron (B.1.1.529) variant and BA.1/BA.1.1 or BA.2 subvariant infection in southern California

Lewnard

Hong

Patel

et al. 2022

Preprint

118

103

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“…Although prior studies have demonstrated reduced neutralizing antibodies against Omicron relative to other variants following receipt of 2 mRNA vaccines 4-7 9 (but with potent neutralization following a third dose 29 30 ), CD8+ cytotoxic T cells are less impacted by mutations in the Omicron variant and are likely to continue to provide protection against severe disease. 30 31 To date, little real-world data on protection against hospitalization are available.…”

Section: Discussionmentioning

confidence: 94%

“…Despite very high 2-dose COVID-19 vaccine coverage (88% among those aged ≥12 years by mid-December), 2 the rate of cases among fully vaccinated individuals increased substantially during this period. 3 While reduced neutralizing antibodies against Omicron following second and third doses of mRNA vaccines has been established, [4][5][6][7][8][9] real-world data evaluating vaccine performance against Omicron infection are more limited, [10][11][12] particularly in a North American context. The objective of this study was to estimate vaccine effectiveness (VE) against infection caused by Omicron or Delta in Ontario.…”

Section: Introductionmentioning

confidence: 99%

“…While reduced neutralizing antibodies against Omicron following second and third doses of mRNA vaccines has been established, 4-9 real-world data evaluating vaccine performance against Omicron infection are more limited, 10-12 particularly in a North American context. The objective of this study was to estimate vaccine effectiveness (VE) against infection caused by Omicron or Delta in Ontario.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of COVID-19 vaccines against Omicron or Delta symptomatic infection and severe outcomes

Buchan

Chung

Brown

et al. 2022

Preprint

133

125

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Background The incidence of SARS-CoV-2 infection, including among those who have received 2 doses of COVID-19 vaccines, has increased substantially since Omicron was first identified in the province of Ontario, Canada. Methods Applying the test-negative design to linked provincial data, we estimated vaccine effectiveness against infection (irrespective of symptoms or severity) caused by Omicron or Delta between November 22 and December 19, 2021. We included individuals who had received at least 2 COVID-19 vaccine doses (with at least 1 mRNA vaccine dose for the primary series) and used multivariable logistic regression to estimate the effectiveness of two or three doses by time since the latest dose. Results We included 3,442 Omicron-positive cases, 9,201 Delta-positive cases, and 471,545 test-negative controls. After 2 doses of COVID-19 vaccine, vaccine effectiveness against Delta infection declined steadily over time but recovered to 93% (95%CI, 92-94%) ≥7 days after receiving an mRNA vaccine for the third dose. In contrast, receipt of 2 doses of COVID-19 vaccines was not protective against Omicron. Vaccine effectiveness against Omicron was 37% (95%CI, 19-50%) ≥7 days after receiving an mRNA vaccine for the third dose. Conclusions Two doses of COVID-19 vaccines are unlikely to protect against infection by Omicron. A third dose provides some protection in the immediate term, but substantially less than against Delta. Our results may be confounded by behaviours that we were unable to account for in our analyses. Further research is needed to examine protection against severe outcomes.

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“…Omicron partially evades vaccine-induced immunity, 3 but a third vaccine dose increases omicron nAb responses in the general population. 4 , 5 , 6 Comparable data in patients with cancer are lacking, leaving patients and cancer physicians without the means to calibrate infection risk 7 while maintaining necessary cancer treatments. We used live-virus micro-neutralisation assays to evaluate response to omicron following three doses of COVID-19 vaccine in participants of the CAPTURE study ( NCT03226886 ), a prospective, longitudinal cohort of patients with cancer.…”

mentioning

confidence: 99%

Omicron neutralising antibodies after third COVID-19 vaccine dose in patients with cancer

Fendler

Shepherd

et al. 2022

The Lancet

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Third BNT162b2 Vaccination Neutralization of SARS-CoV-2 Omicron Infection

Cited by 410 publications

References 2 publications

Clinical outcomes associated with Omicron (B.1.1.529) variant and BA.1/BA.1.1 or BA.2 subvariant infection in southern California

Clinical outcomes associated with Omicron (B.1.1.529) variant and BA.1/BA.1.1 or BA.2 subvariant infection in southern California

Effectiveness of COVID-19 vaccines against Omicron or Delta symptomatic infection and severe outcomes

Omicron neutralising antibodies after third COVID-19 vaccine dose in patients with cancer

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