Journal article
Absolute and Relative Vaccine Effectiveness of Primary and Booster Series of COVID-19 Vaccines (mRNA and Adenovirus Vector) Against COVID-19 Hospitalizations in the United States, December 2021–April 2022
Open forum infectious diseases, Vol.10(1), ofac698
01/2023
DOI: 10.1093/ofid/ofac698
PMCID: PMC9868348
PMID: 36695662
Abstract
Background
Coronavirus disease 2019 (COVID-19) vaccine effectiveness (VE) studies are increasingly reporting relative VE (rVE) comparing a primary series plus booster doses with a primary series only. Interpretation of rVE differs from traditional studies measuring absolute VE (aVE) of a vaccine regimen against an unvaccinated referent group. We estimated aVE and rVE against COVID-19 hospitalization in primary-series plus first-booster recipients of COVID-19 vaccines.
Methods
Booster-eligible immunocompetent adults hospitalized at 21 medical centers in the United States during December 25, 2021–April 4, 2022 were included. In a test-negative design, logistic regression with case status as the outcome and completion of primary vaccine series or primary series plus 1 booster dose as the predictors, adjusted for potential confounders, were used to estimate aVE and rVE.
Results
A total of 2060 patients were analyzed, including 1104 COVID-19 cases and 956 controls. Relative VE against COVID-19 hospitalization in boosted mRNA vaccine recipients versus primary series only was 66% (95% confidence interval [CI], 55%–74%); aVE was 81% (95% CI, 75%–86%) for boosted versus 46% (95% CI, 30%–58%) for primary. For boosted Janssen vaccine recipients versus primary series, rVE was 49% (95% CI, −9% to 76%); aVE was 62% (95% CI, 33%–79%) for boosted versus 36% (95% CI, −4% to 60%) for primary.
Conclusions
Vaccine booster doses increased protection against COVID-19 hospitalization compared with a primary series. Comparing rVE measures across studies can lead to flawed interpretations of the added value of a new vaccination regimen, whereas difference in aVE, when available, may be a more useful metric.
Details
- Title: Subtitle
- Absolute and Relative Vaccine Effectiveness of Primary and Booster Series of COVID-19 Vaccines (mRNA and Adenovirus Vector) Against COVID-19 Hospitalizations in the United States, December 2021–April 2022
- Creators
- Nathaniel M LewisNancy MurrayKatherine AdamsDiya SurieManjusha GaglaniAdit A GindeTresa McNealShekhar GhamandeDavid J DouinH Keipp TalbotJonathan D CaseyNicholas M MohrAnne ZepeskiNathan I ShapiroKevin W GibbsD Clark FilesDavid N HagerHarith AliMatthew E PrekkerAnne E FroschMatthew C ExlineMichelle N GongAmira MohamedNicholas J JohnsonVasisht SrinivasanJay S SteingrubIthan D PeltanSamuel M BrownEmily T MartinArnold S MontoAdam S LauringAkram KhanCatherine L HoughLaurence W BusseWilliam BenderAbhijit DuggalJennifer G WilsonAlexandra June GordonNida QadirSteven Y ChangChristopher MallowCarolina RivasHilary M BabcockJennie H KwonJames D ChappellNatasha HalasaCarlos G GrijalvaTodd W RiceWilliam B StubblefieldAdrienne BaughmanChristopher J LindsellKimberly W HartJillian P RhoadsMeredith L McMorrowMark W TenfordeWesley H SelfManish M PatelFor the Influenza and Other Viruses in the Acutely Ill (IVY) Network
- Resource Type
- Journal article
- Publication Details
- Open forum infectious diseases, Vol.10(1), ofac698
- DOI
- 10.1093/ofid/ofac698
- PMID
- 36695662
- PMCID
- PMC9868348
- NLM abbreviation
- Open Forum Infect Dis
- ISSN
- 2328-8957
- eISSN
- 2328-8957
- Publisher
- Oxford University Press
- Grant note
- name: United States Centers Disease Control and Prevention, award: 75D30120F00002, 75D30122C12914
- Language
- English
- Electronic publication date
- 12/31/2022
- Date published
- 01/2023
- Academic Unit
- Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9984354112602771
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