Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccination Against SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 Lineage Hospitalization and a Comparison of Clinical Severity-IVY Network, 26 Hospitals, October 18, 2023-March 9, 2024

Kevin C Ma; Diya Surie; Adam S Lauring; Emily T Martin; Aleda M Leis; Leigh Papalambros; Manjusha Gaglani; Christie Columbus; Robert L Gottlieb; Shekhar Ghamande; Ithan D Peltan; Samuel M Brown; Adit A Ginde; Nicholas M Mohr; Kevin W Gibbs; David N Hager; Safa Saeed; Matthew E Prekker; Michelle Ng Gong; Amira Mohamed; Nicholas J Johnson; Vasisht Srinivasan; Jay S Steingrub; Akram Khan; Catherine L Hough; Abhijit Duggal; Jennifer G Wilson; Nida Qadir; Steven Y Chang; Christopher Mallow; Jennie H Kwon; Bijal Parikh; Matthew C Exline; Ivana A Vaughn; Mayur Ramesh; Basmah Safdar; Jarrod Mosier; Estelle S Harris; Nathan I Shapiro; Jamie Felzer; Yuwei Zhu; Carlos G Grijalva; Natasha Halasa; James D Chappell; Kelsey N Womack; Jillian P Rhoads; Adrienne Baughman; Sydney A Swan; Cassandra A Johnson; Todd W Rice; Jonathan D Casey; Paul W Blair; Jin H Han; Sascha Ellington; Nathaniel M Lewis; Natalie Thornburg; Clinton R Paden; Lydia J Atherton; Wesley H Self; Fatimah S Dawood; Jennifer DeCuir

doi:10.1093/cid/ciae405

Back

Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccination Against SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 Lineage Hospitalization and a Comparison of Clinical Severity-IVY Network, 26 Hospitals, October 18, 2023-March 9, 2024

Journal article

Open access

Peer reviewed

Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccination Against SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 Lineage Hospitalization and a Comparison of Clinical Severity-IVY Network, 26 Hospitals, October 18, 2023-March 9, 2024

Kevin C Ma, Diya Surie, Adam S Lauring, Emily T Martin, Aleda M Leis, Leigh Papalambros, Manjusha Gaglani, Christie Columbus, Robert L Gottlieb, Shekhar Ghamande, …

Clinical infectious diseases, Vol.82(3), pp.e595-e603

03/15/2026

DOI: 10.1093/cid/ciae405

PMCID: PMC13193650

PMID: 39107255

Files and links (1)

url

https://doi.org/10.1093/cid/ciae405View

Published (Version of record) Open Access

Abstract

Assessing variant-specific COVID-19 vaccine effectiveness (VE) and severity can inform public health risk assessments and decisions about vaccine composition. BA.2.86 and its descendants, including JN.1 (referred to collectively as "JN lineages"), emerged in late 2023 and exhibited substantial divergence from co-circulating XBB lineages.BACKGROUNDAssessing variant-specific COVID-19 vaccine effectiveness (VE) and severity can inform public health risk assessments and decisions about vaccine composition. BA.2.86 and its descendants, including JN.1 (referred to collectively as "JN lineages"), emerged in late 2023 and exhibited substantial divergence from co-circulating XBB lineages.We analyzed patients hospitalized with COVID-19-like illness at 26 hospitals in 20 U.S. states admitted October 18, 2023-March 9, 2024. Using a test-negative, case-control design, we estimated effectiveness of an updated 2023-2024 (Monovalent XBB.1.5) COVID-19 vaccine dose against sequence-confirmed XBB and JN lineage hospitalization using logistic regression. Odds of severe outcomes, including intensive care unit (ICU) admission and invasive mechanical ventilation (IMV) or death, were compared for JN versus XBB lineage hospitalizations using logistic regression.METHODSWe analyzed patients hospitalized with COVID-19-like illness at 26 hospitals in 20 U.S. states admitted October 18, 2023-March 9, 2024. Using a test-negative, case-control design, we estimated effectiveness of an updated 2023-2024 (Monovalent XBB.1.5) COVID-19 vaccine dose against sequence-confirmed XBB and JN lineage hospitalization using logistic regression. Odds of severe outcomes, including intensive care unit (ICU) admission and invasive mechanical ventilation (IMV) or death, were compared for JN versus XBB lineage hospitalizations using logistic regression.585 case-patients with XBB lineages, 397 case-patients with JN lineages, and 4,580 control-patients were included. VE in the first 7-89 days after receipt of an updated dose was 54.2% (95% CI = 36.1%-67.1%) against XBB lineage hospitalization and 32.7% (95% CI = 1.9%-53.8%) against JN lineage hospitalization. Odds of ICU admission (adjusted odds ratio [aOR] 0.80; 95% CI = 0.46-1.38) and IMV or death (aOR 0.69; 95% CI = 0.34-1.40) were not significantly different among JN compared to XBB lineage hospitalizations.RESULTS585 case-patients with XBB lineages, 397 case-patients with JN lineages, and 4,580 control-patients were included. VE in the first 7-89 days after receipt of an updated dose was 54.2% (95% CI = 36.1%-67.1%) against XBB lineage hospitalization and 32.7% (95% CI = 1.9%-53.8%) against JN lineage hospitalization. Odds of ICU admission (adjusted odds ratio [aOR] 0.80; 95% CI = 0.46-1.38) and IMV or death (aOR 0.69; 95% CI = 0.34-1.40) were not significantly different among JN compared to XBB lineage hospitalizations.Updated 2023-2024 COVID-19 vaccination provided protection against both XBB and JN lineage hospitalization, but protection against the latter may be attenuated by immune escape. Clinical severity of JN lineage hospitalizations was not higher relative to XBB.CONCLUSIONSUpdated 2023-2024 COVID-19 vaccination provided protection against both XBB and JN lineage hospitalization, but protection against the latter may be attenuated by immune escape. Clinical severity of JN lineage hospitalizations was not higher relative to XBB.

SARS-CoV-2 variants

COVID-19 vaccine effectiveness

JN.1 and BA.2.86

test-negative design

COVID-19 severity

Details

Title: Subtitle: Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccination Against SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 Lineage Hospitalization and a Comparison of Clinical Severity-IVY Network, 26 Hospitals, October 18, 2023-March 9, 2024
Creators: Kevin C Ma - Centers for Disease Control and Prevention
Diya Surie - Centers for Disease Control and Prevention
Adam S Lauring - University of Michigan
Emily T Martin - University of Michigan
Aleda M Leis - University of Michigan
Leigh Papalambros - University of Michigan
Manjusha Gaglani - Baylor Scott & White Medical Center - Temple
Christie Columbus - Baylor Scott & White Health
Robert L Gottlieb - Baylor Scott & White Health
Shekhar Ghamande - Baylor Scott & White Medical Center - Temple
Ithan D Peltan - Intermountain Medical Center
Samuel M Brown - Intermountain Medical Center
Adit A Ginde - University of Colorado Denver
Nicholas M Mohr - University of Iowa
Kevin W Gibbs - Wake Forest University
David N Hager - Johns Hopkins University
Safa Saeed - Johns Hopkins University
Matthew E Prekker - Hennepin County Medical Center
Michelle Ng Gong - Albert Einstein College of Medicine
Amira Mohamed - Albert Einstein College of Medicine
Nicholas J Johnson - University of Washington
Vasisht Srinivasan - University of Washington
Jay S Steingrub - Baystate Medical Center
Akram Khan - Oregon Health & Science University
Catherine L Hough - Oregon Health & Science University
Abhijit Duggal - Cleveland Clinic
Jennifer G Wilson - Stanford University
Nida Qadir - University of California, Los Angeles
Steven Y Chang - University of California, Los Angeles
Christopher Mallow - University of Miami
Jennie H Kwon - Washington University in St. Louis
Bijal Parikh - Washington University in St. Louis
Matthew C Exline
Ivana A Vaughn - Henry Ford Health System
Mayur Ramesh - Henry Ford Health System
Basmah Safdar - Yale University
Jarrod Mosier - University of Arizona
Estelle S Harris - University of Utah
Nathan I Shapiro - Beth Israel Deaconess Medical Center
Jamie Felzer - Emory University
Yuwei Zhu - Vanderbilt University Medical Center
Carlos G Grijalva - Vanderbilt University Medical Center
Natasha Halasa - Vanderbilt University Medical Center
James D Chappell - Vanderbilt University Medical Center
Kelsey N Womack - Vanderbilt University Medical Center
Jillian P Rhoads - Vanderbilt University Medical Center
Adrienne Baughman - Vanderbilt University Medical Center
Sydney A Swan - Vanderbilt University Medical Center
Cassandra A Johnson - Vanderbilt University Medical Center
Todd W Rice - Vanderbilt University Medical Center
Jonathan D Casey - Vanderbilt University Medical Center
Paul W Blair - Vanderbilt University Medical Center
Jin H Han - Vanderbilt University Medical Center
Sascha Ellington - Centers for Disease Control and Prevention
Nathaniel M Lewis - Centers for Disease Control and Prevention
Natalie Thornburg - Centers for Disease Control and Prevention
Clinton R Paden - Centers for Disease Control and Prevention
Lydia J Atherton
Wesley H Self - Vanderbilt University Medical Center
Fatimah S Dawood - Centers for Disease Control and Prevention
Jennifer DeCuir - Centers for Disease Control and Prevention
Resource Type: Journal article
Publication Details: Clinical infectious diseases, Vol.82(3), pp.e595-e603
DOI: 10.1093/cid/ciae405
PMID: 39107255
PMCID: PMC13193650
NLM abbreviation: Clin Infect Dis
ISSN: 1537-6591
eISSN: 1537-6591
Publisher: OXFORD UNIV PRESS INC
Grant note: US Centers for Disease Control and Prevention: 75D30122C14944
This work was supported by the US Centers for Disease Control and Prevention (contract no. 75D30122C14944).
Language: English
Electronic publication date: 08/06/2024
Date published: 03/15/2026
Academic Unit: Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center
Record Identifier: 9984696860802771

Metrics

12 Record Views

35 Times Cited - Web of Science

See more details