Journal article
Protection of mRNA vaccines against hospitalized COVID-19 in adults over the first year following authorization in the United States
Clinical infectious diseases, Vol.76(3), pp.e460-e468
02/01/2023
DOI: 10.1093/cid/ciac381
PMCID: PMC9129194
PMID: 35580849
Abstract
Abstract
Background
COVID-19 mRNA vaccines were authorized in the United States in December 2020. Although vaccine effectiveness (VE) against mild infection declines markedly after several months, limited understanding exists on the long-term durability of protection against COVID-19-associated hospitalization.
Methods
Case control analysis of adults (≥18 years) hospitalized at 21 hospitals in 18 states March 11 – December 15, 2021, including COVID-19 case patients and RT-PCR-negative controls. We included adults who were unvaccinated or vaccinated with two doses of a mRNA vaccine before the date of illness onset. VE over time was assessed using logistic regression comparing odds of vaccination in cases versus controls, adjusting for confounders. Models included dichotomous time (<180 vs ≥180 days since dose two) and continuous time modeled using restricted cubic splines.
Results
10,078 patients were included, 4906 cases (23% vaccinated) and 5172 controls (62% vaccinated). Median age was 60 years (IQR 46–70), 56% were non-Hispanic White, and 81% had ≥1 medical condition. Among immunocompetent adults, VE <180 days was 90% (95%CI: 88–91) vs 82% (95%CI: 79–85) at ≥180 days (p < 0.001). VE declined for Pfizer-BioNTech (88% to 79%, p < 0.001) and Moderna (93% to 87%, p < 0.001) products, for younger adults (18-64 years) [91% to 87%, p = 0.005], and for adults ≥65 years of age (87% to 78%, p < 0.001). In models using restricted cubic splines, similar changes were observed.
Conclusion
In a period largely pre-dating Omicron variant circulation, effectiveness of two mRNA doses against COVID-19-associated hospitalization was largely sustained through 9 months.
Details
- Title: Subtitle
- Protection of mRNA vaccines against hospitalized COVID-19 in adults over the first year following authorization in the United States
- Creators
- Mark W. Tenforde - Centers for Disease Control and PreventionWesley H. Self - Vanderbilt University Medical CenterYuwei Zhu - Vanderbilt University Medical CenterEric A. Naioti - Centers for Disease Control and PreventionManjusha Gaglani - Texas A&M UniversityAdit A. Ginde - University of Colorado DenverKelly Jensen - University of Colorado DenverH. Keipp Talbot - Vanderbilt University Medical CenterJonathan D. Casey - Vanderbilt University Medical CenterNicholas M. Mohr - University of IowaAnne Zepeski - University of IowaTresa McNeal - Texas A&M UniversityShekhar Ghamande - Texas A&M UniversityKevin W. Gibbs - Atrium Health Wake Forest BaptistD. Clark Files - Atrium Health Wake Forest BaptistDavid N. Hager - Johns Hopkins HospitalArber Shehu - Johns Hopkins HospitalMatthew E. Prekker - Hennepin County Medical CenterHeidi L. Erickson - Hennepin County Medical CenterMichelle N. Gong - Albert Einstein College of MedicineAmira Mohamed - Albert Einstein College of MedicineNicholas J. Johnson - University of WashingtonVasisht Srinivasan - University of WashingtonJay S. Steingrub - Baystate Medical CenterIthan D. Peltan - Intermountain Medical CenterSamuel M. Brown - Intermountain Medical CenterEmily T. Martin - University of MichiganArnold S. Monto - University of MichiganAkram Khan - Oregon Health & Science UniversityCatherine L. Hough - Oregon Health & Science UniversityLaurence W. Busse - Emory UniversityCaitlin ten Lohuis - Emory University School of MedicineAbhijit Duggal - Cleveland ClinicJennifer G. Wilson - Stanford UniversityNida Qadir - Ronald Reagan UCLA Medical CenterSteven Y. Chang - Ronald Reagan UCLA Medical CenterChristopher Mallow - University of MiamiCarolina Rivas - University of MiamiHilary M. Babcock - Washington University in St. LouisJennie H. Kwon - Washington University in St. LouisMatthew C. Exline - The Ohio State University Wexner Medical CenterMena M. Botros - The Ohio State University Wexner Medical CenterAdam S. Lauring - University of MichiganNathan I. Shapiro - Beth Israel Deaconess Medical CenterNatasha Halasa - Vanderbilt University Medical CenterJames D. Chappell - Vanderbilt University Medical CenterCarlos G. Grijalva - Vanderbilt University Medical CenterTodd W. Rice - Vanderbilt University Medical CenterIan D. Jones - Vanderbilt University Medical CenterWilliam B. Stubblefield - Vanderbilt University Medical CenterAdrienne Baughman - Vanderbilt University Medical CenterKelsey N. Womack - Vanderbilt University Medical CenterJillian P. Rhoads - Vanderbilt University Medical CenterChristopher J. Lindsell - Vanderbilt University Medical CenterKimberly W. Hart - Vanderbilt University Medical CenterCaitlin Turbyfill - Centers for Disease Control and PreventionSamantha Olson - Centers for Disease Control and PreventionNancy Murray - Centers for Disease Control and PreventionKatherine Adams - Centers for Disease Control and PreventionManish M. Patel - Centers for Disease Control and PreventionInfluenza and Other Viruses in the Acutely Ill (IVY) Network
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.76(3), pp.e460-e468
- DOI
- 10.1093/cid/ciac381
- PMID
- 35580849
- PMCID
- PMC9129194
- NLM abbreviation
- Clin Infect Dis
- ISSN
- 1058-4838
- eISSN
- 1537-6591
- Grant note
- DOI: 10.13039/100000030, name: United States Centers for Disease Control and Prevention
- Language
- English
- Electronic publication date
- 05/17/2022
- Date published
- 02/01/2023
- Academic Unit
- Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9984295917102771
Metrics
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