Cargando…
1939. Who to Boost When: An Analysis of Dosing Interval and Age on COVID-19 Outcomes in the COVE Trial During the Delta and Omicron Waves
BACKGROUND: The effects of age and interval between vaccine doses on COVID-19 are incompletely understood, yet critical for public health policy. METHODS: This analysis evaluated the effectiveness of an mRNA-1273 50 μg booster (3(rd) dose) in ∼17,000 boosted participants in the phase 3 coronavirus e...
Autores principales: | , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10678540/ http://dx.doi.org/10.1093/ofid/ofad500.2470 |
_version_ | 1785150386024218624 |
---|---|
author | Follmann, Dean Wang, Xiaowei Gilbert, Peter Baden, Lindsey R El Sahly, Hana M Essink, Brandon Marovich, Mary Janes, Holly Deng, Weiping Priddy, Frances Dixit, Avika Tomassini, Joanne Das, Rituparna Miller, Jacqueline Zhou, Honghong |
author_facet | Follmann, Dean Wang, Xiaowei Gilbert, Peter Baden, Lindsey R El Sahly, Hana M Essink, Brandon Marovich, Mary Janes, Holly Deng, Weiping Priddy, Frances Dixit, Avika Tomassini, Joanne Das, Rituparna Miller, Jacqueline Zhou, Honghong |
author_sort | Follmann, Dean |
collection | PubMed |
description | BACKGROUND: The effects of age and interval between vaccine doses on COVID-19 are incompletely understood, yet critical for public health policy. METHODS: This analysis evaluated the effectiveness of an mRNA-1273 50 μg booster (3(rd) dose) in ∼17,000 boosted participants in the phase 3 coronavirus efficacy (COVE) trial who previously received 2-doses of 100 µg mRNA-1273 during the randomized placebo-controlled phase (mRNA-1273, 1st dose July-Oct 2020), or open label phase (placebo-mRNA-1273, 1st dose Dec 2020-Apr 2021). A single 50 µg mRNA-1273 (original vaccine) booster was administered starting Sep 2021. The effect of boosting on COVID-19 risk was assessed in Cox models by the initially randomized arm, time since booster, and age groups (< 65, ≥ 65) between Sep 2021-May 2022 during the open label phase of COVE. RESULTS: The median dosing intervals (IQR) between primary series and booster were 8.2 (7.8-8.7) months for the placebo-mRNA-1273 and 12.9 (12.3-13.5) months for the mRNA-1273 arms. A booster dose provided substantial additional protection against COVID-19 during the Delta wave through 60 days and was high for Omicron (BA.1), then waned over time by 110 days (Figure). The risk of Omicron COVID-19 post booster was lower by 24% (95% CI: 16%, 32%) in the mRNA-1273 vs the placebo-mRNA arm indicating possible benefit of longer boost interval. In a separate analysis, among participants ≥ 65 years, the initial booster (95% CI) efficacy against Omicron was 86% (69%, 93%) which waned to 28% (-47%, 65%) after ∼4 months. For those < 65 years, the analogous estimates were 50% (36%, 61%) and 6% (-29%, 31%), indicating a larger boosting effect in those ≥ 65 years. When further stratified by arm, for those ≥ 65 years, the initial boost efficacy against Omicron was 79% (41%, 92%) for the placebo-mRNA arm and 91% (79%, 96%) for mRNA-1273. For those < 65, the analogous estimates were 52% (30%, 62%) and 55% (39%, 66%), suggesting the effect of booster interval was largely concentrated in those ≥ 65 years. [Figure: see text] CONCLUSION: Boosting with mRNA-1273 provided additional COVID-19 protection during the Delta and Omicron variant waves. Overall, boosting reduced the risk of Omicron COVID-19 but waned over time (∼4 months). The effects of boosting and interval were more pronounced in those ≥ 65 years of age. DISCLOSURES: Xiaowei Wang, PhD, Moderna, Inc.: Stocks/Bonds Peter Gilbert, PhD, NIH NIAID: Grant/Research Support Lindsey R. Baden, MD, NIH/NIAID: Grant/Research Support Hana M. El Sahly, MD, NIH and/or NIAID: Grant/Research Support Holly Janes, PhD, National Institutes of Health: Grant/Research Support Weiping Deng, PhD, Moderna, Inc.: Stocks/Bonds Frances Priddy, MD, MPH, Moderna, Inc.: Stocks/Bonds|Moderna, Inc.: Stocks/Bonds Avika Dixit, MBBS, Moderna, Inc.: Stocks/Bonds Joanne Tomassini, Ph.D., Moderna, Inc.: Advisor/Consultant Rituparna Das, M.D., Moderna, Inc.: Employee|Moderna, Inc.: Stocks/Bonds Jacqueline Miller, MD, Moderna, Inc.: Employee|Moderna, Inc.: Stocks/Bonds Honghong Zhou, Ph.D., Moderna, Inc.: Stocks/Bonds |
format | Online Article Text |
id | pubmed-10678540 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-106785402023-11-27 1939. Who to Boost When: An Analysis of Dosing Interval and Age on COVID-19 Outcomes in the COVE Trial During the Delta and Omicron Waves Follmann, Dean Wang, Xiaowei Gilbert, Peter Baden, Lindsey R El Sahly, Hana M Essink, Brandon Marovich, Mary Janes, Holly Deng, Weiping Priddy, Frances Dixit, Avika Tomassini, Joanne Das, Rituparna Miller, Jacqueline Zhou, Honghong Open Forum Infect Dis Abstract BACKGROUND: The effects of age and interval between vaccine doses on COVID-19 are incompletely understood, yet critical for public health policy. METHODS: This analysis evaluated the effectiveness of an mRNA-1273 50 μg booster (3(rd) dose) in ∼17,000 boosted participants in the phase 3 coronavirus efficacy (COVE) trial who previously received 2-doses of 100 µg mRNA-1273 during the randomized placebo-controlled phase (mRNA-1273, 1st dose July-Oct 2020), or open label phase (placebo-mRNA-1273, 1st dose Dec 2020-Apr 2021). A single 50 µg mRNA-1273 (original vaccine) booster was administered starting Sep 2021. The effect of boosting on COVID-19 risk was assessed in Cox models by the initially randomized arm, time since booster, and age groups (< 65, ≥ 65) between Sep 2021-May 2022 during the open label phase of COVE. RESULTS: The median dosing intervals (IQR) between primary series and booster were 8.2 (7.8-8.7) months for the placebo-mRNA-1273 and 12.9 (12.3-13.5) months for the mRNA-1273 arms. A booster dose provided substantial additional protection against COVID-19 during the Delta wave through 60 days and was high for Omicron (BA.1), then waned over time by 110 days (Figure). The risk of Omicron COVID-19 post booster was lower by 24% (95% CI: 16%, 32%) in the mRNA-1273 vs the placebo-mRNA arm indicating possible benefit of longer boost interval. In a separate analysis, among participants ≥ 65 years, the initial booster (95% CI) efficacy against Omicron was 86% (69%, 93%) which waned to 28% (-47%, 65%) after ∼4 months. For those < 65 years, the analogous estimates were 50% (36%, 61%) and 6% (-29%, 31%), indicating a larger boosting effect in those ≥ 65 years. When further stratified by arm, for those ≥ 65 years, the initial boost efficacy against Omicron was 79% (41%, 92%) for the placebo-mRNA arm and 91% (79%, 96%) for mRNA-1273. For those < 65, the analogous estimates were 52% (30%, 62%) and 55% (39%, 66%), suggesting the effect of booster interval was largely concentrated in those ≥ 65 years. [Figure: see text] CONCLUSION: Boosting with mRNA-1273 provided additional COVID-19 protection during the Delta and Omicron variant waves. Overall, boosting reduced the risk of Omicron COVID-19 but waned over time (∼4 months). The effects of boosting and interval were more pronounced in those ≥ 65 years of age. DISCLOSURES: Xiaowei Wang, PhD, Moderna, Inc.: Stocks/Bonds Peter Gilbert, PhD, NIH NIAID: Grant/Research Support Lindsey R. Baden, MD, NIH/NIAID: Grant/Research Support Hana M. El Sahly, MD, NIH and/or NIAID: Grant/Research Support Holly Janes, PhD, National Institutes of Health: Grant/Research Support Weiping Deng, PhD, Moderna, Inc.: Stocks/Bonds Frances Priddy, MD, MPH, Moderna, Inc.: Stocks/Bonds|Moderna, Inc.: Stocks/Bonds Avika Dixit, MBBS, Moderna, Inc.: Stocks/Bonds Joanne Tomassini, Ph.D., Moderna, Inc.: Advisor/Consultant Rituparna Das, M.D., Moderna, Inc.: Employee|Moderna, Inc.: Stocks/Bonds Jacqueline Miller, MD, Moderna, Inc.: Employee|Moderna, Inc.: Stocks/Bonds Honghong Zhou, Ph.D., Moderna, Inc.: Stocks/Bonds Oxford University Press 2023-11-27 /pmc/articles/PMC10678540/ http://dx.doi.org/10.1093/ofid/ofad500.2470 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Abstract Follmann, Dean Wang, Xiaowei Gilbert, Peter Baden, Lindsey R El Sahly, Hana M Essink, Brandon Marovich, Mary Janes, Holly Deng, Weiping Priddy, Frances Dixit, Avika Tomassini, Joanne Das, Rituparna Miller, Jacqueline Zhou, Honghong 1939. Who to Boost When: An Analysis of Dosing Interval and Age on COVID-19 Outcomes in the COVE Trial During the Delta and Omicron Waves |
title | 1939. Who to Boost When: An Analysis of Dosing Interval and Age on COVID-19 Outcomes in the COVE Trial During the Delta and Omicron Waves |
title_full | 1939. Who to Boost When: An Analysis of Dosing Interval and Age on COVID-19 Outcomes in the COVE Trial During the Delta and Omicron Waves |
title_fullStr | 1939. Who to Boost When: An Analysis of Dosing Interval and Age on COVID-19 Outcomes in the COVE Trial During the Delta and Omicron Waves |
title_full_unstemmed | 1939. Who to Boost When: An Analysis of Dosing Interval and Age on COVID-19 Outcomes in the COVE Trial During the Delta and Omicron Waves |
title_short | 1939. Who to Boost When: An Analysis of Dosing Interval and Age on COVID-19 Outcomes in the COVE Trial During the Delta and Omicron Waves |
title_sort | 1939. who to boost when: an analysis of dosing interval and age on covid-19 outcomes in the cove trial during the delta and omicron waves |
topic | Abstract |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10678540/ http://dx.doi.org/10.1093/ofid/ofad500.2470 |
work_keys_str_mv | AT follmanndean 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT wangxiaowei 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT gilbertpeter 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT badenlindseyr 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT elsahlyhanam 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT essinkbrandon 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT marovichmary 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT janesholly 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT dengweiping 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT priddyfrances 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT dixitavika 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT tomassinijoanne 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT dasrituparna 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT millerjacqueline 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves AT zhouhonghong 1939whotoboostwhenananalysisofdosingintervalandageoncovid19outcomesinthecovetrialduringthedeltaandomicronwaves |