Cargando…
SARS-CoV-2 mRNA Vaccine Effectiveness in Health Care Workers by Dosing Interval and Time Since Vaccination: Test-Negative Design, British Columbia, Canada
BACKGROUND: One- and two-dose mRNA vaccine effectiveness (VE) estimates against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by dosing interval and time since vaccination were assessed among healthcare workers (HCWs) in publicly funded acute and community (nonresidential) h...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047244/ https://www.ncbi.nlm.nih.gov/pubmed/35531384 http://dx.doi.org/10.1093/ofid/ofac178 |
_version_ | 1784695683298623488 |
---|---|
author | El Adam, Shiraz Zou, Macy Kim, Shinhye Henry, Bonnie Krajden, Mel Skowronski, Danuta M |
author_facet | El Adam, Shiraz Zou, Macy Kim, Shinhye Henry, Bonnie Krajden, Mel Skowronski, Danuta M |
author_sort | El Adam, Shiraz |
collection | PubMed |
description | BACKGROUND: One- and two-dose mRNA vaccine effectiveness (VE) estimates against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by dosing interval and time since vaccination were assessed among healthcare workers (HCWs) in publicly funded acute and community (nonresidential) healthcare facilities in British Columbia, Canada. METHODS: A test-negative design was used with controls matched to cases (6:1) on epidemiological week of SARS-CoV-2 test date. mRNA vaccination was defined by receipt of the first dose ≥21 days or second dose ≥14 days before the test date. HCWs ≥18 years old tested for SARS-CoV-2 between epi-weeks 3 and 39 (January 17–October 2, 2021) were included, when varying dosing intervals and a mix of circulating variants of concern contributed, including Delta dominance provincially from epi-week 31 (August 1). RESULTS: Single- and two-dose analyses included 1265 and 1246 cases, respectively. The median follow-up period (interquartile range) was 49 (34–69) days for single-dose and 89 (61–123) days for two-dose recipients, with 12%, 31%, and 58% of second doses given 3–5, 6, or ≥7 weeks after the first. Adjusted mRNA VE against SARS-CoV-2 was 71% (95% CI, 66%–76%) for one dose and 90% (95% CI, 88%–92%) for two doses, similar to two heterologous mRNA doses (92%; 95% CI, 86%–95%). Two-dose VE remained >80% at ≥28 weeks post–second dose. Two-dose VE was consistently 5%–7% higher with a ≥7-week vs 3–5-week interval between doses, but with overlapping confidence intervals. CONCLUSIONS: Among HCWs, we report substantial single-dose and strong and sustained two-dose mRNA vaccine protection, with the latter maintained for at least 7 months. These findings support a longer interval between doses, with global health and equity implications. |
format | Online Article Text |
id | pubmed-9047244 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-90472442022-04-28 SARS-CoV-2 mRNA Vaccine Effectiveness in Health Care Workers by Dosing Interval and Time Since Vaccination: Test-Negative Design, British Columbia, Canada El Adam, Shiraz Zou, Macy Kim, Shinhye Henry, Bonnie Krajden, Mel Skowronski, Danuta M Open Forum Infect Dis Major Article BACKGROUND: One- and two-dose mRNA vaccine effectiveness (VE) estimates against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by dosing interval and time since vaccination were assessed among healthcare workers (HCWs) in publicly funded acute and community (nonresidential) healthcare facilities in British Columbia, Canada. METHODS: A test-negative design was used with controls matched to cases (6:1) on epidemiological week of SARS-CoV-2 test date. mRNA vaccination was defined by receipt of the first dose ≥21 days or second dose ≥14 days before the test date. HCWs ≥18 years old tested for SARS-CoV-2 between epi-weeks 3 and 39 (January 17–October 2, 2021) were included, when varying dosing intervals and a mix of circulating variants of concern contributed, including Delta dominance provincially from epi-week 31 (August 1). RESULTS: Single- and two-dose analyses included 1265 and 1246 cases, respectively. The median follow-up period (interquartile range) was 49 (34–69) days for single-dose and 89 (61–123) days for two-dose recipients, with 12%, 31%, and 58% of second doses given 3–5, 6, or ≥7 weeks after the first. Adjusted mRNA VE against SARS-CoV-2 was 71% (95% CI, 66%–76%) for one dose and 90% (95% CI, 88%–92%) for two doses, similar to two heterologous mRNA doses (92%; 95% CI, 86%–95%). Two-dose VE remained >80% at ≥28 weeks post–second dose. Two-dose VE was consistently 5%–7% higher with a ≥7-week vs 3–5-week interval between doses, but with overlapping confidence intervals. CONCLUSIONS: Among HCWs, we report substantial single-dose and strong and sustained two-dose mRNA vaccine protection, with the latter maintained for at least 7 months. These findings support a longer interval between doses, with global health and equity implications. Oxford University Press 2022-04-15 /pmc/articles/PMC9047244/ /pubmed/35531384 http://dx.doi.org/10.1093/ofid/ofac178 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Major Article El Adam, Shiraz Zou, Macy Kim, Shinhye Henry, Bonnie Krajden, Mel Skowronski, Danuta M SARS-CoV-2 mRNA Vaccine Effectiveness in Health Care Workers by Dosing Interval and Time Since Vaccination: Test-Negative Design, British Columbia, Canada |
title | SARS-CoV-2 mRNA Vaccine Effectiveness in Health Care Workers by Dosing Interval and Time Since Vaccination: Test-Negative Design, British Columbia, Canada |
title_full | SARS-CoV-2 mRNA Vaccine Effectiveness in Health Care Workers by Dosing Interval and Time Since Vaccination: Test-Negative Design, British Columbia, Canada |
title_fullStr | SARS-CoV-2 mRNA Vaccine Effectiveness in Health Care Workers by Dosing Interval and Time Since Vaccination: Test-Negative Design, British Columbia, Canada |
title_full_unstemmed | SARS-CoV-2 mRNA Vaccine Effectiveness in Health Care Workers by Dosing Interval and Time Since Vaccination: Test-Negative Design, British Columbia, Canada |
title_short | SARS-CoV-2 mRNA Vaccine Effectiveness in Health Care Workers by Dosing Interval and Time Since Vaccination: Test-Negative Design, British Columbia, Canada |
title_sort | sars-cov-2 mrna vaccine effectiveness in health care workers by dosing interval and time since vaccination: test-negative design, british columbia, canada |
topic | Major Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047244/ https://www.ncbi.nlm.nih.gov/pubmed/35531384 http://dx.doi.org/10.1093/ofid/ofac178 |
work_keys_str_mv | AT eladamshiraz sarscov2mrnavaccineeffectivenessinhealthcareworkersbydosingintervalandtimesincevaccinationtestnegativedesignbritishcolumbiacanada AT zoumacy sarscov2mrnavaccineeffectivenessinhealthcareworkersbydosingintervalandtimesincevaccinationtestnegativedesignbritishcolumbiacanada AT kimshinhye sarscov2mrnavaccineeffectivenessinhealthcareworkersbydosingintervalandtimesincevaccinationtestnegativedesignbritishcolumbiacanada AT henrybonnie sarscov2mrnavaccineeffectivenessinhealthcareworkersbydosingintervalandtimesincevaccinationtestnegativedesignbritishcolumbiacanada AT krajdenmel sarscov2mrnavaccineeffectivenessinhealthcareworkersbydosingintervalandtimesincevaccinationtestnegativedesignbritishcolumbiacanada AT skowronskidanutam sarscov2mrnavaccineeffectivenessinhealthcareworkersbydosingintervalandtimesincevaccinationtestnegativedesignbritishcolumbiacanada |