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COVID-19-Associated Hospitalizations Among Vaccinated and Unvaccinated Adults 18 Years or Older in 13 US States, January 2021 to April 2022

IMPORTANCE: Understanding risk factors for hospitalization in vaccinated persons and the association of COVID-19 vaccines with hospitalization rates is critical for public health efforts to control COVID-19. OBJECTIVE: To determine characteristics of COVID-19–associated hospitalizations among vaccin...

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Autores principales: Havers, Fiona P., Pham, Huong, Taylor, Christopher A., Whitaker, Michael, Patel, Kadam, Anglin, Onika, Kambhampati, Anita K., Milucky, Jennifer, Zell, Elizabeth, Moline, Heidi L., Chai, Shua J., Kirley, Pam Daily, Alden, Nisha B., Armistead, Isaac, Yousey-Hindes, Kimberly, Meek, James, Openo, Kyle P., Anderson, Evan J., Reeg, Libby, Kohrman, Alexander, Lynfield, Ruth, Como-Sabetti, Kathryn, Davis, Elizabeth M., Cline, Cory, Muse, Alison, Barney, Grant, Bushey, Sophrena, Felsen, Christina B., Billing, Laurie M., Shiltz, Eli, Sutton, Melissa, Abdullah, Nasreen, Talbot, H. Keipp, Schaffner, William, Hill, Mary, George, Andrea, Hall, Aron J., Bialek, Stephanie R., Murthy, Neil C., Murthy, Bhavini Patel, McMorrow, Meredith
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459904/
https://www.ncbi.nlm.nih.gov/pubmed/36074486
http://dx.doi.org/10.1001/jamainternmed.2022.4299
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author Havers, Fiona P.
Pham, Huong
Taylor, Christopher A.
Whitaker, Michael
Patel, Kadam
Anglin, Onika
Kambhampati, Anita K.
Milucky, Jennifer
Zell, Elizabeth
Moline, Heidi L.
Chai, Shua J.
Kirley, Pam Daily
Alden, Nisha B.
Armistead, Isaac
Yousey-Hindes, Kimberly
Meek, James
Openo, Kyle P.
Anderson, Evan J.
Reeg, Libby
Kohrman, Alexander
Lynfield, Ruth
Como-Sabetti, Kathryn
Davis, Elizabeth M.
Cline, Cory
Muse, Alison
Barney, Grant
Bushey, Sophrena
Felsen, Christina B.
Billing, Laurie M.
Shiltz, Eli
Sutton, Melissa
Abdullah, Nasreen
Talbot, H. Keipp
Schaffner, William
Hill, Mary
George, Andrea
Hall, Aron J.
Bialek, Stephanie R.
Murthy, Neil C.
Murthy, Bhavini Patel
McMorrow, Meredith
author_facet Havers, Fiona P.
Pham, Huong
Taylor, Christopher A.
Whitaker, Michael
Patel, Kadam
Anglin, Onika
Kambhampati, Anita K.
Milucky, Jennifer
Zell, Elizabeth
Moline, Heidi L.
Chai, Shua J.
Kirley, Pam Daily
Alden, Nisha B.
Armistead, Isaac
Yousey-Hindes, Kimberly
Meek, James
Openo, Kyle P.
Anderson, Evan J.
Reeg, Libby
Kohrman, Alexander
Lynfield, Ruth
Como-Sabetti, Kathryn
Davis, Elizabeth M.
Cline, Cory
Muse, Alison
Barney, Grant
Bushey, Sophrena
Felsen, Christina B.
Billing, Laurie M.
Shiltz, Eli
Sutton, Melissa
Abdullah, Nasreen
Talbot, H. Keipp
Schaffner, William
Hill, Mary
George, Andrea
Hall, Aron J.
Bialek, Stephanie R.
Murthy, Neil C.
Murthy, Bhavini Patel
McMorrow, Meredith
author_sort Havers, Fiona P.
collection PubMed
description IMPORTANCE: Understanding risk factors for hospitalization in vaccinated persons and the association of COVID-19 vaccines with hospitalization rates is critical for public health efforts to control COVID-19. OBJECTIVE: To determine characteristics of COVID-19–associated hospitalizations among vaccinated persons and comparative hospitalization rates in unvaccinated and vaccinated persons. DESIGN, SETTING, AND PARTICIPANTS: From January 1, 2021, to April 30, 2022, patients 18 years or older with laboratory-confirmed SARS-CoV-2 infection were identified from more than 250 hospitals in the population-based COVID-19–Associated Hospitalization Surveillance Network. State immunization information system data were linked to cases, and the vaccination coverage data of the defined catchment population were used to compare hospitalization rates in unvaccinated and vaccinated individuals. Vaccinated and unvaccinated patient characteristics were compared in a representative sample with detailed medical record review; unweighted case counts and weighted percentages were calculated. EXPOSURES: Laboratory-confirmed COVID-19–associated hospitalization, defined as a positive SARS-CoV-2 test result within 14 days before or during hospitalization. MAIN OUTCOMES AND MEASURES: COVID-19–associated hospitalization rates among vaccinated vs unvaccinated persons and factors associated with COVID-19–associated hospitalization in vaccinated persons were assessed. RESULTS: Using representative data from 192 509 hospitalizations (see Table 1 for demographic information), monthly COVID-19–associated hospitalization rates ranged from 3.5 times to 17.7 times higher in unvaccinated persons than vaccinated persons regardless of booster dose status. From January to April 2022, when the Omicron variant was predominant, hospitalization rates were 10.5 times higher in unvaccinated persons and 2.5 times higher in vaccinated persons with no booster dose, respectively, compared with those who had received a booster dose. Among sampled cases, vaccinated hospitalized patients with COVID-19 were older than those who were unvaccinated (median [IQR] age, 70 [58-80] years vs 58 [46-70] years, respectively; P < .001) and more likely to have 3 or more underlying medical conditions (1926 [77.8%] vs 4124 [51.6%], respectively; P < .001). CONCLUSIONS AND RELEVANCE: In this cross-sectional study of US adults hospitalized with COVID-19, unvaccinated adults were more likely to be hospitalized compared with vaccinated adults; hospitalization rates were lowest in those who had received a booster dose. Hospitalized vaccinated persons were older and more likely to have 3 or more underlying medical conditions and be long-term care facility residents compared with hospitalized unvaccinated persons. The study results suggest that clinicians and public health practitioners should continue to promote vaccination with all recommended doses for eligible persons.
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spelling pubmed-94599042022-09-24 COVID-19-Associated Hospitalizations Among Vaccinated and Unvaccinated Adults 18 Years or Older in 13 US States, January 2021 to April 2022 Havers, Fiona P. Pham, Huong Taylor, Christopher A. Whitaker, Michael Patel, Kadam Anglin, Onika Kambhampati, Anita K. Milucky, Jennifer Zell, Elizabeth Moline, Heidi L. Chai, Shua J. Kirley, Pam Daily Alden, Nisha B. Armistead, Isaac Yousey-Hindes, Kimberly Meek, James Openo, Kyle P. Anderson, Evan J. Reeg, Libby Kohrman, Alexander Lynfield, Ruth Como-Sabetti, Kathryn Davis, Elizabeth M. Cline, Cory Muse, Alison Barney, Grant Bushey, Sophrena Felsen, Christina B. Billing, Laurie M. Shiltz, Eli Sutton, Melissa Abdullah, Nasreen Talbot, H. Keipp Schaffner, William Hill, Mary George, Andrea Hall, Aron J. Bialek, Stephanie R. Murthy, Neil C. Murthy, Bhavini Patel McMorrow, Meredith JAMA Intern Med Original Investigation IMPORTANCE: Understanding risk factors for hospitalization in vaccinated persons and the association of COVID-19 vaccines with hospitalization rates is critical for public health efforts to control COVID-19. OBJECTIVE: To determine characteristics of COVID-19–associated hospitalizations among vaccinated persons and comparative hospitalization rates in unvaccinated and vaccinated persons. DESIGN, SETTING, AND PARTICIPANTS: From January 1, 2021, to April 30, 2022, patients 18 years or older with laboratory-confirmed SARS-CoV-2 infection were identified from more than 250 hospitals in the population-based COVID-19–Associated Hospitalization Surveillance Network. State immunization information system data were linked to cases, and the vaccination coverage data of the defined catchment population were used to compare hospitalization rates in unvaccinated and vaccinated individuals. Vaccinated and unvaccinated patient characteristics were compared in a representative sample with detailed medical record review; unweighted case counts and weighted percentages were calculated. EXPOSURES: Laboratory-confirmed COVID-19–associated hospitalization, defined as a positive SARS-CoV-2 test result within 14 days before or during hospitalization. MAIN OUTCOMES AND MEASURES: COVID-19–associated hospitalization rates among vaccinated vs unvaccinated persons and factors associated with COVID-19–associated hospitalization in vaccinated persons were assessed. RESULTS: Using representative data from 192 509 hospitalizations (see Table 1 for demographic information), monthly COVID-19–associated hospitalization rates ranged from 3.5 times to 17.7 times higher in unvaccinated persons than vaccinated persons regardless of booster dose status. From January to April 2022, when the Omicron variant was predominant, hospitalization rates were 10.5 times higher in unvaccinated persons and 2.5 times higher in vaccinated persons with no booster dose, respectively, compared with those who had received a booster dose. Among sampled cases, vaccinated hospitalized patients with COVID-19 were older than those who were unvaccinated (median [IQR] age, 70 [58-80] years vs 58 [46-70] years, respectively; P < .001) and more likely to have 3 or more underlying medical conditions (1926 [77.8%] vs 4124 [51.6%], respectively; P < .001). CONCLUSIONS AND RELEVANCE: In this cross-sectional study of US adults hospitalized with COVID-19, unvaccinated adults were more likely to be hospitalized compared with vaccinated adults; hospitalization rates were lowest in those who had received a booster dose. Hospitalized vaccinated persons were older and more likely to have 3 or more underlying medical conditions and be long-term care facility residents compared with hospitalized unvaccinated persons. The study results suggest that clinicians and public health practitioners should continue to promote vaccination with all recommended doses for eligible persons. American Medical Association 2022-09-08 2022-10 /pmc/articles/PMC9459904/ /pubmed/36074486 http://dx.doi.org/10.1001/jamainternmed.2022.4299 Text en Copyright 2022 Havers FP et al. JAMA Internal Medicine. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Havers, Fiona P.
Pham, Huong
Taylor, Christopher A.
Whitaker, Michael
Patel, Kadam
Anglin, Onika
Kambhampati, Anita K.
Milucky, Jennifer
Zell, Elizabeth
Moline, Heidi L.
Chai, Shua J.
Kirley, Pam Daily
Alden, Nisha B.
Armistead, Isaac
Yousey-Hindes, Kimberly
Meek, James
Openo, Kyle P.
Anderson, Evan J.
Reeg, Libby
Kohrman, Alexander
Lynfield, Ruth
Como-Sabetti, Kathryn
Davis, Elizabeth M.
Cline, Cory
Muse, Alison
Barney, Grant
Bushey, Sophrena
Felsen, Christina B.
Billing, Laurie M.
Shiltz, Eli
Sutton, Melissa
Abdullah, Nasreen
Talbot, H. Keipp
Schaffner, William
Hill, Mary
George, Andrea
Hall, Aron J.
Bialek, Stephanie R.
Murthy, Neil C.
Murthy, Bhavini Patel
McMorrow, Meredith
COVID-19-Associated Hospitalizations Among Vaccinated and Unvaccinated Adults 18 Years or Older in 13 US States, January 2021 to April 2022
title COVID-19-Associated Hospitalizations Among Vaccinated and Unvaccinated Adults 18 Years or Older in 13 US States, January 2021 to April 2022
title_full COVID-19-Associated Hospitalizations Among Vaccinated and Unvaccinated Adults 18 Years or Older in 13 US States, January 2021 to April 2022
title_fullStr COVID-19-Associated Hospitalizations Among Vaccinated and Unvaccinated Adults 18 Years or Older in 13 US States, January 2021 to April 2022
title_full_unstemmed COVID-19-Associated Hospitalizations Among Vaccinated and Unvaccinated Adults 18 Years or Older in 13 US States, January 2021 to April 2022
title_short COVID-19-Associated Hospitalizations Among Vaccinated and Unvaccinated Adults 18 Years or Older in 13 US States, January 2021 to April 2022
title_sort covid-19-associated hospitalizations among vaccinated and unvaccinated adults 18 years or older in 13 us states, january 2021 to april 2022
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459904/
https://www.ncbi.nlm.nih.gov/pubmed/36074486
http://dx.doi.org/10.1001/jamainternmed.2022.4299
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