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Vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the United States: living test negative design study
OBJECTIVE: To compare the effectiveness of a primary covid-19 vaccine series plus booster doses with a primary series alone for the prevention of hospital admission with omicron related covid-19 in the United States. DESIGN: Multicenter observational case-control study with a test negative design. S...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group Ltd.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9551237/ https://www.ncbi.nlm.nih.gov/pubmed/36220174 http://dx.doi.org/10.1136/bmj-2022-072065 |
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author | Adams, Katherine Rhoads, Jillian P Surie, Diya Gaglani, Manjusha Ginde, Adit A McNeal, Tresa Talbot, H Keipp Casey, Jonathan D Zepeski, Anne Shapiro, Nathan I Gibbs, Kevin W Files, D Clark Hager, David N Frosch, Anne E Exline, Matthew C Mohamed, Amira Johnson, Nicholas J Steingrub, Jay S Peltan, Ithan D Brown, Samuel M Martin, Emily T Lauring, Adam S Khan, Akram Busse, Laurence W Duggal, Abhijit Wilson, Jennifer G Chang, Steven Y Mallow, Christopher Kwon, Jennie H Chappell, James D Halasa, Natasha Grijalva, Carlos G Lindsell, Christopher J Lester, Sandra N Thornburg, Natalie J Park, SoHee McMorrow, Meredith L Patel, Manish M Tenforde, Mark W Self, Wesley H Ghamande, Shekhar Calhoun, Nicole Murthy, Kempapura Herrick, Judy McKillop, Amanda Hoffman, Eric Zayed, Martha Smith, Michael Kozikowski, Lori-Ann De Souza, Lesley Ouellette, Scott Bolstad, Michael Coviello, Brianna Ciottone, Robert Devilla, Arnaldo Grafals, Ana Higgins, Conor Ottanelli, Carlo Redman, Kimberly Scaffidi, Douglas Weingart, Alexander Lewis, Nathaniel Mehkri, Omar Mitchell, Megan Griffith, Zachary Brennan, Connery Ashok, Kiran Poynter, Bryan ten Lohuis, Caitlin Stanley, Nicholas Zhang, Sophia Prekker, Matthew Erickson, Heidi Hendrickson, Audrey Caspers, Sean Tordsen, Walker Kaus, Olivia Scharber, Tyler Lumpkin, Jenna Smith, Cassie Marshall, Hunter Shehu, Arber Ali, Harith Rothman, Richard E Mohamed, Amira Nair, Rahul Chen, Jen-Ting (Tina) Karow, Sarah Robart, Emily Maldonado, Paulo Nunes Khan, Maryiam So, Preston So, Madison Schwartz, Elizabeth Botros, Mena Hough, Catherine L Jung, Haeun Martinez, Jesus Luong, Andrea Huynh, Bao Ibrahim, Habiba Villanueva-Vargas, Cynthia Villanueva-Vargas, Juliana Quadri, Suha Gordon, Alexandra June Levitt, Joe Perez, Cynthia Visweswaran, Anita Roque, Jonasel Qadir, Nida Frankel, Trevor Garner, Omai Chandrasekaran, Sukantha Douin, David Jensen, Kelly Huynh, David Steinwand, Aimee Withers, Cori Mohr, Nicholas Nassar, Paul Landers, Shannon Nielsen, Karin Briggs, Noble Fairfield, Cathy Gershengorn, Hayley Rivas, Carolina Monto, Arnold McSpadden, E J Truscon, Rachel Kaniclides, Anne Thomas, Lara Bielak, Ramsay Valvano, Weronika Damek Fong, Rebecca Fitzsimmons, William J Blair, Christopher Gilbert, Julie Baker, Leigh Srinivasan, Vasisht Crider, Christine D Steinbock, Kyle A Paulsen, Thomas C Anderson, Layla A Jones, Ian Womack, Kelsey Baughman, Adrienne Kampe, Christy Johnson, Jakea Hart, Kim Rice, Todd Stubblefield, William B Zhu, Yuwei Short, Laura L Ezzell, Lauren J Whitsett, Margaret E McHenry, Rendie E Hargrave, Samarian J Blair, Marcia Luther, Jennifer L Pulido, Claudia Guevara Peterson, Bryan P M LaRose, Mary Landreth, Leigha Hicks, Madeline Parks, Lisa Babcock, Hilary Bongu, Jahnavi McDonald, David Cass, Candice Seiler, Sondra Park, David Hink, Tiffany Wallace, Meghan Burnham, Carey-Ann Arter, Olivia G |
author_facet | Adams, Katherine Rhoads, Jillian P Surie, Diya Gaglani, Manjusha Ginde, Adit A McNeal, Tresa Talbot, H Keipp Casey, Jonathan D Zepeski, Anne Shapiro, Nathan I Gibbs, Kevin W Files, D Clark Hager, David N Frosch, Anne E Exline, Matthew C Mohamed, Amira Johnson, Nicholas J Steingrub, Jay S Peltan, Ithan D Brown, Samuel M Martin, Emily T Lauring, Adam S Khan, Akram Busse, Laurence W Duggal, Abhijit Wilson, Jennifer G Chang, Steven Y Mallow, Christopher Kwon, Jennie H Chappell, James D Halasa, Natasha Grijalva, Carlos G Lindsell, Christopher J Lester, Sandra N Thornburg, Natalie J Park, SoHee McMorrow, Meredith L Patel, Manish M Tenforde, Mark W Self, Wesley H Ghamande, Shekhar Calhoun, Nicole Murthy, Kempapura Herrick, Judy McKillop, Amanda Hoffman, Eric Zayed, Martha Smith, Michael Kozikowski, Lori-Ann De Souza, Lesley Ouellette, Scott Bolstad, Michael Coviello, Brianna Ciottone, Robert Devilla, Arnaldo Grafals, Ana Higgins, Conor Ottanelli, Carlo Redman, Kimberly Scaffidi, Douglas Weingart, Alexander Lewis, Nathaniel Mehkri, Omar Mitchell, Megan Griffith, Zachary Brennan, Connery Ashok, Kiran Poynter, Bryan ten Lohuis, Caitlin Stanley, Nicholas Zhang, Sophia Prekker, Matthew Erickson, Heidi Hendrickson, Audrey Caspers, Sean Tordsen, Walker Kaus, Olivia Scharber, Tyler Lumpkin, Jenna Smith, Cassie Marshall, Hunter Shehu, Arber Ali, Harith Rothman, Richard E Mohamed, Amira Nair, Rahul Chen, Jen-Ting (Tina) Karow, Sarah Robart, Emily Maldonado, Paulo Nunes Khan, Maryiam So, Preston So, Madison Schwartz, Elizabeth Botros, Mena Hough, Catherine L Jung, Haeun Martinez, Jesus Luong, Andrea Huynh, Bao Ibrahim, Habiba Villanueva-Vargas, Cynthia Villanueva-Vargas, Juliana Quadri, Suha Gordon, Alexandra June Levitt, Joe Perez, Cynthia Visweswaran, Anita Roque, Jonasel Qadir, Nida Frankel, Trevor Garner, Omai Chandrasekaran, Sukantha Douin, David Jensen, Kelly Huynh, David Steinwand, Aimee Withers, Cori Mohr, Nicholas Nassar, Paul Landers, Shannon Nielsen, Karin Briggs, Noble Fairfield, Cathy Gershengorn, Hayley Rivas, Carolina Monto, Arnold McSpadden, E J Truscon, Rachel Kaniclides, Anne Thomas, Lara Bielak, Ramsay Valvano, Weronika Damek Fong, Rebecca Fitzsimmons, William J Blair, Christopher Gilbert, Julie Baker, Leigh Srinivasan, Vasisht Crider, Christine D Steinbock, Kyle A Paulsen, Thomas C Anderson, Layla A Jones, Ian Womack, Kelsey Baughman, Adrienne Kampe, Christy Johnson, Jakea Hart, Kim Rice, Todd Stubblefield, William B Zhu, Yuwei Short, Laura L Ezzell, Lauren J Whitsett, Margaret E McHenry, Rendie E Hargrave, Samarian J Blair, Marcia Luther, Jennifer L Pulido, Claudia Guevara Peterson, Bryan P M LaRose, Mary Landreth, Leigha Hicks, Madeline Parks, Lisa Babcock, Hilary Bongu, Jahnavi McDonald, David Cass, Candice Seiler, Sondra Park, David Hink, Tiffany Wallace, Meghan Burnham, Carey-Ann Arter, Olivia G |
author_sort | Adams, Katherine |
collection | PubMed |
description | OBJECTIVE: To compare the effectiveness of a primary covid-19 vaccine series plus booster doses with a primary series alone for the prevention of hospital admission with omicron related covid-19 in the United States. DESIGN: Multicenter observational case-control study with a test negative design. SETTING: Hospitals in 18 US states. PARTICIPANTS: 4760 adults admitted to one of 21 hospitals with acute respiratory symptoms between 26 December 2021 and 30 June 2022, a period when the omicron variant was dominant. Participants included 2385 (50.1%) patients with laboratory confirmed covid-19 (cases) and 2375 (49.9%) patients who tested negative for SARS-CoV-2 (controls). MAIN OUTCOME MEASURES: The main outcome was vaccine effectiveness against hospital admission with covid-19 for a primary series plus booster doses and a primary series alone by comparing the odds of being vaccinated with each of these regimens versus being unvaccinated among cases versus controls. Vaccine effectiveness analyses were stratified by immunosuppression status (immunocompetent, immunocompromised). The primary analysis evaluated all covid-19 vaccine types combined, and secondary analyses evaluated specific vaccine products. RESULTS: Overall, median age of participants was 64 years (interquartile range 52-75 years), 994 (20.8%) were immunocompromised, 85 (1.8%) were vaccinated with a primary series plus two boosters, 1367 (28.7%) with a primary series plus one booster, and 1875 (39.3%) with a primary series alone, and 1433 (30.1%) were unvaccinated. Among immunocompetent participants, vaccine effectiveness for prevention of hospital admission with omicron related covid-19 for a primary series plus two boosters was 63% (95% confidence interval 37% to 78%), a primary series plus one booster was 65% (58% to 71%), and for a primary series alone was 37% (25% to 47%) (P<0.001 for the pooled boosted regimens compared with a primary series alone). Vaccine effectiveness was higher for a boosted regimen than for a primary series alone for both mRNA vaccines (BNT162b2 (Pfizer-BioNTech): 73% (44% to 87%) for primary series plus two boosters, 64% (55% to 72%) for primary series plus one booster, and 36% (21% to 48%) for primary series alone (P<0.001); mRNA-1273 (Moderna): 68% (17% to 88%) for primary series plus two boosters, 65% (55% to 73%) for primary series plus one booster, and 41% (25% to 54%) for primary series alone (P=0.001)). Among immunocompromised patients, vaccine effectiveness for a primary series plus one booster was 69% (31% to 86%) and for a primary series alone was 49% (30% to 63%) (P=0.04). CONCLUSION: During the first six months of 2022 in the US, booster doses of a covid-19 vaccine provided additional benefit beyond a primary vaccine series alone for preventing hospital admissions with omicron related covid-19. READERS’ NOTE: This article is a living test negative design study that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication. |
format | Online Article Text |
id | pubmed-9551237 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95512372022-10-11 Vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the United States: living test negative design study Adams, Katherine Rhoads, Jillian P Surie, Diya Gaglani, Manjusha Ginde, Adit A McNeal, Tresa Talbot, H Keipp Casey, Jonathan D Zepeski, Anne Shapiro, Nathan I Gibbs, Kevin W Files, D Clark Hager, David N Frosch, Anne E Exline, Matthew C Mohamed, Amira Johnson, Nicholas J Steingrub, Jay S Peltan, Ithan D Brown, Samuel M Martin, Emily T Lauring, Adam S Khan, Akram Busse, Laurence W Duggal, Abhijit Wilson, Jennifer G Chang, Steven Y Mallow, Christopher Kwon, Jennie H Chappell, James D Halasa, Natasha Grijalva, Carlos G Lindsell, Christopher J Lester, Sandra N Thornburg, Natalie J Park, SoHee McMorrow, Meredith L Patel, Manish M Tenforde, Mark W Self, Wesley H Ghamande, Shekhar Calhoun, Nicole Murthy, Kempapura Herrick, Judy McKillop, Amanda Hoffman, Eric Zayed, Martha Smith, Michael Kozikowski, Lori-Ann De Souza, Lesley Ouellette, Scott Bolstad, Michael Coviello, Brianna Ciottone, Robert Devilla, Arnaldo Grafals, Ana Higgins, Conor Ottanelli, Carlo Redman, Kimberly Scaffidi, Douglas Weingart, Alexander Lewis, Nathaniel Mehkri, Omar Mitchell, Megan Griffith, Zachary Brennan, Connery Ashok, Kiran Poynter, Bryan ten Lohuis, Caitlin Stanley, Nicholas Zhang, Sophia Prekker, Matthew Erickson, Heidi Hendrickson, Audrey Caspers, Sean Tordsen, Walker Kaus, Olivia Scharber, Tyler Lumpkin, Jenna Smith, Cassie Marshall, Hunter Shehu, Arber Ali, Harith Rothman, Richard E Mohamed, Amira Nair, Rahul Chen, Jen-Ting (Tina) Karow, Sarah Robart, Emily Maldonado, Paulo Nunes Khan, Maryiam So, Preston So, Madison Schwartz, Elizabeth Botros, Mena Hough, Catherine L Jung, Haeun Martinez, Jesus Luong, Andrea Huynh, Bao Ibrahim, Habiba Villanueva-Vargas, Cynthia Villanueva-Vargas, Juliana Quadri, Suha Gordon, Alexandra June Levitt, Joe Perez, Cynthia Visweswaran, Anita Roque, Jonasel Qadir, Nida Frankel, Trevor Garner, Omai Chandrasekaran, Sukantha Douin, David Jensen, Kelly Huynh, David Steinwand, Aimee Withers, Cori Mohr, Nicholas Nassar, Paul Landers, Shannon Nielsen, Karin Briggs, Noble Fairfield, Cathy Gershengorn, Hayley Rivas, Carolina Monto, Arnold McSpadden, E J Truscon, Rachel Kaniclides, Anne Thomas, Lara Bielak, Ramsay Valvano, Weronika Damek Fong, Rebecca Fitzsimmons, William J Blair, Christopher Gilbert, Julie Baker, Leigh Srinivasan, Vasisht Crider, Christine D Steinbock, Kyle A Paulsen, Thomas C Anderson, Layla A Jones, Ian Womack, Kelsey Baughman, Adrienne Kampe, Christy Johnson, Jakea Hart, Kim Rice, Todd Stubblefield, William B Zhu, Yuwei Short, Laura L Ezzell, Lauren J Whitsett, Margaret E McHenry, Rendie E Hargrave, Samarian J Blair, Marcia Luther, Jennifer L Pulido, Claudia Guevara Peterson, Bryan P M LaRose, Mary Landreth, Leigha Hicks, Madeline Parks, Lisa Babcock, Hilary Bongu, Jahnavi McDonald, David Cass, Candice Seiler, Sondra Park, David Hink, Tiffany Wallace, Meghan Burnham, Carey-Ann Arter, Olivia G BMJ Research OBJECTIVE: To compare the effectiveness of a primary covid-19 vaccine series plus booster doses with a primary series alone for the prevention of hospital admission with omicron related covid-19 in the United States. DESIGN: Multicenter observational case-control study with a test negative design. SETTING: Hospitals in 18 US states. PARTICIPANTS: 4760 adults admitted to one of 21 hospitals with acute respiratory symptoms between 26 December 2021 and 30 June 2022, a period when the omicron variant was dominant. Participants included 2385 (50.1%) patients with laboratory confirmed covid-19 (cases) and 2375 (49.9%) patients who tested negative for SARS-CoV-2 (controls). MAIN OUTCOME MEASURES: The main outcome was vaccine effectiveness against hospital admission with covid-19 for a primary series plus booster doses and a primary series alone by comparing the odds of being vaccinated with each of these regimens versus being unvaccinated among cases versus controls. Vaccine effectiveness analyses were stratified by immunosuppression status (immunocompetent, immunocompromised). The primary analysis evaluated all covid-19 vaccine types combined, and secondary analyses evaluated specific vaccine products. RESULTS: Overall, median age of participants was 64 years (interquartile range 52-75 years), 994 (20.8%) were immunocompromised, 85 (1.8%) were vaccinated with a primary series plus two boosters, 1367 (28.7%) with a primary series plus one booster, and 1875 (39.3%) with a primary series alone, and 1433 (30.1%) were unvaccinated. Among immunocompetent participants, vaccine effectiveness for prevention of hospital admission with omicron related covid-19 for a primary series plus two boosters was 63% (95% confidence interval 37% to 78%), a primary series plus one booster was 65% (58% to 71%), and for a primary series alone was 37% (25% to 47%) (P<0.001 for the pooled boosted regimens compared with a primary series alone). Vaccine effectiveness was higher for a boosted regimen than for a primary series alone for both mRNA vaccines (BNT162b2 (Pfizer-BioNTech): 73% (44% to 87%) for primary series plus two boosters, 64% (55% to 72%) for primary series plus one booster, and 36% (21% to 48%) for primary series alone (P<0.001); mRNA-1273 (Moderna): 68% (17% to 88%) for primary series plus two boosters, 65% (55% to 73%) for primary series plus one booster, and 41% (25% to 54%) for primary series alone (P=0.001)). Among immunocompromised patients, vaccine effectiveness for a primary series plus one booster was 69% (31% to 86%) and for a primary series alone was 49% (30% to 63%) (P=0.04). CONCLUSION: During the first six months of 2022 in the US, booster doses of a covid-19 vaccine provided additional benefit beyond a primary vaccine series alone for preventing hospital admissions with omicron related covid-19. READERS’ NOTE: This article is a living test negative design study that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication. BMJ Publishing Group Ltd. 2022-10-11 /pmc/articles/PMC9551237/ /pubmed/36220174 http://dx.doi.org/10.1136/bmj-2022-072065 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Research Adams, Katherine Rhoads, Jillian P Surie, Diya Gaglani, Manjusha Ginde, Adit A McNeal, Tresa Talbot, H Keipp Casey, Jonathan D Zepeski, Anne Shapiro, Nathan I Gibbs, Kevin W Files, D Clark Hager, David N Frosch, Anne E Exline, Matthew C Mohamed, Amira Johnson, Nicholas J Steingrub, Jay S Peltan, Ithan D Brown, Samuel M Martin, Emily T Lauring, Adam S Khan, Akram Busse, Laurence W Duggal, Abhijit Wilson, Jennifer G Chang, Steven Y Mallow, Christopher Kwon, Jennie H Chappell, James D Halasa, Natasha Grijalva, Carlos G Lindsell, Christopher J Lester, Sandra N Thornburg, Natalie J Park, SoHee McMorrow, Meredith L Patel, Manish M Tenforde, Mark W Self, Wesley H Ghamande, Shekhar Calhoun, Nicole Murthy, Kempapura Herrick, Judy McKillop, Amanda Hoffman, Eric Zayed, Martha Smith, Michael Kozikowski, Lori-Ann De Souza, Lesley Ouellette, Scott Bolstad, Michael Coviello, Brianna Ciottone, Robert Devilla, Arnaldo Grafals, Ana Higgins, Conor Ottanelli, Carlo Redman, Kimberly Scaffidi, Douglas Weingart, Alexander Lewis, Nathaniel Mehkri, Omar Mitchell, Megan Griffith, Zachary Brennan, Connery Ashok, Kiran Poynter, Bryan ten Lohuis, Caitlin Stanley, Nicholas Zhang, Sophia Prekker, Matthew Erickson, Heidi Hendrickson, Audrey Caspers, Sean Tordsen, Walker Kaus, Olivia Scharber, Tyler Lumpkin, Jenna Smith, Cassie Marshall, Hunter Shehu, Arber Ali, Harith Rothman, Richard E Mohamed, Amira Nair, Rahul Chen, Jen-Ting (Tina) Karow, Sarah Robart, Emily Maldonado, Paulo Nunes Khan, Maryiam So, Preston So, Madison Schwartz, Elizabeth Botros, Mena Hough, Catherine L Jung, Haeun Martinez, Jesus Luong, Andrea Huynh, Bao Ibrahim, Habiba Villanueva-Vargas, Cynthia Villanueva-Vargas, Juliana Quadri, Suha Gordon, Alexandra June Levitt, Joe Perez, Cynthia Visweswaran, Anita Roque, Jonasel Qadir, Nida Frankel, Trevor Garner, Omai Chandrasekaran, Sukantha Douin, David Jensen, Kelly Huynh, David Steinwand, Aimee Withers, Cori Mohr, Nicholas Nassar, Paul Landers, Shannon Nielsen, Karin Briggs, Noble Fairfield, Cathy Gershengorn, Hayley Rivas, Carolina Monto, Arnold McSpadden, E J Truscon, Rachel Kaniclides, Anne Thomas, Lara Bielak, Ramsay Valvano, Weronika Damek Fong, Rebecca Fitzsimmons, William J Blair, Christopher Gilbert, Julie Baker, Leigh Srinivasan, Vasisht Crider, Christine D Steinbock, Kyle A Paulsen, Thomas C Anderson, Layla A Jones, Ian Womack, Kelsey Baughman, Adrienne Kampe, Christy Johnson, Jakea Hart, Kim Rice, Todd Stubblefield, William B Zhu, Yuwei Short, Laura L Ezzell, Lauren J Whitsett, Margaret E McHenry, Rendie E Hargrave, Samarian J Blair, Marcia Luther, Jennifer L Pulido, Claudia Guevara Peterson, Bryan P M LaRose, Mary Landreth, Leigha Hicks, Madeline Parks, Lisa Babcock, Hilary Bongu, Jahnavi McDonald, David Cass, Candice Seiler, Sondra Park, David Hink, Tiffany Wallace, Meghan Burnham, Carey-Ann Arter, Olivia G Vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the United States: living test negative design study |
title | Vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the United States: living test negative design study |
title_full | Vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the United States: living test negative design study |
title_fullStr | Vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the United States: living test negative design study |
title_full_unstemmed | Vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the United States: living test negative design study |
title_short | Vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the United States: living test negative design study |
title_sort | vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the united states: living test negative design study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9551237/ https://www.ncbi.nlm.nih.gov/pubmed/36220174 http://dx.doi.org/10.1136/bmj-2022-072065 |
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