Effectiveness of Homologous and Heterologous COVID-19 Booster Doses Following 1 Ad.26.COV2.S (Janssen [Johnson & Johnson]) Vaccine Dose Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults — VISION Network, 10 States, December 2021–March 2022

Details

• Journal Article:
  Morbidity and Mortality Weekly Report (MMWR)
• Personal Author:
  Natarajan, Karthik ; Prasad, Namrata ; Dascomb, Kristin ; Irving, Stephanie A. ; Yang, Duck-Hye ; Gaglani, Manjusha ; Klein, Nicola P. ; DeSilva, Malini B. ; Ong, Toan C. ; Grannis, Shaun J. ; Stenehjem, Edward ; Link-Gelles, Ruth ; Rowley, Elizabeth A. ; Naleway, Allison L. ; Han, Jungmi ; Raiyani, Chandni ; Benitez, Gabriela Vazquez ; Rao, Suchitra ; Lewis, Ned ; Fadel, William F. ; Grisel, Nancy ; Griggs, Eric P. ; Dunne, Margaret M. ; Stockwell, Melissa S. ; Mamawala, Mufaddal ; McEvoy, Charlene ; Barron, Michelle A. ; Goddard, Kristin ; Valvi, Nimish R. ; Arndorfer, Julie ; Patel, Palak ; Mitchell, Patrick K ; Smith, Michael ; Kharbanda, Anupam B. ; Fireman, Bruce ; Embi, Peter J. ; Dickerson, Monica ; Davis, Jonathan M. ; Zerbo, Ousseny ; Dalton, Alexandra F. ; Wondimu, Mehiret H. ; Azziz-Baumgartner, Eduardo ; Bozio, Catherine H. ; Reynolds, Sue ; Ferdinands, Jill ; Williams, Jeremiah ; Schrag, Stephanie J. ; Verani, Jennifer R. ; Ball, Sarah ; Thompson, Mark G. ; Dixon, Brian E.
• Description:
  CDC recommends that all persons aged ≥18 years receive a single COVID-19 vaccine booster dose ≥2 months after receipt of an Ad.26.COV2.S (Janssen [Johnson & Johnson]) adenoVirus vector-based primary series vaccine; a heterologous COVID-19 mRNA vaccine is preferred over a homologous (matching) Janssen vaccine for booster vaccination. This recommendation was made in light of the risks for rare but serious adverse events following receipt of a Janssen vaccine, including thrombosis with thrombocytopenia syndrome and Guillain-Barré syndrome| (1), and clinical trial data indicating similar or higher neutralizing antibody response following heterologous boosting compared with homologous boosting (2). Data on real-world vaccine effectiveness (VE) of different booster strategies following a primary Janssen vaccine dose are limited, particularly during the period of Omicron Variants predominance. The VISION Network| determined real-world VE of 1 Janssen vaccine dose and 2 alternative booster dose strategies: 1) a homologous booster (i.e., 2 Janssen doses) and 2) a heterologous mRNA booster (i.e., 1 Janssen dose/1 mRNA dose). In addition, VE of these booster strategies was compared with VE of a homologous booster following mRNA primary series vaccination (i.e., 3 mRNA doses). The study examined 80,287 emergency department/urgent care (ED/UC) visits| and 25,244 hospitalizations across 10 states during December 16, 2021-March 7, 2022, when Omicron was the predominant circulating Variants.** VE against laboratory-confirmed COVID-19-associated ED/UC encounters was 24% after 1 Janssen dose, 54% after 2 Janssen doses, 79% after 1 Janssen/1 mRNA dose, and 83% after 3 mRNA doses. VE for the same vaccination strategies against laboratory-confirmed COVID-19-associated hospitalizations were 31%, 67%, 78%, and 90%, respectively. All booster strategies provided higher protection than a single Janssen dose against ED/UC visits and hospitalizations during Omicron Variants predominance. Vaccination with 1 Janssen/1 mRNA dose provided higher protection than did 2 Janssen doses against COVID-19-associated ED/UC visits and was comparable to protection provided by 3 mRNA doses during the first 120 days after a booster dose. However, 3 mRNA doses provided higher protection against COVID-19-associated hospitalizations than did other booster strategies during the same time interval since booster dose. All adults who have received mRNA vaccines for their COVID-19 primary series vaccination should receive an mRNA booster dose when eligible. Adults who received a primary Janssen vaccine dose should preferentially receive a heterologous mRNA vaccine booster dose ≥2 months later, or a homologous Janssen vaccine booster dose if mRNA vaccine is contraindicated or unavailable. Further investigation of the durability of protection afforded by different booster strategies is warranted.
• Subjects:
  Adolescent Adult Ambulatory Care COVID-19 COVID-19 Vaccines Emergency Service, Hospital Hospitalization Humans Immunization, Secondary Influenza Vaccines MRNA Vaccines SARS-CoV-2 Vaccines, Synthetic

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• Source:
  MMWR Morbidity Mortal Weekly Rep. 71(13):495-502
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• DOI:
  http://dx.doi.org/10.15585/mmwr.mm7113e2
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Pubmed ID:
  35358170
• Pubmed Central ID:
  PMC8979598
• Document Type:
  Journal Article
• Pages in Document:
  8 pdf pages
• Volume:
  71
• Issue:
  13
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:b1ddce3f11ce913fb658fff171d97b38e26d55f91ab70e74bef7868d37d4c4a86b8fd620a3dae1945c3d525efe5250f8d96ba0a53a83870b3ca482a427b99aeb
• Download URL:
  https://stacks.cdc.gov/view/cdc/116614/cdc_116614_DS1.pdf
• File Type:
  [PDF - 445.48 KB ]