Effectiveness of 2, 3, and 4 COVID-19 MRNA Vaccine Doses Among Immunocompetent Adults During Periods When SARS-CoV-2 Omicron BA.1 and BA.2/BA.2.12.1 Sublineages Predominated — VISION Network, 10 States

Details

• Personal Author:
  Link-Gelles, Ruth ; Levy, Matthew E. ; Gaglani, Manjusha ; Irving, Stephanie A. ; Stockwell, Melissa ; Dascomb, Kristin ; DeSilva, Malini B. ; Reese, Sarah E. ; Liao, I-Chia ; Ong, Toan C. ; Grannis, Shaun J. ; McEvoy, Charlene ; Patel, Palak ; Klein, Nicola P. ; Hartmann, Emily ; Stenehjem, Edward ; Natarajan, Karthik ; Naleway, Allison L. ; Murthy, Kempapura ; Rao, Suchitra ; Dixon, Brian E. ; Kharbanda, Anupam B. ; Akinseye, Akintunde ; Dickerson, Monica ; Lewis, Ned ; Grisel, Nancy ; Han, Jungmi ; Barron, Michelle A. ; Fadel, William F. ; Dunne, Margaret M. ; Goddard, Kristin ; Arndorfer, Julie ; Konatham, Deepika ; Valvi, Nimish R. ; Currey, J. C. ; Fireman, Bruce ; Raiyani, Chandni ; Zerbo, Ousseny ; Sloan-Aagard, Chantel ; Ball, Sarah W. ; Thompson, Mark G. ; Tenforde, Mark W.
• Corporate Authors:
  CDC COVID-19 Emergency Response Team. ; Westat, Rockville, Maryland. ; Texas A&M University College of Medicine. Baylor Scott & White Health. ; Center for Health Research (Kaiser-Permanente Medical Care Program. Northwest Region) ; Columbia University Vagelos College of Physicians and Surgeons. Division of Child and Adolescent Health. Department of Pediatrics. ; Columbia University Mailman School of Public Health. Department of Population and Family Health. ; New York Presbyterian Hospital. ; Intermountain Healthcare (Utah). Division of Infectious Diseases and Clinical Epidemiology. ; HealthPartners Institute. ; University of Colorado Anschutz Medical Campus. School of Medicine. ; Regenstrief Institute for Health Care‏. Center for Biomedical Informatics. ; Kaiser Permanente Vaccine Study Center. ; Paso Del Norte Health Information Exchange (El Paso, Texas) ; Columbia University. Department of Biomedical Informatics. ; Indiana University. Fairbanks School of Public Health ; Children’s Minnesota (Minneapolis, Minnesota ; Brigham Young University. Department of Public Health. ; VISION Network.
• Description:
  What is already known about this topic? Little is known about COVID-19 vaccine effectiveness (VE) during the Omicron variant BA.2/BA.2.12.2–predominant period or VE of a fourth COVID-19 vaccine dose in persons aged ≥50 years.
  
  What is added by this report? VE during the BA.2/BA.2.12.2 period was lower than that during the BA.1 period. A third vaccine dose provided additional protection against moderate and severe COVID-19–associated illness in all age groups, and a fourth dose provided additional protection in eligible adults aged ≥50 years.
  
  What are the implications for public health practice? Immunocompetent persons should receive recommended COVID-19 booster doses to prevent moderate to severe COVID-19, including a first booster dose for all eligible persons and second dose for adults aged ≥50 years at least 4 months after an initial booster dose. Booster doses should be obtained immediately when persons become eligible.
  
  The Omicron variant (B.1.1.529) of SARS-CoV-2, the virus that causes COVID-19, was first identified in the United States in November 2021, with the BA.1 sublineage (including BA.1.1) causing the largest surge in COVID-19 cases to date. Omicron sublineages BA.2 and BA.2.12.1 emerged later and by late April 2022, accounted for most cases.* Estimates of COVID-19 vaccine effectiveness (VE) can be reduced by newly emerging variants or sublineages that evade vaccine-induced immunity (1), protection from previous SARS-CoV-2 infection in unvaccinated persons (2), or increasing time since vaccination (3). Real-world data comparing VE during the periods when the BA.1 and BA.2/BA.2.12.1 predominated (BA.1 period and BA.2/BA.2.12.1 period, respectively) are limited. The VISION network† examined 214,487 emergency department/urgent care (ED/UC) visits and 58,782 hospitalizations with a COVID-19–like illness§ diagnosis among 10 states during December 18, 2021–June 10, 2022, to evaluate VE of 2, 3, and 4 doses of mRNA COVID-19 vaccines (BNT162b2 [Pfizer-BioNTech] or mRNA-1273 [Moderna]) compared with no vaccination among adults without immunocompromising conditions. VE against COVID-19–associated hospitalization 7–119 days and ≥120 days after receipt of dose 3 was 92% (95% CI = 91%–93%) and 85% (95% CI = 81%–89%), respectively, during the BA.1 period, compared with 69% (95% CI = 58%–76%) and 52% (95% CI = 44%–59%), respectively, during the BA.2/BA.2.12.1 period. Patterns were similar for ED/UC encounters. Among adults aged ≥50 years, VE against COVID-19–associated hospitalization ≥120 days after receipt of dose 3 was 55% (95% CI = 46%–62%) and ≥7 days (median = 27 days) after a fourth dose was 80% (95% CI = 71%–85%) during BA.2/BA.2.12.1 predominance. Immunocompetent persons should receive recommended COVID-19 booster doses to prevent moderate to severe COVID-19, including a first booster dose for all eligible persons and second booster dose for adults aged ≥50 years at least 4 months after an initial booster dose. Booster doses should be obtained immediately when persons become eligible
  
  Suggested citation for this article: Suggested citation for this article: Link-Gelles R, Levy ME, Gaglani M, et al. Effectiveness of 2, 3, and 4 COVID-19 mRNA Vaccine Doses Among Immunocompetent Adults During Periods when SARS-CoV-2 Omicron BA.1 and BA.2/BA.2.12.1 Sublineages Predominated — VISION Network, 10 States, December 2021–June 2022. MMWR Morb Mortal Wkly Rep. ePub: 15 July 2022.
  
  mm7129e1.htm?s_cid=mm7129e1_w
  
  mm7129e1-H.pdf
  
  mm7128e1-H.pdf
  
  
• Subjects:
  2019-nCoV Vaccine MRNA-1273 BNT162 Vaccine Coronavirus Infections/prevention & Control COVID-19 Vaccines COVID-19/prevention & Control Immunization, Secondary Immunogenicity, Vaccine Vaccine Potency Vaccines, Synthetic Viral Vaccines
• Source:
  MMWR: Morbidity and Mortality Weekly Report 2022; v. 71 Early Release
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Document Type:
  Journal Article
• Name as Subject:
  Pfizer-BioNTech COVID-19 vaccine ; Moderna COVID-19 vaccine ; Pfizer-BioNTech COVID-19 vaccine ; Moderna COVID-19 vaccine
• Place as Subject:
  United States
• Pages in Document:
  9 pdf pages
• Volume:
  71
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:f642432e0582d237857a5af358637cd752d1273b066d711eb9ed23b8e8fbf0eaea0d20611c1c062faf5279d9f7f9263bfdd12bef1a02a86797818e131f5fd575
• Download URL:
  https://stacks.cdc.gov/view/cdc/119433/cdc_119433_DS1.pdf
• File Type:
  [PDF - 712.01 KB ]