Effectiveness of a Third Dose of mRNA Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance — VISION Network, 10 States, August 2021–January 2022

Details

• Journal Article:
  Morbidity and Mortality Weekly Report (MMWR)
• Personal Author:
  Thompson, Mark G. ; Natarajan, Karthik ; Irving, Stephanie A. ; Rowley, Elizabeth A. ; Griggs, Eric P. ; Gaglani, Manjusha ; Klein, Nicola P. ; Grannis, Shaun J. ; DeSilva, Malini B. ; Stenehjem, Edward ; Reese, Sarah E. ; Dickerson, Monica ; Naleway, Allison L. ; Han, Jungmi ; Konatham, Deepika ; McEvoy, Charlene ; Rao, Suchitra ; Dixon, Brian E. ; Dascomb, Kristin ; Lewis, Ned ; Levy, Matthew E. ; Patel, Palak ; Liao, I-Chia ; Kharbanda, Anupam B. ; Barron, Michelle A. ; Fadel, William F. ; Grisel, Nancy ; Goddard, Kristin ; Yang, Duck-Hye ; Wondimu, Mehiret H. ; Murthy, Kempapura ; Valvi, Nimish R. ; Arndorfer, Julie ; Fireman, Bruce ; Dunne, Margaret M. ; Embi, Peter ; Azziz-Baumgartner, Eduardo ; Zerbo, Ousseny ; Bozio, Catherine H. ; Reynolds, Sue ; Ferdinands, Jill ; Williams, Jeremiah ; Link-Gelles, Ruth ; Schrag, Stephanie J. ; Verani, Jennifer R. ; Ball, Sarah ; Ong, Toan C.
• Description:
  Estimates of COVID-19 mRNA vaccine effectiveness (VE) have declined in recent months (1,2) because of waning vaccine induced immunity over time,* possible increased immune evasion by SARS-CoV-2 variants (3), or a combination of these and other factors. CDC recommends that all persons aged ≥12 years receive a third dose (booster) of an mRNA vaccine ≥5 months after receipt of the second mRNA vaccine dose and that immunocompromised individuals receive a third primary dose.| A third dose of BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine increases neutralizing antibody levels (4), and three recent studies from Israel have shown improved effectiveness of a third dose in preventing COVID-19 associated with infections with the SARS-CoV-2 B.1.617.2 (Delta) variant (5-7). Yet, data are limited on the real-world effectiveness of third doses of COVID-19 mRNA vaccine in the United States, especially since the SARS-CoV-2 B.1.1.529 (Omicron) variant became predominant in mid-December 2021. The VISION Network| examined VE by analyzing 222,772 encounters from 383 emergency departments (EDs) and urgent care (UC) clinics and 87,904 hospitalizations from 259 hospitals among adults aged ≥18 years across 10 states from August 26, 2021| to January 5, 2022. Analyses were stratified by the period before and after the Omicron variant became the predominant strain (>50% of sequenced viruses) at each study site. During the period of Delta predominance across study sites in the United States (August-mid-December 2021), VE against laboratory-confirmed COVID-19-associated ED and UC encounters was 86% 14-179 days after dose 2, 76% ≥180 days after dose 2, and 94% ≥14 days after dose 3. Estimates of VE for the same intervals after vaccination during Omicron variant predominance were 52%, 38%, and 82%, respectively. During the period of Delta variant predominance, VE against laboratory-confirmed COVID-19-associated hospitalizations was 90% 14-179 days after dose 2, 81% ≥180 days after dose 2, and 94% ≥14 days after dose 3. During Omicron variant predominance, VE estimates for the same intervals after vaccination were 81%, 57%, and 90%, respectively. The highest estimates of VE against COVID-19-associated ED and UC encounters or hospitalizations during both Delta- and Omicron-predominant periods were among adults who received a third dose of mRNA vaccine. All unvaccinated persons should get vaccinated as soon as possible. All adults who have received mRNA vaccines during their primary COVID-19 vaccination series should receive a third dose when eligible, and eligible persons should stay up to date with COVID-19 vaccinations.
• Subjects:
  Adult Aged Aged, 80 And Over Ambulatory Care COVID-19 COVID-19 Vaccines Emergency Service, Hospital Female Hospitalization Humans Immunization, Secondary Male Middle Aged MRNA Vaccines SARS-CoV-2 Vaccine Efficacy

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• Source:
  MMWR Morbidity Mortal Weekly Rep. 71(4):139-145
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• DOI:
  http://dx.doi.org/10.15585/mmwr.mm7104e3
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Pubmed ID:
  35085224
• Pubmed Central ID:
  PMC9351525
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  7 pdf pages
• Volume:
  71
• Issue:
  4
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:26a7e759597ad7199e277001d727e1d4f0c012b390b8d996f7b9a74666f44cabd499ac6f5fa142132d017096ea66a145a97552d6aa9a6cf1a7b5a9440ba30258
• Download URL:
  https://stacks.cdc.gov/view/cdc/120645/cdc_120645_DS1.pdf
• File Type:
  [PDF - 482.30 KB ]