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Estimating the early impact of the US COVID-19 vaccination programme on COVID-19 cases, emergency department visits, hospital admissions, and deaths among adults aged 65 years and older: an ecological analysis of national surveillance data.
McNamara, Lucy A; Wiegand, Ryan E; Burke, Rachel M; Sharma, Andrea J; Sheppard, Michael; Adjemian, Jennifer; Ahmad, Farida B; Anderson, Robert N; Barbour, Kamil E; Binder, Alison M; Dasgupta, Sharoda; Dee, Deborah L; Jones, Emma S; Kriss, Jennifer L; Lyons, B Casey; McMorrow, Meredith; Payne, Daniel C; Reses, Hannah E; Rodgers, Loren E; Walker, David; Verani, Jennifer R; Schrag, Stephanie J.
  • McNamara LA; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Wiegand RE; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Burke RM; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Sharma AJ; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA; US Public Health Service Commissioned Corps, Atlanta, GA, USA.
  • Sheppard M; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Adjemian J; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA; US Public Health Service Commissioned Corps, Atlanta, GA, USA.
  • Ahmad FB; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Anderson RN; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Barbour KE; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Binder AM; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Dasgupta S; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA; US Public Health Service Commissioned Corps, Atlanta, GA, USA.
  • Dee DL; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA; US Public Health Service Commissioned Corps, Atlanta, GA, USA.
  • Jones ES; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Kriss JL; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Lyons BC; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • McMorrow M; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA; US Public Health Service Commissioned Corps, Atlanta, GA, USA.
  • Payne DC; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Reses HE; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Rodgers LE; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA; US Public Health Service Commissioned Corps, Atlanta, GA, USA.
  • Walker D; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Verani JR; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA; US Public Health Service Commissioned Corps, Atlanta, GA, USA. Electronic address: qzr7@cdc.gov.
  • Schrag SJ; CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: zha6@cdc.gov.
Lancet ; 399(10320): 152-160, 2022 01 08.
Article in English | MEDLINE | ID: covidwho-1506422
ABSTRACT

BACKGROUND:

In the USA, COVID-19 vaccines became available in mid-December, 2020, with adults aged 65 years and older among the first groups prioritised for vaccination. We estimated the national-level impact of the initial phases of the US COVID-19 vaccination programme on COVID-19 cases, emergency department visits, hospital admissions, and deaths among adults aged 65 years and older.

METHODS:

We analysed population-based data reported to US federal agencies on COVID-19 cases, emergency department visits, hospital admissions, and deaths among adults aged 50 years and older during the period Nov 1, 2020, to April 10, 2021. We calculated the relative change in incidence among older age groups compared with a younger reference group for pre-vaccination and post-vaccination periods, defined by the week when vaccination coverage in a given age group first exceeded coverage in the reference age group by at least 1%; time lags for immune response and time to outcome were incorporated. We assessed whether the ratio of these relative changes differed when comparing the pre-vaccination and post-vaccination periods.

FINDINGS:

The ratio of relative changes comparing the change in the COVID-19 case incidence ratio over the post-vaccine versus pre-vaccine periods showed relative decreases of 53% (95% CI 50 to 55) and 62% (59 to 64) among adults aged 65 to 74 years and 75 years and older, respectively, compared with those aged 50 to 64 years. We found similar results for emergency department visits with relative decreases of 61% (52 to 68) for adults aged 65 to 74 years and 77% (71 to 78) for those aged 75 years and older compared with adults aged 50 to 64 years. Hospital admissions declined by 39% (29 to 48) among those aged 60 to 69 years, 60% (54 to 66) among those aged 70 to 79 years, and 68% (62 to 73), among those aged 80 years and older, compared with adults aged 50 to 59 years. COVID-19 deaths also declined (by 41%, 95% CI -14 to 69 among adults aged 65-74 years and by 30%, -47 to 66 among those aged ≥75 years, compared with adults aged 50 to 64 years), but the magnitude of the impact of vaccination roll-out on deaths was unclear.

INTERPRETATION:

The initial roll-out of the US COVID-19 vaccination programme was associated with reductions in COVID-19 cases, emergency department visits, and hospital admissions among older adults.

FUNDING:

None.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Mortality / Emergency Service, Hospital / COVID-19 Vaccines / COVID-19 Type of study: Incidence study / Prognostic study / Randomized controlled trials / Screening study Limits: Aged / Female / Humans / Male Country/Region as subject: North America Language: English Journal: Lancet Year: 2022 Document Type: Article Affiliation country: S0140-6736(21)02226-1

Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Mortality / Emergency Service, Hospital / COVID-19 Vaccines / COVID-19 Type of study: Incidence study / Prognostic study / Randomized controlled trials / Screening study Limits: Aged / Female / Humans / Male Country/Region as subject: North America Language: English Journal: Lancet Year: 2022 Document Type: Article Affiliation country: S0140-6736(21)02226-1