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Effectiveness of Severe Acute Respiratory Syndrome Coronavirus 2 Messenger RNA Vaccines for Preventing Coronavirus Disease 2019 Hospitalizations in the United States.
Tenforde, Mark W; Patel, Manish M; Ginde, Adit A; Douin, David J; Talbot, H Keipp; Casey, Jonathan D; Mohr, Nicholas M; Zepeski, Anne; Gaglani, Manjusha; McNeal, Tresa; Ghamande, Shekhar; Shapiro, Nathan I; Gibbs, Kevin W; Files, D Clark; Hager, David N; Shehu, Arber; Prekker, Matthew E; Erickson, Heidi L; Exline, Matthew C; Gong, Michelle N; Mohamed, Amira; Henning, Daniel J; Steingrub, Jay S; Peltan, Ithan D; Brown, Samuel M; Martin, Emily T; Monto, Arnold S; Khan, Akram; Hough, Catherine L; Busse, Laurence W; Ten Lohuis, Caitlin C; Duggal, Abhijit; Wilson, Jennifer G; Gordon, Alexandra June; Qadir, Nida; Chang, Steven Y; Mallow, Christopher; Gershengorn, Hayley B; Babcock, Hilary M; Kwon, Jennie H; Halasa, Natasha; Chappell, James D; Lauring, Adam S; Grijalva, Carlos G; Rice, Todd W; Jones, Ian D; Stubblefield, William B; Baughman, Adrienne; Womack, Kelsey N; Lindsell, Christopher J.
  • Tenforde MW; CDC COVID-19 Response Team, Atlanta, Georgia, USA.
  • Patel MM; CDC COVID-19 Response Team, Atlanta, Georgia, USA.
  • Ginde AA; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
  • Douin DJ; Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado, USA.
  • Talbot HK; Departments of Medicine and Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Casey JD; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Mohr NM; Department of Emergency Medicine, University of Iowa, Iowa City, Iowa, USA.
  • Zepeski A; Department of Emergency Medicine, University of Iowa, Iowa City, Iowa, USA.
  • Gaglani M; Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, Texas, USA.
  • McNeal T; Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, Texas, USA.
  • Ghamande S; Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, Texas, USA.
  • Shapiro NI; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
  • Gibbs KW; Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
  • Files DC; Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
  • Hager DN; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Shehu A; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Prekker ME; Department of Emergency Medicine and Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA.
  • Erickson HL; Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA.
  • Exline MC; Department of Medicine, The Ohio State University, Columbus, Ohio, USA.
  • Gong MN; Department of Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA.
  • Mohamed A; Department of Medicine, Montefiore Medical Center, Bronx, New York, USA.
  • Henning DJ; Department of Emergency Medicine, University of Washington, Seattle, Washington, USA.
  • Steingrub JS; Department of Medicine, Baystate Medical Center, Springfield, Massachusetts, USA.
  • Peltan ID; Department of Medicine, Intermountain Medical Center, Murray, Utah and University of Utah, Salt Lake City, Utah, USA.
  • Brown SM; Department of Medicine, Intermountain Medical Center, Murray, Utah and University of Utah, Salt Lake City, Utah, USA.
  • Martin ET; School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
  • Monto AS; School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
  • Khan A; Department of Medicine, Oregon Health and Sciences University, Portland, Oregon, USA.
  • Hough CL; Department of Medicine, Oregon Health and Sciences University, Portland, Oregon, USA.
  • Busse LW; Department of Medicine, Emory University, Atlanta, Georgia, USA.
  • Ten Lohuis CC; Emory Critical Care Center, Emory Healthcare, Atlanta, Georgia, USA.
  • Duggal A; Department of Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
  • Wilson JG; Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA.
  • Gordon AJ; Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA.
  • Qadir N; Department of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Chang SY; Department of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Mallow C; Department of Medicine, University of Miami, Miami, Florida, USA.
  • Gershengorn HB; Department of Medicine, University of Miami, Miami, Florida, USA.
  • Babcock HM; Department of Medicine, Washington University, St. Louis, Missouri, USA.
  • Kwon JH; Department of Medicine, Washington University, St. Louis, Missouri, USA.
  • Halasa N; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Chappell JD; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Lauring AS; Departments of Internal Medicine and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA.
  • Grijalva CG; Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Rice TW; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Jones ID; Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Stubblefield WB; Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Baughman A; Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Womack KN; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Lindsell CJ; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Clin Infect Dis ; 74(9): 1515-1524, 2022 05 03.
Article in English | MEDLINE | ID: covidwho-1700456
ABSTRACT

BACKGROUND:

As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination coverage increases in the United States, there is a need to understand the real-world effectiveness against severe coronavirus disease 2019 (COVID-19) and among people at increased risk for poor outcomes.

METHODS:

In a multicenter case-control analysis of US adults hospitalized March 11-May 5, 2021, we evaluated vaccine effectiveness to prevent COVID-19 hospitalizations by comparing odds of prior vaccination with a messenger RNA (mRNA) vaccine (Pfizer-BioNTech or Moderna) between cases hospitalized with COVID-19 and hospital-based controls who tested negative for SARS-CoV-2.

RESULTS:

Among 1212 participants, including 593 cases and 619 controls, median age was 58 years, 22.8% were Black, 13.9% were Hispanic, and 21.0% had immunosuppression. SARS-CoV-2 lineage B0.1.1.7 (Alpha) was the most common variant (67.9% of viruses with lineage determined). Full vaccination (receipt of 2 vaccine doses ≥14 days before illness onset) had been received by 8.2% of cases and 36.4% of controls. Overall vaccine effectiveness was 87.1% (95% confidence interval [CI], 80.7-91.3). Vaccine effectiveness was similar for Pfizer-BioNTech and Moderna vaccines, and highest in adults aged 18-49 years (97.4%; 95% CI, 79.3-9.7). Among 45 patients with vaccine-breakthrough COVID hospitalizations, 44 (97.8%) were ≥50 years old and 20 (44.4%) had immunosuppression. Vaccine effectiveness was lower among patients with immunosuppression (62.9%; 95% CI,20.8-82.6) than without immunosuppression (91.3%; 95% CI, 85.6-94.8).

CONCLUSION:

During March-May 2021, SARS-CoV-2 mRNA vaccines were highly effective for preventing COVID-19 hospitalizations among US adults. SARS-CoV-2 vaccination was beneficial for patients with immunosuppression, but effectiveness was lower in the immunosuppressed population.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Controlled clinical trial / Observational study Topics: Vaccines / Variants Limits: Adult / Humans / Middle aged Country/Region as subject: North America Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Controlled clinical trial / Observational study Topics: Vaccines / Variants Limits: Adult / Humans / Middle aged Country/Region as subject: North America Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid