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Vaccine effectiveness against Delta, Omicron BA.1, and BA.2 in a highly vaccinated Asian setting: a test-negative design study.
Tan, Celine Y; Chiew, Calvin J; Pang, Deanette; Lee, Vernon J; Ong, Benjamin; Lye, David Chien; Tan, Kelvin Bryan.
  • Tan CY; Ministry of Health, Singapore. Electronic address: celine_ys_tan@moh.gov.sg.
  • Chiew CJ; Ministry of Health, Singapore.
  • Pang D; Ministry of Health, Singapore.
  • Lee VJ; Ministry of Health, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
  • Ong B; Ministry of Health, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
  • Lye DC; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; National Centre for Infectious Diseases, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.
  • Tan KB; Ministry of Health, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Clin Microbiol Infect ; 2022 Aug 24.
Article in English | MEDLINE | ID: covidwho-2236103
ABSTRACT

OBJECTIVES:

We compared the vaccine effectiveness over time of the primary series and booster against infection and severe disease with the Delta, Omicron BA.1, and BA.2 variants in Singapore, an Asian setting with high vaccination coverage.

METHODS:

We conducted a test-negative case-control study on all adult residents in Singapore who underwent PCR testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in acute hospitals. Individuals with a negative PCR from 1 September, 2021, to 30 November, 2021, and 1 December, 2021, to 25 April, 2022, served as controls for the Delta and Omicron variants respectively, and PCR-positive individuals within these two time periods served as cases. Associations between vaccination status and severe SARS-CoV-2 infection and severe disease with the Delta or Omicron variants were measured using Poisson regressions. Vaccine effectiveness was calculated by taking 1 minus risk ratio.

RESULTS:

There were 68 114 individuals comprising 58 495 controls and 9619 cases for the Delta period, of whom 53 093 completed the primary series and 9161 were boosted. For the Omicron period, 104 601 individuals comprising 80 428 controls, 8643 BA.1 cases, and 15 530 BA.2 cases were included, of whom 29 183 and 71 513 were vaccinated with the primary series and boosted, respectively. The primary series provided greater protection against infection with Delta (45%, 95% CI 40-50%) than against infection with Omicron (21%, 95% CI 7-34% for BA.1; 18%, 95% CI 6-29% for BA.2) at <2 months from vaccination. Vaccine effectiveness of the booster was similar against infection with BA.1 (44%, 95% CI 38-50%) and BA.2 (40%, 95% CI 35-40%). Protection against severe disease by the booster for BA.1 (83%, 95% CI 76-88%) and BA.2 (78%, 95% CI 73-82%) was comparable to that by the primary series for Delta (80%, 95% CI 73-85%).

CONCLUSION:

Our findings support the use of a booster dose to reduce the risk of severe disease and mitigate the impact on the healthcare system in an Omicron-predominant epidemic.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines / Variants Language: English Journal subject: Communicable Diseases / Microbiology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines / Variants Language: English Journal subject: Communicable Diseases / Microbiology Year: 2022 Document Type: Article