COVID-19 Bivalent Booster Vaccination Coverage and Intent to Receive Booster Vaccination Among Adolescents and Adults — United States, November–December 2022

Lu, Peng–jun; Zhou, Tianyi; Santibanez, Tammy A.; Jain, Anurag; Black, Carla L.; Srivastav, Anup; Hung, Mei-Chuan; Kriss, Jennifer L.; Schorpp, Susanne; Yankey, David; Sterrett, Natalie; Fast, Hannah E; Razzaghi, Hilda; Elam–Evans, Laurie D.; Singleton, James A.

doi:10.15585/mmwr.mm7207a5

Cited by 33 publications

(21 citation statements)

References 7 publications

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“…Upon entry into the simulation, each person was assigned an age, immune status, vaccine status (1 or 2 monovalent mRNA booster doses) 28 , and prior infection status 27 . For the age-specific cohorts and the immunocompromised risk group, prior infection status was informed by estimates of seroprevalence (nucleocapsid antibody consistent with prior infection; see Appendix for full methodologic approach) 27,29 .…”

Section: Methodsmentioning

confidence: 99%

“…We modeled the population in 12 key risk groups defined by: i) age: 18-49 years, 50-64 years, 65-74 years, 75+ years; and ii) immune status: immunocompetent, mild immunocompromised status (e.g., low-dose corticosteroids, mild immunosuppressive medications), and moderate/severe immunocompromised status (e.g., hematologic malignancy with active treatment or poor response to vaccines, solid organ or bone marrow transplant, high-dose corticosteroids or other moderate/severely immunosuppressive medications) 16 (see Appendix, “Model calibration”). Upon entry into the simulation, each person was assigned an age, immune status, vaccine status (1 or 2 monovalent mRNA booster doses) 28 , and prior infection status 27 . For the age-specific cohorts and the immunocompromised risk group, prior infection status was informed by estimates of seroprevalence (nucleocapsid antibody consistent with prior infection; see Appendix for full methodologic approach) 27,29 .…”

Section: Methodsmentioning

confidence: 99%

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Comparing frequency of booster vaccination to prevent severe COVID-19 by risk group in the United States

Park

Gonsalves

Tan

et al. 2023

Preprint

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While waning protection from vaccination and natural infection against SARS-CoV-2 infection is well-documented, recent analyses have also found waning of protection against severe COVID-19. This highlights a broader need to understand the optimal timing of COVID-19 booster vaccines specific to an individual to mitigate the risk of severe COVID-19, while accounting for waning of protection and differential risk by age group and immune status. Here we show that more frequent COVID-19 booster vaccination (every 6-12 months) in older age groups and the immunocompromised population would effectively mitigate the burden of severe COVID-19, while frequent boosters in the younger population may only provide modest benefit. Analyzing United States COVID-19 surveillance and seroprevalence data in a microsimulation model, we estimated that in persons 75+ years, annual and semiannual bivalent boosters would reduce annual absolute risk of severe COVID-19 by 311 (277-369) and 578 (494-671) cases, respectively, compared to a one-time bivalent booster dose. In contrast, for persons 18-49 years, the model estimated that annual and semiannual bivalent boosters would reduce annual absolute risk of severe COVID-19 by 20 (13-26) and 37 (24-50) cases per 100,000 persons, respectively, compared to a one-time bivalent booster dose. Persons with prior infection had a much lower benefit of more frequent boosting, while immunocompromised persons had larger benefit. This study underscores the benefit of customizing timing of COVID-19 booster vaccines based on individual risk.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Comparing frequency of booster vaccination to prevent severe COVID-19 by risk group in the United States

Park

Gonsalves

Tan

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…5 Furthermore, more than 50% of the total population has experienced breakthrough infection (BI) despite the high coverage of the third dose, and the actual vaccination rate for the bivalent vaccine has remained below 30%, reflecting questions about the additive effects of the vaccine after a BI. 8,9 Currently, the epidemic waves of Omicron subvariants are continuing, and the introduction of monovalent vaccines against XBB.1.5 is scheduled. 10 To establish a vaccination strategy for the upcoming COVID-19 endemic era, we used long-term follow-up data from a healthcare worker (HCW) vaccinee cohort to evaluate whether BIs and additional vaccination for updated strains could overcome antigenic imprinting.…”

Section: Introductionmentioning

confidence: 99%

“…However, the additive effect of bivalent vaccines (in terms of overcoming the antigenic imprinting of WT SARS‐CoV‐2 primed by the initial vaccine series) has been controversial 5 . Furthermore, more than 50% of the total population has experienced breakthrough infection (BI) despite the high coverage of the third dose, and the actual vaccination rate for the bivalent vaccine has remained below 30%, reflecting questions about the additive effects of the vaccine after a BI 8,9 …”

Section: Introductionmentioning

confidence: 99%

Evolution of neutralizing antibodies through vaccination and breakthrough infections in the era of COVID‐19 endemicity

Yang,

Kim,

Kim

et al. 2023

Journal of Medical Virology

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Despite a high vaccination rate, the COVID‐19 pandemic continues with immune‐evading Omicron variants. The success of additional antigenic stimulation through breakthrough infection (BI) and updated vaccination in overcoming antigenic imprinting needs to be determined. Participants in a long‐term follow‐up cohort of healthcare worker (HCW) vaccinee were categorized according to their infection/vaccination status. Anti‐SARS‐CoV‐2 spike/nucleocapsid protein antibodies were measured, and plaque reduction neutralization tests (PRNTs) against wild‐type (WT), BA.5, BN.1, and XBB.1.5 were conducted. The neutralization activity of intravenous immunoglobulin (IVIG) products was evaluated to assess the immune status of the general population. Ninety‐five HCWs were evaluated and categorized into seven groups. The WT PRNT ND50 value was highest regardless of infection/vaccination status, and groups with recent antigenic stimulation showed high PRNT titers overall. Groups with double Omicron stimulation, either by BI plus BA.4/5 bivalent vaccination or repeated BI, exhibited significantly higher BA.5 and BN.1 PRNT to WT PRNT ratios than those with single Omicron stimulation. Overall group immunity was estimated to be boosted in January 2023, reflecting the effect of the BA.4/5 bivalent booster and additional BIs, but slightly declined in June 2023. A substantial increase in the antibody concentrations of IVIG products was noticed in 2022, and recently produced IVIG products exhibited a substantial level of cross‐reactive neutralizing activity against emerging variants. Neutralizing activity against emerging variants could be enhanced by repeated antigenic stimulation via BI and/or updated vaccination. Overall group immunity was elevated accordingly, and IVIG products showed substantial activity against circulating strains.

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“…Since only 17% of US individuals received a bivalent vaccine dose, concerns exist that uptake of the updated monovalent XBB vaccine may also be low [10,11]. Hence, data on the durability of bivalent COVID-19 vaccine effectiveness against COVID-19 outcomes with currently circulating variants are needed to inform regulatory agencies, healthcare providers, and individuals, of the potential importance of receiving an updated monovalent XBB vaccine [12]. Therefore, we evaluated the absolute and relative effectiveness and durability of mRNA-1273 bivalent vaccine against a range of outcomes with sequencingconfirmed omicron BA.4/BA.5-and XBB-related sublineages.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and durability of mRNA-1273 BA.4/BA.5 bivalent vaccine (mRNA-1273.222) against SARS-CoV-2 BA.4/BA.5 and XBB sublineages

Ackerson,

Bruxvoort,

Qian

et al. 2023

Preprint

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BackgroundEmerging SARS-CoV-2 sublineages continue to cause serious COVID-19 disease, but most individuals have not received COVID-19 vaccine for >1 year. Assessment of long-term effectiveness of bivalent COVID-19 vaccines against circulating sublineages is important to inform the potential need for vaccination with updated vaccines.MethodsIn this test-negative study at Kaiser Permanente Southern California, sequencing-confirmed BA.4/BA.5- or XBB-related SARS-CoV-2-positive cases during 9/1/2022-6/30/2023 were matched 1:3 to SARS-CoV-2-negative controls. We assessed mRNA-1273 bivalent relative (rVE) and absolute vaccine effectiveness (VE) compared to ≥2 or 0 doses of original monovalent vaccine, respectively. Outcomes were BA.4/BA.5- or XBB-related infection, emergency department/urgent care (ED/UC) encounters, and hospitalization.ResultsThe rVE analysis included 20,966 cases and 62,898 controls. rVE (95%CI) against BA.4/BA.5 at 14-60 days and 121-180 days was 52.7% (46.9-57.8%) and 35.5% (-2.8%-59.5%) for infection, and 59.3% (49.7-67.0%) and 33.2% (-28.2-68.0%) for ED/UC encounters. For BA.4/BA.5-related hospitalizations, rVE was 71.3% (44.9-85.1%) and 52.0% (-1.2-77.3%) at 14-60 days and 61-120 days, respectively. rVE against XBB at 14-60 days and 121-180 days, was 48.8% (33.4-60.7%) and -3.9% (-18.1-11.3%) for infection, 70.7% (52.4-82.0%) and 15.7% (-6.0-33.2%) for ED/UC encounters, and 87.9% (43.8-97.4%) and 57.1% (17.0-77.8%) for hospitalization. Results for VE and subgroup analyses (age, immunocompromise, and previous SARS-CoV-2 infection) were similar to rVE analyses.ConclusionsrVE of mRNA-1273 bivalent vaccine against BA.4/BA.5 and XBB infections, ED/UC encounters, and hospitalizations waned over time. Periodic adjustment of vaccines to target emerging variants and revaccination may be important in reducing COVID-19 morbidity and mortality.SummarymRNA-1273 BA.4/BA.5 bivalent vaccine effectiveness against infection and hospitalization with BA.4/BA.5-related and XBB-related sublineages waned over time. Periodic vaccination with vaccines reflecting circulating variants may reduce SARS-CoV-2 associated morbidity and mortality.

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COVID-19 Bivalent Booster Vaccination Coverage and Intent to Receive Booster Vaccination Among Adolescents and Adults — United States, November–December 2022

Cited by 33 publications

References 7 publications

Comparing frequency of booster vaccination to prevent severe COVID-19 by risk group in the United States

Comparing frequency of booster vaccination to prevent severe COVID-19 by risk group in the United States

Evolution of neutralizing antibodies through vaccination and breakthrough infections in the era of COVID‐19 endemicity

Effectiveness and durability of mRNA-1273 BA.4/BA.5 bivalent vaccine (mRNA-1273.222) against SARS-CoV-2 BA.4/BA.5 and XBB sublineages

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