Effectiveness of COVID-19 mRNA Vaccines Against COVID-19–Associated Hospitalizations Among Immunocompromised Adults During SARS-CoV-2 Omicron Predominance — VISION Network, 10 States, December 2021—August 2022

Britton, Amadea; Embí, Peter J.; Levy, Matthew E.; Gaglani, Manjusha; DeSilva, Malini B.; Dixon, Brian E.; Dascomb, Kristin; Patel, Palak; Schrader, Kristin E.; Klein, Nicola P.; Ong, Toan C.; Natarajan, Karthik; Hartmann, Emily; Kharbanda, Anupam B.; Irving, Stephanie A.; Dickerson, Monica; Dunne, Margaret M.; Raiyani, Chandni; Grannis, Shaun J.; Stenehjem, Edward; Zerbo, Ousseny; Rao, Suchitra; Han, Jungmi; Sloan-Aagard, Chantel; Griggs, Eric P.; Weber, Zachary A.; Murthy, Kempapura; Fadel, William F.; Grisel, Nancy; McEvoy, Charlene; Lewis, Ned; Barron, Michelle A.; Nañez, Juan; Reese, Sarah E.; Mamawala, Mufaddal; Valvi, Nimish R; Arndorfer, Julie; Goddard, Kristin; Yang, Deying; Fireman, Bruce; Ball, Sarah; Link‐Gelles, Ruth; Naleway, Allison L.; Tenforde, Mark W

doi:10.15585/mmwr.mm7142a4

Cited by 65 publications

(57 citation statements)

References 8 publications

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“…Covid-19 vaccination policies recommending the bivalent mRNA-booster vaccines as a fourth dose are mainly supported by studies on immunogenicity where some have shown higher induction of antibody levels against omicron subvariants including BA.4-5 compared with monovalent boosters. [4][5][6][7][8] Previous observational effectiveness studies of fourth dose monovalent vaccination, primarily on data from before BA.4-5 subvariant predominance, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] also lend some indirect support to these recommendations.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12] Previous observational studies of fourth doses are primarily limited to the monovalent mRNA Covid-19 vaccines and mainly during periods prior to the emergence of the current predominating omicron subvariants BA.4 and BA.5. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] As such, data on the effectiveness of the bivalent mRNA-vaccines are needed to guide Covid-19 vaccination policy and to evaluate the benefit of developing variant-adapted Covid-19 vaccines.…”

Section: Introductionmentioning

confidence: 99%

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Comparative effectiveness of the bivalent BA.4-5 and BA.1 mRNA-booster vaccines in the Nordic countries

Andersson

Thiesson

Baum

et al. 2023

Preprint

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Background: Data on the comparative vaccine effectiveness (CVE) of the bivalent mRNA-booster vaccines containing the original SARS-CoV-2 and omicron BA.4-5 and BA.1 subvariants are limited. Methods: In a period of BA.4-5 subvariants predominance, we estimated the CVE of the bivalent Comirnaty (Pfizer-BioNTech) and Spikevax (Moderna) BA.4-5 and BA.1 mRNA-booster vaccines given as a fourth dose in Denmark, Finland, Norway, and Sweden. From 1 July 2022 to 12 December 2022, we conducted nationwide cohort analyses using target trial emulation to compare risks of Covid-19 hospitalization and death in four-dose (second booster) with three-dose (first booster) vaccinated and between four-dose vaccinated individuals. Results: Compared with having received three vaccine doses, receipt of a bivalent BA.4-5 booster as a fourth dose was associated with a country-combined CVE against Covid-19 hospitalization of 80.5% (95% confidence interval, 69.5% to 91.5%). The corresponding CVE for bivalent BA.1 boosters was 74.0% (68.6% to 79.4%). CVE against Covid-19 death was 77.8% (48.3% to 100%) and 80.1% (72.0% to 88.2%) for bivalent BA.4-5 and BA.1 boosters as a fourth dose, respectively. The CVE of bivalent BA.4-5 vs. BA.1 boosters were 32.3% (10.6% to 53.9%) for Covid-19 hospitalization and 12.3% (-36.1% to 60.7%) for death (the latter estimable in Denmark only). Conclusions: Vaccination with bivalent BA.4-5 or BA.1 mRNA-booster vaccines as a fourth dose was associated with increased protection against Covid-19 hospitalization and death during a period of BA.4-5 predominance. Bivalent BA.4-5 boosters conferred moderately greater vaccine effectiveness against Covid-19 hospitalization compared with bivalent BA.1 boosters.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative effectiveness of the bivalent BA.4-5 and BA.1 mRNA-booster vaccines in the Nordic countries

Andersson

Thiesson

Baum

et al. 2023

Preprint

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“…Due to the arrival of new VOC and the low effectiveness of the mRNA vaccines against the Omicron variants [ 31 ], the new bivalent mRNA containing the original SARS-CoV-2 strains and Omicron BA.4 and BA.5 sublineages was developed [ 32 ]. Since September 2022 a single boost of the bivalent mRNA vaccine has been recommended by the CDC.…”

Section: Discussionmentioning

confidence: 99%

Reduced Neutralization Efficacy against Omicron Variant after Third Boost of BNT162b2 Vaccine among Liver Transplant Recipients

Davidov

Indenbaum

Mandelboim

et al. 2023

Viruses

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The immune responses of liver transplant (LT) recipients after the third boost of the BNT162b2mRNA vaccine improved. This study evaluates the durability of the immune response of LT recipients after the third boost, its predictors, and the impact of emerging variants. The receptor-binding domain IgG was determined at median times of 22 (first test) and 133 days (second test) after the administration of the third boost. IgG antibody titers > 21.4 BAU/mL were defined as a positive response. The neutralization efficacies of the vaccine against the wild-type, Omicron, and Delta variants were compared in the first test. The 59 LT recipients were of a median age of 61 years (range 25–82); 53.5% were male. Following administration of the third dose, the positive immune response decreased from 81.4% to 76.3% between the first and second tests, respectively, (p < 0.0001). The multivariate analysis identified CNI monotherapy (p = 0.02) and hemoglobin > 12 g/dL (p = 0.02) as independent predictors of a maintained positive immune response 133 days after the third dose. The geometric mean titers of Omicron neutralization were significantly lower than the wild-type and Delta virus (21, 137, 128, respectively; p < 0.0001). The immune response after the third BNT162b2mRNA vaccine dose decreased significantly in LT recipients. Further studies are required to evaluate the efficacy of the fourth vaccine dose and the durability of the immune response.

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“…Adults receiving testing at participating sites during September 14–November 11, 2022, (when Omicron variant BA.4/BA.5 lineages and their sublineages predominated ¶ ) who reported one or more COVID-19–compatible symptoms were included; case-patients were persons who received a positive rapid or laboratory-based NAAT result; control-patients were those who received a negative NAAT result. Tests from persons who reported an immunocompromising condition ( 4 ), who received non-mRNA COVID-19 vaccines, who had received only a single monovalent mRNA vaccine dose or >4 monovalent mRNA doses, or who had received their last monovalent dose <2 months before the SARS-CoV-2 test were excluded from analyses. ** In addition, tests from persons who reported a positive result during the preceding 90 days †† were excluded to avoid analyzing repeated tests for the same illness episode or reinfections within a relatively short time frame.…”

mentioning

confidence: 99%

Effectiveness of Bivalent mRNA Vaccines in Preventing Symptomatic SARS-CoV-2 Infection — Increasing Community Access to Testing Program, United States, September–November 2022

Link‐Gelles¹,

Ciesla²,

Fleming-Dutra³

et al. 2022

MMWR Morb. Mortal. Wkly. Rep.

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155

124

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On November 22, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr).On September 1, 2022, bivalent COVID-19 mRNA vaccines, composed of components from the SARS-CoV-2 ancestral and Omicron BA.4/BA.5 strains, were recommended by the Advisory Committee on Immunization Practices (ACIP) to address reduced effectiveness of COVID-19 monovalent vaccines during SARS-CoV-2 Omicron variant predominance (1). Initial recommendations included persons aged ≥12 years (Pfizer-BioNTech) and ≥18 years (Moderna) who had completed at least a primary series of any Food and Drug Administrationauthorized or -approved monovalent vaccine ≥2 months earlier (1). On October 12, 2022, the recommendation was expanded to include children aged 5-11 years. At the time of recommendation, immunogenicity data were available from clinical trials of bivalent vaccines composed of ancestral and Omicron BA.1 strains; however, no clinical efficacy data were available. In this study, effectiveness of the bivalent (Omicron BA.4/BA.5-containing) booster formulation against symptomatic SARS-CoV-2 infection was examined using data from the Increasing Community Access to Testing (ICATT) national SARS-CoV-2 testing program.* During September 14-November 11, 2022, a total of 360,626 nucleic acid amplification tests (NAATs) performed at 9,995 retail pharmacies for adults aged ≥18 years, who reported symptoms consistent with COVID-19 at the time of testing and no immunocompromising conditions, were included in the analysis. Relative vaccine effectiveness (rVE) of a bivalent booster dose compared with that of ≥2 monovalent vaccine doses among persons for whom 2-3 months and ≥8 months had elapsed since last monovalent dose was 30% and 56% among persons aged 18-49 years, 31% and 48% among persons aged 50-64 years, and 28% and 43% among persons aged ≥65 years, respectively. Bivalent mRNA booster doses provide additional protection against symptomatic SARS-CoV-2 in immunocompetent persons who previously received monovalent vaccine only, with relative benefits increasing with time since receipt of the most recent monovalent vaccine dose. Staying up to date with COVID-19 vaccination, including getting a bivalent booster dose when eligible, is critical to maximizing protection against COVID-19 (1). * https://www.cdc.gov/icatt/index.html

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Effectiveness of COVID-19 mRNA Vaccines Against COVID-19–Associated Hospitalizations Among Immunocompromised Adults During SARS-CoV-2 Omicron Predominance — VISION Network, 10 States, December 2021—August 2022

Cited by 65 publications

References 8 publications

Comparative effectiveness of the bivalent BA.4-5 and BA.1 mRNA-booster vaccines in the Nordic countries

Comparative effectiveness of the bivalent BA.4-5 and BA.1 mRNA-booster vaccines in the Nordic countries

Reduced Neutralization Efficacy against Omicron Variant after Third Boost of BNT162b2 Vaccine among Liver Transplant Recipients

Effectiveness of Bivalent mRNA Vaccines in Preventing Symptomatic SARS-CoV-2 Infection — Increasing Community Access to Testing Program, United States, September–November 2022

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