Predicting vaccine effectiveness against severe COVID-19 over time and against variants: a meta-analysis

Cromer, Deborah; Steain, Megan; Reynaldi, Arnold; Schlub, Timothy E.; Khan, Shanchita R.; Sasson, Sarah C.; Kent, Stephen J.; Khoury, David S.; Davenport, Miles P.

doi:10.1038/s41467-023-37176-7

Cited by 66 publications

(35 citation statements)

References 52 publications

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“…20 In their Communicable Disease Control Manual, The British Columbia Centre for Disease Control lists the Moderna Fall 2023 vaccine as the preferred vaccine over the Pfizer-BioNTech version for IC individuals due to its potentially greater immune response, 9 which is correlated with VE. 59,60 If we expect similar VE outcomes as in previous version of the vaccine, then we can expect fewer infections, hospitalizations and deaths and lower COVID-19 treatment costs with the Moderna updated Fall 2023 vaccine.…”

Section: Discussionmentioning

confidence: 92%

Clinical and Economic impact of updated Fall 2023 COVID-19 vaccines in the Immunocompromised Population in Canada

Lee,

Jayasundara,

Kohli

et al. 2023

Preprint

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BackgroundImmunocompromised (IC) individuals are at increased risk of COVID-19 infection-related severe outcomes. Moderna and Pfizer-BioNTech COVID-19 mRNA vaccines are available in Canada, and differences in vaccine effectiveness (VE) have been found between the two in IC individuals. The objective of this analysis was to compare the clinical and economic impact of a Moderna XBB.1.5 updated COVID-19 mRNA Fall 2023 vaccine to a Pfizer-BioNTech XBB.1.5 updated COVID-19 mRNA Fall 2023 vaccine in Canadian IC individuals aged ≥18 years.MethodsA static decision-analytic model estimated the number of COVID-19 infections, hospitalizations, deaths, and resulting quality-adjusted life years (QALYs) over a one-year time horizon (September 2023-August 2024) in the Canadian IC adult population (n=894,580). Costs associated with COVID-19 infection were estimated from health care and societal perspectives. The predicted VE of the updated Moderna vaccine was based on prior variant versions, which were well-matched to the circulating variant. Pfizer-BioNTech VE was calculated based on a meta-analysis of comparative effectiveness between both vaccines (relative risk for Moderna vaccine: infection=0.85 [95%CI 0.75-0.97], hospitalization=0.88 [95%CI 0.79-0.97]). The model combined VE estimates with COVID-19 incidence and probability of COVID-19 related severe outcomes. Sensitivity analyses tested the impact of uncertainty surrounding incidence, hospitalization and mortality rates, costs, and QALYs.ResultsGiven the expected higher VE against infection and hospitalizations with the Moderna Fall 2023 vaccine, its use is predicted to prevent an additional 2,411 infections (3.6%), 275 hospitalizations (3.7%), and 47 deaths (4.0%) compared to the Pfizer-BioNTech Fall 2023 vaccine, resulting in 330 QALYs gained, and savings of $7.4M in infection treatment costs, and $0.9M in productivity loss costs. Results were most sensitive to variations in VE parameters, specifically the relative risk of infection and hospitalizations between the vaccines, and waning rates.ConclusionsIf the Moderna and Pfizer-BioNTech Fall 2023 vaccines protect against infection and hospitalizations similar to previous vaccines, using the Moderna Fall 2023 vaccine would result in substantial public health benefits in IC individuals, as well as provide health care and societal cost savings.

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Section: Discussionmentioning

confidence: 92%

Clinical and Economic impact of updated Fall 2023 COVID-19 vaccines in the Immunocompromised Population in Canada

Lee,

Jayasundara,

Kohli

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…Individuals with a past COVID-19 episode and poor glucose control should be prioritized for evaluation of a latent TB infection in TB endemic regions, and if positive, offered latent TB infection treatment. This will be particularly important in recent contacts of a new TB case [30], or individuals who are not fully vaccinated against COVID-19, given that vaccines protect against the severity of this disease and dampen the COVID-19 related immune alterations that are likely to contribute to TB development risk [31].…”

Section: Discussionmentioning

confidence: 99%

Interaction between type 2 diabetes and past COVID-19 on active tuberculosis

Calles-Cabanillas,

Aguillón-Durán,

Ayala

et al. 2024

Preprint

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BACKGROUND The global setback in tuberculosis (TB) prevalence and mortality in the post-COVID-19 era have been partially attributed to pandemic-related disruptions in healthcare systems. The additional biological contribution of COVID-19 to TB is less clear. The goal of this study was to determine if there is an association between COVID-19 in the past 18 months and a new TB episode, and the role played by type 2 diabetes mellitus (DM) comorbidity in this relationship. METHODS A cross-sectional study was conducted among 112 new active TB patients and 373 non-TB controls, identified between June 2020 and November 2021 in communities along the Mexican border with Texas. Past COVID-19 was based on self-report or positive serology. Bivariable/multivariable analysis were used to evaluate the odds of new TB in hosts with past COVID-19 and/or DM status. RESULTS The odds of new TB were higher among past COVID-19 cases vs. controls, but only significant among DM patients (aOR 2.3). The odds of TB given DM was 2.7-fold among participants without past COVID-19 and increased to 7.9-fold among those with past COVID-19. CONCLUSION DM interacts with past COVID-19 synergistically to magnify the risk of TB. Latent TB screening and prophylactic treatment, if positive, is recommended in this COVID-19/DM/latent TB high-risk group.

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“…26 The results of these studies demonstrate that these updated vaccines provide a stronger antibody response to circulating COVID-19 viruses than either the bivalent or previous monovalent version, suggesting higher VE and potentially longer duration of protection. 27 However, studies with clinical outcomes are required to validate these conclusions and they will not be available ahead of Fall 2023 when the vaccine will be implemented.…”

Section: Discussionmentioning

confidence: 99%

Projections of the incidence of COVID-19 in Japan and the potential impact of a Fall 2023 COVID-19 Vaccine

Kohli,

Maschio,

Lee

et al. 2023

Preprint

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Background: The study objective was to estimate the incidence of COVID-19 infection, hospitalization, and deaths in Japan from September 2023 to August 2024 and potential impact of a Fall 2023 COVID-19 vaccine for adults 18 years and older on these outcomes. Methods: A previously developed Susceptible Exposed Infected Recovered model for the United States (US) was adapted to Japan. The numbers of symptomatic infections, COVID-19 related hospitalizations, and deaths were calculated. Given differences in vaccination coverage, masking practices and social mixing patterns between the US and Japan, all inputs were updated to reflect the Japanese context. Vaccine effectiveness (VE) values are hypothetical, but predicted based on existing VE values of bivalent BA.4/BA.5 boosters against BA.4/BA.5 in Japan, from the VERSUS test-negative case-control study. Sensitivity analyses were performed. Results: The base case model predicts overall that there will be approximately 35.2 million symptomatic COVID-19 infections, 690,000 hospitalizations, and 62,000 deaths in Japan between September 2023 and August 2024. If an updated COVID-19 vaccine is offered to all adults aged 18 years and older in Fall 2023, the model predicts that 7.3 million infections, 275,000 hospitalizations and 26,000 deaths will be prevented. If vaccines are only given to those aged 65 years and older, only 2.9 million infections, 180,000 hospitalizations and 19,000 deaths will be prevented. Sensitivity analysis results suggest that hospitalizations and deaths prevented are most sensitive to initial vaccine effectiveness (VE) against infection and hospitalizations, and the waning rate associated with VE against infection. Symptomatic infections prevented was most sensitive to initial VE against infection and VE waning. Conclusions: Results suggest that a Fall 2023 COVID-19 vaccine would reduce total numbers of COVID-19 related infections, hospitalizations, and deaths.

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Predicting vaccine effectiveness against severe COVID-19 over time and against variants: a meta-analysis

Cited by 66 publications

References 52 publications

Clinical and Economic impact of updated Fall 2023 COVID-19 vaccines in the Immunocompromised Population in Canada

Clinical and Economic impact of updated Fall 2023 COVID-19 vaccines in the Immunocompromised Population in Canada

Interaction between type 2 diabetes and past COVID-19 on active tuberculosis

Projections of the incidence of COVID-19 in Japan and the potential impact of a Fall 2023 COVID-19 Vaccine

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