Protection of COVID-19 vaccination and previous infection against Omicron BA.1, BA.2 and Delta SARS-CoV-2 infections

Andeweg, Stijn P.; Gier, Brechje de; Eggink, Dirk; Ende, Caroline van den; Maarseveen, Noortje van; Ali, Lubna; Vlaemynck, Boris; Schepers, Raf; Hahné, Susan; Reusken, Chantal; Melker, Hester E. de; Hof, Susan van den; Knol, Mirjam J.

doi:10.1038/s41467-022-31838-8

Cited by 105 publications

(91 citation statements)

References 19 publications

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“…We found that the Omicron variant was associated with a higher proportion of infections in boosted individuals compared to both unvaccinated and fully vaccinated individuals, however, we could not find a difference in the proportion of infections between Delta and Omicron when comparing individuals who completed their primary vaccination schedule to unvaccinated individuals. In contrast to this, other studies found that vaccine effectiveness was considerably lower for Omicron versus Delta when comparing both boosted and fully vaccinated individuals to unvaccinated subjects (Andeweg et al, 2022;Jalali et al, 2022;Lyngse et al, 2022;Tseng et al, 2022). This discrepancy could be explained by the effect of waning immunity since most individuals who completed their primary vaccination schedule during our study period received their second dose >6 months before the first positive PCR, a time after which vaccine protection against infection decreases significantly against both the Delta and Omicron variants (Gilboa et al, 2022;Goldberg et al, 2022).…”

Section: Discussioncontrasting

confidence: 85%

Investigating SARS-CoV-2 breakthrough infections per variant and vaccine type

et al. 2022

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Breakthrough SARS-CoV-2 infections have been reported in fully vaccinated individuals, in spite of the high efficacy of the currently available vaccines, proven in trials and real-world studies. Several variants of concern (VOC) have been proffered to be associated with breakthrough infections following immunization. In this study, we investigated 378 breakthrough infections recorded between January and July 2021 and compared the distribution of SARS-CoV-2 genotypes identified in 225 fully vaccinated individuals to the frequency of circulating community lineages in the region of South Limburg (The Netherlands) in a week-by-week comparison. Although the proportion of breakthrough infections was relatively low and stable when the Alpha variant was predominant, the rapid emergence of the Delta variant lead to a strong increase in breakthrough infections, with a higher relative proportion of individuals vaccinated with Vaxzevria or Jcovden being infected compared to those immunized with mRNA-based vaccines. A significant difference in median age was observed when comparing fully vaccinated individuals with severe symptoms (83 years) to asymptomatic cases (46.5 years) or individuals with mild-to-moderate symptoms (42 years). There was no association between SARS-CoV-2 genotype or vaccine type and disease symptoms. Furthermore, the majority of adaptive mutations were concentrated in the N-terminal domain of the Spike protein, highlighting its role in immune evasion. Interestingly, symptomatic individuals harbored significantly higher SARS-CoV-2 loads than asymptomatic vaccinated individuals and breakthrough infections caused by the Delta variant were associated with increased viral loads compared to those caused by the Alpha variant. In addition, we investigated the role of the Omicron variant in causing breakthrough infections by analyzing 135 samples that were randomly selected for genomic surveillance during the transition period from Delta to Omicron. We found that the proportion of Omicron vs. Delta infections was significantly higher in individuals who received a booster vaccine compared to both unvaccinated and fully vaccinated individuals. Altogether, these results indicate that the emergence of the Delta variant and in particular Omicron has lowered the efficiency of particular vaccine types to prevent SARS-CoV-2 infections and that, although rare, the elderly are particularly at risk of becoming severely infected as the consequence of a breakthrough infection.

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Section: Discussioncontrasting

confidence: 85%

Investigating SARS-CoV-2 breakthrough infections per variant and vaccine type

et al. 2022

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“…In our study, vaccine effectiveness against the BA.2 lineage was lower than against the BA.1 lineage, consistent with a recent US based electronic health record study, 15 but different from recent studies from the United Kingdom and the Netherlands that suggested similar vaccine effectiveness against BA.2 and BA.1. 37 38 The use of viral whole genome sequencing in the current study enabled genetic characterization of many of the viruses. Importantly, 56% of the sequenced BA.2 viruses in this study had a BA.2.12.1 sequence, which has enhanced immune escape features compared with earlier omicron lineages.…”

Section: Discussionmentioning

confidence: 99%

Vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the United States: living test negative design study

Adams

Rhoads

Surie

et al. 2022

BMJ

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Objective To compare the effectiveness of a primary covid-19 vaccine series plus booster doses with a primary series alone for the prevention of hospital admission with omicron related covid-19 in the United States. Design Multicenter observational case-control study with a test negative design. Setting Hospitals in 18 US states. Participants 4760 adults admitted to one of 21 hospitals with acute respiratory symptoms between 26 December 2021 and 30 June 2022, a period when the omicron variant was dominant. Participants included 2385 (50.1%) patients with laboratory confirmed covid-19 (cases) and 2375 (49.9%) patients who tested negative for SARS-CoV-2 (controls). Main outcome measures The main outcome was vaccine effectiveness against hospital admission with covid-19 for a primary series plus booster doses and a primary series alone by comparing the odds of being vaccinated with each of these regimens versus being unvaccinated among cases versus controls. Vaccine effectiveness analyses were stratified by immunosuppression status (immunocompetent, immunocompromised). The primary analysis evaluated all covid-19 vaccine types combined, and secondary analyses evaluated specific vaccine products. Results Overall, median age of participants was 64 years (interquartile range 52-75 years), 994 (20.8%) were immunocompromised, 85 (1.8%) were vaccinated with a primary series plus two boosters, 1367 (28.7%) with a primary series plus one booster, and 1875 (39.3%) with a primary series alone, and 1433 (30.1%) were unvaccinated. Among immunocompetent participants, vaccine effectiveness for prevention of hospital admission with omicron related covid-19 for a primary series plus two boosters was 63% (95% confidence interval 37% to 78%), a primary series plus one booster was 65% (58% to 71%), and for a primary series alone was 37% (25% to 47%) (P<0.001 for the pooled boosted regimens compared with a primary series alone). Vaccine effectiveness was higher for a boosted regimen than for a primary series alone for both mRNA vaccines (BNT162b2 (Pfizer-BioNTech): 73% (44% to 87%) for primary series plus two boosters, 64% (55% to 72%) for primary series plus one booster, and 36% (21% to 48%) for primary series alone (P<0.001); mRNA-1273 (Moderna): 68% (17% to 88%) for primary series plus two boosters, 65% (55% to 73%) for primary series plus one booster, and 41% (25% to 54%) for primary series alone (P=0.001)). Among immunocompromised patients, vaccine effectiveness for a primary series plus one booster was 69% (31% to 86%) and for a primary series alone was 49% (30% to 63%) (P=0.04). Conclusion During the first six months of 2022 in the US, booster doses of a covid-19 vaccine provided additional benefit beyond a primary vaccine series alone for preventing hospital admissions with omicron related covid-19. Readers’ note This article is a living test negative design study that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication.

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“…Despite the timely development of effective and safe COVID-19 vaccines, hesitancy to get vaccinated emerged as a major hindrance to preventive efforts [ 8 , 9 , 10 ]. In addition, waning immunity following infection or vaccination and the continuous emergence of SARS-CoV-2 variants with immune escape potential underlined the necessity of booster doses of COVID-19 vaccines [ 11 , 12 , 13 ]. Booster dose can be defined as an extra dose of vaccine administered following the completion of a primary vaccination series [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Vaccine Booster Dose Acceptance: Systematic Review and Meta-Analysis

et al. 2022

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The World Health Organization (WHO) recommended coronavirus disease 2019 (COVID-19) booster dose vaccination after completing the primary vaccination series for individuals ≥18 years and most-at-risk populations. This study aimed to estimate the pooled proportion of COVID-19 vaccine booster dose uptake and intention to get the booster dose among general populations and healthcare workers (HCWs). We searched PsycINFO, Scopus, EBSCO, MEDLINE Central/PubMed, ProQuest, SciELO, SAGE, Web of Science, Google Scholar, and ScienceDirect according to PRISMA guidelines. From a total of 1079 screened records, 50 studies were extracted. Meta-analysis was conducted using 48 high-quality studies according to the Newcastle-Ottawa Scale quality assessment tool. Using the 48 included studies, the pooled proportion of COVID-19 vaccine booster dose acceptance among 198,831 subjects was 81% (95% confidence interval (CI): 75–85%, I2 = 100%). The actual uptake of the booster dose in eight studies involving 12,995 subjects was 31% (95% CI: 19–46%, I2 = 100%), while the intention to have the booster dose of the vaccine was 79% (95% CI: 72–85%, I2 = 100%). The acceptance of the booster dose of COVID-19 vaccines among HCWs was 66% (95% CI: 58–74%), I2 = 99%). Meta-regression revealed that previous COVID-19 infection was associated with a lower intention to have the booster dose. Conversely, previous COVID-19 infection was associated with a significantly higher level of booster dose actual uptake. Subgroup analyses revealed that the pooled booster dose acceptance in the WHO region of the Americas, which did not include any actual vaccination, was 77% (95% CI: 66–85%, I2 = 100%). The pooled acceptance of the booster dose in the Western Pacific was 89% (95% CI: 84–92%, I2 = 100), followed by the European region: 86% (95% CI: 81–90%, I2 = 99%), the Eastern Mediterranean region: 59% (95% CI: 46–71%, I2 = 99%), and the Southeast Asian region: 52% (95% CI: 43–61%, I2 = 95). Having chronic disease and trust in the vaccine effectiveness were the significant predictors of booster dose COVID-19 vaccine acceptance. The global acceptance rate of COVID-19 booster vaccine is high, but the rates vary by region. To achieve herd immunity for the disease, a high level of vaccination acceptance is required. Intensive vaccination campaigns and programs are still needed around the world to raise public awareness regarding the importance of accepting COVID-19 vaccines needed for proper control of the pandemic.

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Protection of COVID-19 vaccination and previous infection against Omicron BA.1, BA.2 and Delta SARS-CoV-2 infections

Cited by 105 publications

References 19 publications

Investigating SARS-CoV-2 breakthrough infections per variant and vaccine type

Investigating SARS-CoV-2 breakthrough infections per variant and vaccine type

Vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the United States: living test negative design study

COVID-19 Vaccine Booster Dose Acceptance: Systematic Review and Meta-Analysis

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