Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants.
Emma Accorsi,Amadea Britton,Katherine E. Fleming-Dutra,Zachary R Smith,Nong Shang,Gordana Derado,Joseph D. Miller,Stephanie J. Schrag,Jennifer R. Verani +8 more
TLDR
These findings suggest that among individuals seeking testing for COVID-like illness in the US in December 2021, receipt of 3 doses of mRNA CO VID-19 vaccine (compared with unvaccinated and with receipt of 2 doses) was less likely among cases with symptomatic SARS-CoV-2 infection.Abstract:
Importance
Assessing COVID-19 vaccine performance against the rapidly spreading SARS-CoV-2 Omicron variant is critical to inform public health guidance.
Objective
To estimate the association between receipt of 3 doses of Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273 vaccine and symptomatic SARS-CoV-2 infection, stratified by variant (Omicron and Delta).
Design, Setting, and Participants
A test-negative case-control analysis among adults 18 years or older with COVID-like illness tested December 10, 2021, through January 1, 2022, by a national pharmacy-based testing program (4666 COVID-19 testing sites across 49 US states).
Exposures
Three doses of mRNA COVID-19 vaccine (third dose ≥14 days before test and ≥6 months after second dose) vs unvaccinated and vs 2 doses 6 months or more before test (ie, eligible for a booster dose).
Main Outcomes and Measures
Association between symptomatic SARS-CoV-2 infection (stratified by Omicron or Delta variants defined using S-gene target failure) and vaccination (3 doses vs unvaccinated and 3 doses vs 2 doses). Associations were measured with multivariable multinomial regression. Among cases, a secondary outcome was median cycle threshold values (inversely proportional to the amount of target nucleic acid present) for 3 viral genes, stratified by variant and vaccination status.
Results
Overall, 23 391 cases (13 098 Omicron; 10 293 Delta) and 46 764 controls were included (mean age, 40.3 [SD, 15.6] years; 42 050 [60.1%] women). Prior receipt of 3 mRNA vaccine doses was reported for 18.6% (n = 2441) of Omicron cases, 6.6% (n = 679) of Delta cases, and 39.7% (n = 18 587) of controls; prior receipt of 2 mRNA vaccine doses was reported for 55.3% (n = 7245), 44.4% (n = 4570), and 41.6% (n = 19 456), respectively; and being unvaccinated was reported for 26.0% (n = 3412), 49.0% (n = 5044), and 18.6% (n = 8721), respectively. The adjusted odds ratio for 3 doses vs unvaccinated was 0.33 (95% CI, 0.31-0.35) for Omicron and 0.065 (95% CI, 0.059-0.071) for Delta; for 3 vaccine doses vs 2 doses the adjusted odds ratio was 0.34 (95% CI, 0.32-0.36) for Omicron and 0.16 (95% CI, 0.14-0.17) for Delta. Median cycle threshold values were significantly higher in cases with 3 doses vs 2 doses for both Omicron and Delta (Omicron N gene: 19.35 vs 18.52; Omicron ORF1ab gene: 19.25 vs 18.40; Delta N gene: 19.07 vs 17.52; Delta ORF1ab gene: 18.70 vs 17.28; Delta S gene: 23.62 vs 20.24).
Conclusions and Relevance
Among individuals seeking testing for COVID-like illness in the US in December 2021, receipt of 3 doses of mRNA COVID-19 vaccine (compared with unvaccinated and with receipt of 2 doses) was less likely among cases with symptomatic SARS-CoV-2 infection compared with test-negative controls. These findings suggest that receipt of 3 doses of mRNA vaccine, relative to being unvaccinated and to receipt of 2 doses, was associated with protection against both the Omicron and Delta variants, although the higher odds ratios for Omicron suggest less protection for Omicron than for Delta.read more
Citations
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Journal ArticleDOI
Effectiveness of mRNA-1273 against SARS-CoV-2 Omicron and Delta variants
Hung Fu Tseng,Bradley Ackerson,Yi Luo,Lina S. Sy,Carla A. Talarico,Yun Tian,Katia Bruxvoort,Julia Tubert,Ana Florea,J.-H. Ku,Soon Kyu Choi,Harpreet S. Takhar,M. Aragones,Lei Qian +13 more
TL;DR: In this paper , a test-negative case-control study was conducted to evaluate mRNA-1273 vaccine effectiveness against infection and hospitalization with Omicron (B.1.529) variant.
Journal ArticleDOI
Waning 2-Dose and 3-Dose Effectiveness of mRNA Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance — VISION Network, 10 States, August 2021–January 2022
Jill M. Ferdinands,S. Rao,Brian E. Dixon,Patrick K. Mitchell,Malini B. DeSilva,Stephanie A. Irving,Ned Lewis,Karthik Natarajan,Edward Stenehjem,Shaun J. Grannis,Jungmi Han,Charlene McEvoy,Toan C. Ong,Allison L. Naleway,Sara E. Reese,Peter J. Embi,Kristin Dascomb,Nicola P. Klein,E. Griggs,D. Konatham,Anupam B. Kharbanda,Duck-Hye Yang,William F. Fadel,Nancy Grisel,Kristin Goddard,Palak Patel,I-Chia Liao,Rebecca Birch,Nimish Valvi,Sue Reynolds,Julie Arndorfer,Ousseny Zerbo,M. Dickerson,Kempapura Murthy,Jeremiah Williams,Catherine H Bozio,Lenee Blanton,Jennifer R. Verani,Stephanie J. Schrag,Alexandra F. Dalton,Mehiret Wondimu,Ruth Link-Gelles,Eduardo Azziz-Baumgartner,Michelle A. Barron,Manjusha Gaglani,Mark Thompson,Bruce Fireman +46 more
TL;DR: VE after receipt of a third dose was higher than that after a second dose; however, VE waned with increasing time since vaccination, and VE was generally higher for protection against hospitalizations than against ED/UC visits.
Journal ArticleDOI
COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence — 25 U.S. Jurisdictions, April 4–December 25, 2021
Amelia G Johnson,Avnika B. Amin,Akilah R. Ali,Brooke E. Hoots,Betsy L. Cadwell,Shivani Arora,Tigran Avoundjian,Abiola O. Awofeso,Jason Barnes,Nagla S. Bayoumi,Katherine Busen,Carolyn Chang,Michael J. Cima,Molly J. Crockett,Alicia Cronquist,Sherri L. Davidson,Elizabeth M. Davis,Janelle Delgadillo,Vajeera Dorabawila,Cherie Drenzek,Leah Eisenstein,H. Fast,A. M. van Gent,Julie Hand,Dina Hoefer,Corinne Holtzman,Amanda Jara,Amanda B. Jones,Ishrat Kamal-Ahmed,Sarah Kangas,Fnu Kanishka,Ramandeep Kaur,S. Khan,Justice Eleanor King,Sam E. Kirkendall,Anna Klioueva,Anna Kocharian,Frances Y Kwon,Jacqueline Logan,B. Casey Lyons,S. L. Lyons,Andrea L. May,Donald McCormick,Erica Mendoza,Lauren Milroy,Allison T. O'Donnell,Melissa G. Pike,Sargis Pogosjans,Amy Saupe,Jessica Sell,E. Smith,Daniel M. Sosin,Emma Suzanne Stanislawski,Molly Steele,Meagan Stephenson,A. M. Stout,Kyle Strand,Buddhi Tilakaratne,Kathryn Turner,Hailey Vest,Sydni Warner,Caleb Wiedeman,Allison Zaldivar,Benjamin J. Silk,Heather M. Scobie +64 more
TL;DR: The highest impact of booster doses against infection and death compared with full vaccination without booster doses was recorded among persons aged 50-64 and ≥65 years, and eligibility to stay up to date with COVID-19 vaccinations.
Journal ArticleDOI
Evolution of the SARS‐CoV‐2 omicron variants BA.1 to BA.5: Implications for immune escape and transmission
TL;DR: The theories that have been proposed on the evolution of Omicron including zoonotic spillage, infection in immunocompromised individuals and cryptic spread in the community without being diagnosed are examined.
Journal ArticleDOI
SARS-CoV-2 Omicron variant: recent progress and future perspectives
TL;DR: In this article , a review of the molecular and clinical characteristics of the Omicron variant of SARS-CoV-2 was presented, and potential therapeutic applications in response to omicron infection were discussed.
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