Protection of Messenger RNA Vaccines Against Hospitalized Coronavirus Disease 2019 in Adults Over the First Year Following Authorization in the United States

被引：8

作者：

Tenforde, Mark W. ^{[1
]}

Self, Wesley H. ^{[2
]}

Zhu, Yuwei ^{[2
]}

Naioti, Eric A. ^{[1
]}

Gaglani, Manjusha ^{[3
,4
]}

Ginde, Adit A. ^{[5
]}

Jensen, Kelly ^{[5
]}

Talbot, H. Keipp ^{[2
]}

Casey, Jonathan D. ^{[2
]}

Mohr, Nicholas M. ^{[6
]}

Zepeski, Anne ^{[6
]}

McNeal, Tresa ^{[3
,4
]}

Ghamande, Shekhar ^{[3
,4
]}

Gibbs, Kevin W. ^{[7
]}

Files, D. Clark ^{[7
]}

Hager, David N. ^{[8
]}

Shehu, Arber ^{[8
]}

Prekker, Matthew E. ^{[9
]}

Erickson, Heidi L. ^{[9
]}

Gong, Michelle N. ^{[10
]}

Mohamed, Amira ^{[10
]}

Johnson, Nicholas J. ^{[11
]}

Srinivasan, Vasisht ^{[11
]}

Steingrub, Jay S. ^{[12
]}

Peltan, Ithan D. ^{[13
,14
]}

Brown, Samuel M. ^{[13
,14
]}

Martin, Emily T. ^{[14
,15
]}

Monto, Arnold S. ^{[14
,15
]}

Khan, Akram ^{[16
]}

Hough, Catherine L. ^{[16
]}

Busse, Laurence W. ^{[17
]}

ten Lohuis, Caitlin ^{[17
]}

Duggal, Abhijit ^{[18
]}

Wilson, Jennifer G. ^{[19
]}

Qadir, Nida ^{[20
]}

Chang, Steven Y. ^{[20
]}

Mallow, Christopher ^{[21
]}

Rivas, Carolina ^{[21
]}

Babcock, Hilary M. ^{[22
]}

Kwon, Jennie H. ^{[22
]}

Exline, Matthew C. ^{[23
]}

Botros, Mena M. ^{[23
]}

Lauring, Adam S. ^{[24
]}

Shapiro, Nathan, I ^{[25
]}

Halasa, Natasha ^{[2
]}

Chappell, James D. ^{[2
]}

Grijalva, Carlos G. ^{[2
]}

Rice, Todd W. ^{[2
]}

Jones, Ian D. ^{[2
]}

Stubblefield, William B. ^{[2
]}

机构：

[1] CDC COVID 19 Response Team, Atlanta, GA USA

[2] Vanderbilt Univ Sch Med, Nashville, TN USA

[3] Baylor Scott & White Hlth, Temple, TX USA

[4] Texas A&M Univ, Coll Med, Temple, TX USA

[5] Univ Colorado, Sch Med, Aurora, CO USA

[6] Univ Iowa, Iowa City, IA USA

[7] Wake Forest Univ, Baptist Med Ctr, Winston Salem, NC USA

[8] Johns Hopkins Univ Hosp, Baltimore, MD USA

[9] Hennepin Cty Med Ctr, Minneapolis, MN USA

[10] Albert Einstein Coll Med, Montefiore Healthcare Ctr, Bronx, NY USA

[11] Univ Washington, Sch Med, Seattle, WA USA

[12] Baystate Med Ctr, Springfield, MA USA

[13] Intermountain Med Ctr, Salt Lake City, UT USA

[14] Univ Utah, Salt Lake City, UT USA

[15] Univ Michigan, Sch Publ Hlth, Ann Arbor, MI USA

[16] Oregon Hlth & Sci Univ Hosp, Portland, OR USA

[17] Emory Univ, Sch Med, Atlanta, GA USA

[18] Cleveland Clin, Cleveland, OH USA

[19] Stanford Univ, Sch Med, Palo Alto, CA USA

[20] Ronald Reagan UCLA Med Ctr, Los Angeles, CA USA

[21] Univ Miami, Miami, FL USA

[22] Washington Univ, St Louis, MO USA

[23] Ohio State Univ, Wexner Med Ctr, Columbus, OH USA

[24] Univ Michigan, Sch Med, Ann Arbor, MI USA

[25] Beth Israel Deaconess Med Ctr, Boston, MA USA

来源：

CLINICAL INFECTIOUS DISEASES | 2023年 / 76卷 / 03期

关键词：

COVID-19; duration of protection; waning; vaccine effectiveness; mRNA; COVID-19; VACCINES; SARS-COV-2; INFECTION; VACCINATION; BNT162B2; 2-DOSE;

D O I：

10.1093/cid/ciac381

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Among 10 078 adults hospitalized at 21 centers March-December 2021, 2-dose coronavirus disease 2019 (COVID-19) messenger RNA vaccine effectiveness (VE) in immunocompetent patients decreased from 90% to 82% at 6 months postvaccination. Background Coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines were authorized in the United States in December 2020. Although vaccine effectiveness (VE) against mild infection declines markedly after several months, limited understanding exists on the long-term durability of protection against COVID-19-associated hospitalization. Methods Case-control analysis of adults (>= 18 years) hospitalized at 21 hospitals in 18 states 11 March-15 December 2021, including COVID-19 case patients and reverse transcriptase-polymerase chain reaction-negative controls. We included adults who were unvaccinated or vaccinated with 2 doses of a mRNA vaccine before the date of illness onset. VE over time was assessed using logistic regression comparing odds of vaccination in cases versus controls, adjusting for confounders. Models included dichotomous time (<180 vs >= 180 days since dose 2) and continuous time modeled using restricted cubic splines. Results A total of 10 078 patients were included, 4906 cases (23% vaccinated) and 5172 controls (62% vaccinated). Median age was 60 years (interquartile range, 46-70), 56% were non-Hispanic White, and 81% had >= 1 medical condition. Among immunocompetent adults, VE <180 days was 90% (95% confidence interval [CI], 88-91) versus 82% (95% CI, 79-85) at >= 180 days (P < .001). VE declined for Pfizer-BioNTech (88% to 79%, P < .001) and Moderna (93% to 87%, P < .001) products, for younger adults (18-64 years) (91% to 87%, P = .005), and for adults >= 65 years of age (87% to 78%, P < .001). In models using restricted cubic splines, similar changes were observed. Conclusions In a period largely predating Omicron variant circulation, effectiveness of 2 mRNA doses against COVID-19-associated hospitalization was largely sustained through 9 months.

引用

页码：E460 / E468

页数：9

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