Covid-19 Rates by Time since Vaccination during Delta Variant Predominance.
Journal
NEJM evidence
ISSN: 2766-5526
Titre abrégé: NEJM Evid
Pays: United States
ID NLM: 9918317485806676
Informations de publication
Date de publication:
10 Jan 2022
10 Jan 2022
Historique:
medline:
10
1
2022
pubmed:
10
1
2022
entrez:
19
5
2023
Statut:
ppublish
Résumé
With the emergence of the delta variant, the United States experienced a rapid increase in Covid-19 cases in 2021. We estimated the risk of breakthrough infection and death by month of vaccination as a proxy for waning immunity during a period of delta variant predominance. Covid-19 case and death data from 15 U.S. jurisdictions during January 3 to September 4, 2021 were used to estimate weekly hazard rates among fully vaccinated persons, stratified by age group and vaccine product. Case and death rates during August 1 to September 4, 2021 were presented across four cohorts defined by month of vaccination. Poisson models were used to estimate adjusted rate ratios comparing the earlier cohorts to July rates. During August 1 to September 4, 2021, case rates per 100,000 person-weeks among all vaccine recipients for the January to February, March to April, May to June, and July cohorts were 168.8 (95% confidence interval [CI], 167.5 to 170.1), 123.5 (95% CI, 122.8 to 124.1), 83.6 (95% CI, 82.9 to 84.3), and 63.1 (95% CI, 61.6 to 64.6), respectively. Similar trends were observed by age group for BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccine recipients. Rates for the Ad26.COV2.S (Janssen-Johnson & Johnson) vaccine were higher; however, trends were inconsistent. BNT162b2 vaccine recipients 65 years of age or older had higher death rates among those vaccinated earlier in the year. Protection against death was sustained for the mRNA-1273 vaccine recipients. Across age groups and vaccine types, people who were vaccinated 6 months ago or longer (January-February) were 3.44 (3.36 to 3.53) times more likely to be infected and 1.70 (1.29 to 2.23) times more likely to die from COVID-19 than people vaccinated recently in July 2021. Our study suggests that protection from SARS-CoV-2 infection among all ages or death among older adults waned with increasing time since vaccination during a period of delta predominance. These results add to the evidence base that supports U.S. booster recommendations, especially for older adults vaccinated with BNT162b2 and recipients of the Ad26.COV2.S vaccine. (Funded by the Centers for Disease Control and Prevention.).
Sections du résumé
BACKGROUND
BACKGROUND
With the emergence of the delta variant, the United States experienced a rapid increase in Covid-19 cases in 2021. We estimated the risk of breakthrough infection and death by month of vaccination as a proxy for waning immunity during a period of delta variant predominance.
METHODS
METHODS
Covid-19 case and death data from 15 U.S. jurisdictions during January 3 to September 4, 2021 were used to estimate weekly hazard rates among fully vaccinated persons, stratified by age group and vaccine product. Case and death rates during August 1 to September 4, 2021 were presented across four cohorts defined by month of vaccination. Poisson models were used to estimate adjusted rate ratios comparing the earlier cohorts to July rates.
RESULTS
RESULTS
During August 1 to September 4, 2021, case rates per 100,000 person-weeks among all vaccine recipients for the January to February, March to April, May to June, and July cohorts were 168.8 (95% confidence interval [CI], 167.5 to 170.1), 123.5 (95% CI, 122.8 to 124.1), 83.6 (95% CI, 82.9 to 84.3), and 63.1 (95% CI, 61.6 to 64.6), respectively. Similar trends were observed by age group for BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccine recipients. Rates for the Ad26.COV2.S (Janssen-Johnson & Johnson) vaccine were higher; however, trends were inconsistent. BNT162b2 vaccine recipients 65 years of age or older had higher death rates among those vaccinated earlier in the year. Protection against death was sustained for the mRNA-1273 vaccine recipients. Across age groups and vaccine types, people who were vaccinated 6 months ago or longer (January-February) were 3.44 (3.36 to 3.53) times more likely to be infected and 1.70 (1.29 to 2.23) times more likely to die from COVID-19 than people vaccinated recently in July 2021.
CONCLUSIONS
CONCLUSIONS
Our study suggests that protection from SARS-CoV-2 infection among all ages or death among older adults waned with increasing time since vaccination during a period of delta predominance. These results add to the evidence base that supports U.S. booster recommendations, especially for older adults vaccinated with BNT162b2 and recipients of the Ad26.COV2.S vaccine. (Funded by the Centers for Disease Control and Prevention.).
Identifiants
pubmed: 37207114
doi: 10.1056/evidoa2100057
pmc: PMC10193243
mid: NIHMS1877582
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Intramural CDC HHS
ID : CC999999
Pays : United States
Références
N Engl J Med. 2021 Jun 10;384(23):2187-2201
pubmed: 33882225
Lancet. 2022 Mar 5;399(10328):924-944
pubmed: 35202601
Nat Med. 2021 Sep;27(9):1614-1621
pubmed: 34244681
Nat Med. 2021 Dec;27(12):2108-2110
pubmed: 34728830
MMWR Morb Mortal Wkly Rep. 2021 Aug 27;70(34):1150-1155
pubmed: 34437517
N Engl J Med. 2021 Nov 4;385(19):1761-1773
pubmed: 34525277
N Engl J Med. 2021 Nov 18;385(21):2010-2012
pubmed: 34648703
J Infect Dis. 2022 Jan 5;225(1):30-33
pubmed: 34726239
N Engl J Med. 2021 Sep 2;385(10):951-953
pubmed: 34260834
N Engl J Med. 2021 Dec 9;385(24):e85
pubmed: 34706170
N Engl J Med. 2021 Oct 7;385(15):1393-1400
pubmed: 34525275
N Engl J Med. 2021 Nov 4;385(19):1774-1785
pubmed: 34551225
MMWR Morb Mortal Wkly Rep. 2021 Sep 17;70(37):1284-1290
pubmed: 34529637
N Engl J Med. 2021 Aug 12;385(7):585-594
pubmed: 34289274