Effectiveness of a bivalent mRNA vaccine dose against symptomatic SARS-CoV-2 infection among U.S. Healthcare personnel, September 2022-May 2023.

Bivalent COVID-19 COVID-19 vaccines Healthcare personnel SARS-CoV-2 Vaccine effectiveness mRNA vaccines

Journal

Vaccine

ISSN: 1873-2518

Titre abrégé: Vaccine

Pays: Netherlands

ID NLM: 8406899

Informations de publication

Date de publication:
14 Nov 2023

Historique:

received: 05 09 2023

revised: 27 10 2023

accepted: 30 10 2023

medline: 17 11 2023

pubmed: 17 11 2023

entrez: 16 11 2023

Statut: aheadofprint

Résumé

Bivalent mRNA vaccines were recommended since September 2022. However, coverage with a recent vaccine dose has been limited, and there are few robust estimates of bivalent VE against symptomatic SARS-CoV-2 infection (COVID-19). We estimated VE of a bivalent mRNA vaccine dose against COVID-19 among eligible U.S. healthcare personnel who had previously received monovalent mRNA vaccine doses. We conducted a case-control study in 22 U.S. states, and enrolled healthcare personnel with COVID-19 (case-participants) or without COVID-19 (control-participants) during September 2022-May 2023. Participants were considered eligible for a bivalent mRNA dose if they had received 2-4 monovalent (ancestral-strain) mRNA vaccine doses, and were ≥67 days after the most recent vaccine dose. We estimated VE of a bivalent mRNA dose using conditional logistic regression, accounting for matching by region and four-week calendar period. We adjusted estimates for age group, sex, race and ethnicity, educational level, underlying health conditions, community COVID-19 exposure, prior SARS-CoV-2 infection, and days since the last monovalent mRNA dose. Among 3,647 healthcare personnel, 1,528 were included as case-participants and 2,119 as control-participants. Participants received their last monovalent mRNA dose a median of 404 days previously; 1,234 (33.8%) also received a bivalent mRNA dose a median of 93 days previously. Overall, VE of a bivalent dose was 34.1% (95% CI, 22.6%-43.9%) against COVID-19 and was similar by product, days since last monovalent dose, number of prior doses, age group, and presence of underlying health conditions. However, VE declined from 54.8% (95% CI, 40.7%-65.6%) after 7-59 days to 21.6% (95% CI 5.6%-34.9%) after ≥60 days. Bivalent mRNA COVID-19 vaccines initially conferred approximately 55% protection against COVID-19 among U.S. healthcare personnel. However, protection waned after two months. These findings indicate moderate initial protection against symptomatic SARS-CoV-2 infection by remaining up-to-date with COVID-19 vaccines.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

We conducted a case-control study in 22 U.S. states, and enrolled healthcare personnel with COVID-19 (case-participants) or without COVID-19 (control-participants) during September 2022-May 2023. Participants were considered eligible for a bivalent mRNA dose if they had received 2-4 monovalent (ancestral-strain) mRNA vaccine doses, and were ≥67 days after the most recent vaccine dose. We estimated VE of a bivalent mRNA dose using conditional logistic regression, accounting for matching by region and four-week calendar period. We adjusted estimates for age group, sex, race and ethnicity, educational level, underlying health conditions, community COVID-19 exposure, prior SARS-CoV-2 infection, and days since the last monovalent mRNA dose.

RESULTS RESULTS

Among 3,647 healthcare personnel, 1,528 were included as case-participants and 2,119 as control-participants. Participants received their last monovalent mRNA dose a median of 404 days previously; 1,234 (33.8%) also received a bivalent mRNA dose a median of 93 days previously. Overall, VE of a bivalent dose was 34.1% (95% CI, 22.6%-43.9%) against COVID-19 and was similar by product, days since last monovalent dose, number of prior doses, age group, and presence of underlying health conditions. However, VE declined from 54.8% (95% CI, 40.7%-65.6%) after 7-59 days to 21.6% (95% CI 5.6%-34.9%) after ≥60 days.

CONCLUSIONS CONCLUSIONS

Bivalent mRNA COVID-19 vaccines initially conferred approximately 55% protection against COVID-19 among U.S. healthcare personnel. However, protection waned after two months. These findings indicate moderate initial protection against symptomatic SARS-CoV-2 infection by remaining up-to-date with COVID-19 vaccines.

Identifiants

DOI: 10.1016/j.vaccine.2023.10.072 PMID: 37973512

pubmed: 37973512

pii: S0264-410X(23)01287-2

doi: 10.1016/j.vaccine.2023.10.072

pii:

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Subventions

Organisme : NCEZID CDC HHS

ID : U01 CK000643

Pays : United States

Investigateurs

Christopher Watts (C)

Matthew McCullough (M)

Sankan Nyanseor (S)

Erin Licherdell (E)

Alexander Peebles (A)

Joelle Nadle (J)

Helen Johnston (H)

Monica Brackney (M)

Scott Fridkin (S)

Kaytlynn Marceaux-Galli (K)

Ruth Lynfield (R)

Rebecca Pierce (R)

H Keipp Talbot (H)

Jillian Tozloski (J)

Dean M Hashimoto (DM)

Monica Bahamon (M)

Elizabeth Krebs (E)

Amy M Stubbs (AM)

Michelle Huber (M)

James C Crosby (JC)

Sara Roy (S)

Gregory Volturo (G)

James Galbraith (J)

Megan Fuentes (M)

Jennifer Smith (J)

Leslie Olivia Hopkins (L)

Joseph Stuppy (J)

Gaby Dashler (G)

Mastura Wahedi (M)

Informations de copyright

Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Dr. Brackney owned stock in Moderna from November 2022–April 2023 stock as part of portfolio managed by Parametric Investments Portfolio LLC. All other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.].