Journal Article

Effectiveness of 2, 3, and 4 COVID-19 mRNA Vaccine Doses Among Immunocompetent Adults During Periods when SARS-CoV-2 Omicron BA.1 and BA.2/BA.2.12.1 Sublineages Predominated — VISION Network, 10 States, December 2021–June 2022

Rao, Suchitra, Grisel, Nancy, Currey, J. C., DeSilva, Malini B., Barron, Michelle A., Hartmann, Emily, Goddard, Kristin, Natarajan, Karthik, Liao, I-Chia, Zerbo, Ousseny, Murthy, Kempapura, Grannis, Shaun J., Levy, Matthew E., Arndorfer, Julie, Stockwell, Melissa, Tenforde, Mark W., Han, Jungmi, Irving, Stephanie A., Fireman, Bruce, Thompson, Mark G., Dickerson, Monica, McEvoy, Charlene, Ball, Sarah W., Klein, Nicola P., Dixon, Brian E., Dascomb, Kristin, Valvi, Nimish R., Reese, Sarah E., Link-Gelles, Ruth, Ong, Toan C., Gaglani, Manjusha, Konatham, Deepika, Lewis, Ned, Stenehjem, Edward, Patel, Palak, Naleway, Allison L., Kharbanda, Anupam B., Fadel, William F., Dunne, Margaret M., Akinseye, Akintunde, Raiyani, Chandni, Sloan-Aagard, Chantel

2022

Overview

The Omicron variant (B.1.1.529) of SARS-CoV-2, the virus that causes COVID-19, was first identified in the United States in November 2021, with the BA.1 sublineage (including BA.1.1) causing the largest surge in COVID-19 cases to date. Omicron sublineages BA.2 and BA.2.12.1 emerged later and by late April 2022, accounted for most cases.* Estimates of COVID-19 vaccine effectiveness (VE) can be reduced by newly emerging variants or sublineages that evade vaccine-induced immunity (1), protection from previous SARS-CoV-2 infection in unvaccinated persons (2), or increasing time since vaccination (3). Real-world data comparing VE during the periods when the BA.1 and BA.2/BA.2.12.1 predominated (BA.1 period and BA.2/BA.2.12.1 period, respectively) are limited. The VISION network examined 214,487 emergency department/urgent care (ED/UC) visits and 58,782 hospitalizations with a COVID-19-like illness diagnosis among 10 states during December 18, 2021-June 10, 2022, to evaluate VE of 2, 3, and 4 doses of mRNA COVID-19 vaccines (BNT162b2 [Pfizer-BioNTech] or mRNA-1273 [Moderna]) compared with no vaccination among adults without immunocompromising conditions. VE against COVID-19-associated hospitalization 7-119 days and ≥120 days after receipt of dose 3 was 92% (95% CI = 91%-93%) and 85% (95% CI = 81%-89%), respectively, during the BA.1 period, compared with 69% (95% CI = 58%-76%) and 52% (95% CI = 44%-59%), respectively, during the BA.2/BA.2.12.1 period. Patterns were similar for ED/UC encounters. Among adults aged ≥50 years, VE against COVID-19-associated hospitalization ≥120 days after receipt of dose 3 was 55% (95% CI = 46%-62%) and ≥7 days (median = 27 days) after a fourth dose was 80% (95% CI = 71%-85%) during BA.2/BA.2.12.1 predominance. Immunocompetent persons should receive recommended COVID-19 booster doses to prevent moderate to severe COVID-19, including a first booster dose for all eligible persons and second booster dose for adults aged ≥50 years at least 4 months after an initial booster dose. Booster doses should be obtained immediately when persons become eligible. .

• Publisher: U.S. Government Printing Office,U.S. Center for Disease Control,Centers for Disease Control and Prevention
• Subject: Adult / Adults / Age groups / BNT162 Vaccine / Coronaviruses / COVID-19 / COVID-19 - epidemiology / COVID-19 - prevention & control / COVID-19 Vaccines / Dosage / Effectiveness / Estimates / Full Report / Hospitalization / Humans / Immunization / Immunocompetence / Infection / Infections / Influenza Vaccines / Influenza, Human / Medical research / Medicine, Experimental / Messenger RNA / mRNA / mRNA Vaccines / Protection / Public health / SARS-CoV-2 - genetics / Severe acute respiratory syndrome coronavirus 2 / United States - epidemiology / Vaccine efficacy / Vaccines / Vaccines, Synthetic