tetano
Editor, Senior Moderator
Age Ageing
. 2024 Nov 1;53(11):afae251.
doi: 10.1093/ageing/afae251. Effectiveness of bivalent mRNA booster vaccination and previous infection in older adults during Omicron period: real-world evidence
Pedro-Pablo España[SUP] 1 2 [/SUP], Idoia Castillo-Sintes[SUP] 3 4 5 [/SUP], Maria J Legarreta[SUP] 4 5 6 [/SUP], Amaia Bilbao-González[SUP] 3 4 5 [/SUP], Nere Larrea[SUP] 4 5 6 [/SUP], Maria Gascon[SUP] 4 5 7 [/SUP], Ane Uranga[SUP] 1 2 [/SUP], Amaia Artaraz[SUP] 1 2 [/SUP], Julia Garcia-Asensio[SUP] 8 [/SUP], Jose M Quintana[SUP] 4 5 6 [/SUP]; COVID-Health Basque Country Research Group
Collaborators, Affiliations
Background: The effectiveness of booster bivalent vaccines against the Omicron variant, particularly amongst older patients, remains uncertain.
Objective: We sought to compare the relative effectiveness of a fourth dose of vaccine using bivalent messenger ribonucleic acid (mRNA), by comparing patients who had and had not received this dose.
Methods: We conducted a matched retrospective cohort study to assess the risk of COVID-19 infection, hospitalization and death of people aged >60 years with four doses as compared to those with only three doses. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). We adjusted by age, sex, nursing-home, comorbidities, primary care setting and previous episodes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. We also investigated the impact of prior SARS-CoV-2 infection within each cohort, using the same methodology.
Results: The administration of a fourth bivalent mRNA vaccine dose conferred significant additional protection against COVID-19 infection (HR: 0.479; 95% CI: 0.454-0.506), hospitalization (HR: 0.393; 95% CI: 0.348-0.443) and 30-day mortality (HR: 0.234; 95% CI: 0.171-0.318), as compared to individuals who had received only a third monovalent vaccine dose. In both cohorts, a prior history of COVID-19 infection involves lower risk of COVID-infection, hospitalization and death.
Conclusions: During the period of Omicron predominance, receiving a bivalent booster vaccine as a fourth dose, as compared to receiving only three doses of a monovalent mRNA vaccine, provides significant extra protection against COVID-19 infection, hospitalization and mortality. Antecedents of SARS-CoV-2 prior to vaccination involves a notable reduction in the above COVID-19 outcomes.
Keywords: COVID-19; SARS coronavirus 2 vaccines; hospital admission; mortality; older people; vaccine effectiveness.
. 2024 Nov 1;53(11):afae251.
doi: 10.1093/ageing/afae251. Effectiveness of bivalent mRNA booster vaccination and previous infection in older adults during Omicron period: real-world evidence
Pedro-Pablo España[SUP] 1 2 [/SUP], Idoia Castillo-Sintes[SUP] 3 4 5 [/SUP], Maria J Legarreta[SUP] 4 5 6 [/SUP], Amaia Bilbao-González[SUP] 3 4 5 [/SUP], Nere Larrea[SUP] 4 5 6 [/SUP], Maria Gascon[SUP] 4 5 7 [/SUP], Ane Uranga[SUP] 1 2 [/SUP], Amaia Artaraz[SUP] 1 2 [/SUP], Julia Garcia-Asensio[SUP] 8 [/SUP], Jose M Quintana[SUP] 4 5 6 [/SUP]; COVID-Health Basque Country Research Group
Collaborators, Affiliations
- PMID: 39572391
- DOI: 10.1093/ageing/afae251
Background: The effectiveness of booster bivalent vaccines against the Omicron variant, particularly amongst older patients, remains uncertain.
Objective: We sought to compare the relative effectiveness of a fourth dose of vaccine using bivalent messenger ribonucleic acid (mRNA), by comparing patients who had and had not received this dose.
Methods: We conducted a matched retrospective cohort study to assess the risk of COVID-19 infection, hospitalization and death of people aged >60 years with four doses as compared to those with only three doses. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). We adjusted by age, sex, nursing-home, comorbidities, primary care setting and previous episodes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. We also investigated the impact of prior SARS-CoV-2 infection within each cohort, using the same methodology.
Results: The administration of a fourth bivalent mRNA vaccine dose conferred significant additional protection against COVID-19 infection (HR: 0.479; 95% CI: 0.454-0.506), hospitalization (HR: 0.393; 95% CI: 0.348-0.443) and 30-day mortality (HR: 0.234; 95% CI: 0.171-0.318), as compared to individuals who had received only a third monovalent vaccine dose. In both cohorts, a prior history of COVID-19 infection involves lower risk of COVID-infection, hospitalization and death.
Conclusions: During the period of Omicron predominance, receiving a bivalent booster vaccine as a fourth dose, as compared to receiving only three doses of a monovalent mRNA vaccine, provides significant extra protection against COVID-19 infection, hospitalization and mortality. Antecedents of SARS-CoV-2 prior to vaccination involves a notable reduction in the above COVID-19 outcomes.
Keywords: COVID-19; SARS coronavirus 2 vaccines; hospital admission; mortality; older people; vaccine effectiveness.