tetano
Editor, Senior Moderator
Lancet Reg Health Am
. 2023 Jul;23:100530.
doi: 10.1016/j.lana.2023.100530. Epub 2023 Jun 14. Number needed to vaccinate with a COVID-19 booster to prevent a COVID-19-associated hospitalization during SARS-CoV-2 Omicron BA.1 variant predominance, December 2021-February 2022, VISION Network: a retrospective cohort study
Katherine Adams[SUP] 1 [/SUP], John J Riddles[SUP] 2 [/SUP], Elizabeth A K Rowley[SUP] 2 [/SUP], Shaun J Grannis[SUP] 3 4 [/SUP], Manjusha Gaglani[SUP] 5 6 [/SUP], Bruce Fireman[SUP] 7 [/SUP], Emily Hartmann[SUP] 8 [/SUP], Allison L Naleway[SUP] 9 [/SUP], Edward Stenehjem[SUP] 10 [/SUP], Alexandria Hughes[SUP] 2 [/SUP], Alexandra F Dalton[SUP] 1 [/SUP], Karthik Natarajan[SUP] 11 12 [/SUP], Kristin Dascomb[SUP] 10 [/SUP], Chandni Raiyani[SUP] 5 [/SUP], Stephanie A Irving[SUP] 9 [/SUP], Chantel Sloan-Aagard[SUP] 8 13 [/SUP], Anupam B Kharbanda[SUP] 14 [/SUP], Malini B DeSilva[SUP] 15 [/SUP], Brian E Dixon[SUP] 3 16 [/SUP], Toan C Ong[SUP] 17 [/SUP], Jean Keller[SUP] 2 [/SUP], Monica Dickerson[SUP] 1 [/SUP], Nancy Grisel[SUP] 10 [/SUP], Kempapura Murthy[SUP] 5 [/SUP], Juan Nanez[SUP] 8 [/SUP], William F Fadel[SUP] 3 16 [/SUP], Sarah W Ball[SUP] 2 [/SUP], Palak Patel[SUP] 1 [/SUP], Julie Arndorfer[SUP] 10 [/SUP], Mufaddal Mamawala[SUP] 5 [/SUP], Nimish R Valvi[SUP] 3 [/SUP], Margaret M Dunne[SUP] 2 [/SUP], Eric P Griggs[SUP] 18 [/SUP], Peter J Embi[SUP] 3 19 [/SUP], Mark G Thompson[SUP] 1 [/SUP], Ruth Link-Gelles[SUP] 18 [/SUP], Mark W Tenforde[SUP] 1 [/SUP]
Affiliations
Background: Understanding the usefulness of additional COVID-19 vaccine doses-particularly given varying disease incidence-is needed to support public health policy. We characterize the benefits of COVID-19 booster doses using number needed to vaccinate (NNV) to prevent one COVID-19-associated hospitalization or emergency department encounter.
Methods: We conducted a retrospective cohort study of immunocompetent adults at five health systems in four U.S. states during SARS-CoV-2 Omicron BA.1 predominance (December 2021-February 2022). Included patients completed a primary mRNA COVID-19 vaccine series and were either eligible to or received a booster dose. NNV were estimated using hazard ratios for each outcome (hospitalization and emergency department encounters), with results stratified by three 25-day periods and site.
Findings: 1,285,032 patients contributed 938 hospitalizations and 2076 emergency department encounters. 555,729 (43.2%) patients were aged 18-49 years, 363,299 (28.3%) 50-64 years, and 366,004 (28.5%) ≥65 years. Most patients were female (n = 765,728, 59.6%), White (n = 990,224, 77.1%), and non-Hispanic (n = 1,063,964, 82.8%). 37.2% of patients received a booster and 62.8% received only two doses. Median estimated NNV to prevent one hospitalization was 205 (range 44-615) and NNV was lower across study periods for adults aged ≥65 years (110, 46, and 88, respectively) and those with underlying medical conditions (163, 69, and 131, respectively). Median estimated NNV to prevent one emergency department encounter was 156 (range 75-592).
Interpretation: The number of patients needed to receive a booster dose was highly dependent on local disease incidence, outcome severity, and patient risk factors for moderate-to-severe disease.
Funding: Funding was provided by the Centers for Disease Control and Prevention though contract 75D30120C07986 to Westat, Inc. and contract 75D30120C07765 to Kaiser Foundation Hospitals.
Keywords: Boosters; COVID-19; Hospitalization; Number needed to vaccinate; mRNA vaccines.
. 2023 Jul;23:100530.
doi: 10.1016/j.lana.2023.100530. Epub 2023 Jun 14. Number needed to vaccinate with a COVID-19 booster to prevent a COVID-19-associated hospitalization during SARS-CoV-2 Omicron BA.1 variant predominance, December 2021-February 2022, VISION Network: a retrospective cohort study
Katherine Adams[SUP] 1 [/SUP], John J Riddles[SUP] 2 [/SUP], Elizabeth A K Rowley[SUP] 2 [/SUP], Shaun J Grannis[SUP] 3 4 [/SUP], Manjusha Gaglani[SUP] 5 6 [/SUP], Bruce Fireman[SUP] 7 [/SUP], Emily Hartmann[SUP] 8 [/SUP], Allison L Naleway[SUP] 9 [/SUP], Edward Stenehjem[SUP] 10 [/SUP], Alexandria Hughes[SUP] 2 [/SUP], Alexandra F Dalton[SUP] 1 [/SUP], Karthik Natarajan[SUP] 11 12 [/SUP], Kristin Dascomb[SUP] 10 [/SUP], Chandni Raiyani[SUP] 5 [/SUP], Stephanie A Irving[SUP] 9 [/SUP], Chantel Sloan-Aagard[SUP] 8 13 [/SUP], Anupam B Kharbanda[SUP] 14 [/SUP], Malini B DeSilva[SUP] 15 [/SUP], Brian E Dixon[SUP] 3 16 [/SUP], Toan C Ong[SUP] 17 [/SUP], Jean Keller[SUP] 2 [/SUP], Monica Dickerson[SUP] 1 [/SUP], Nancy Grisel[SUP] 10 [/SUP], Kempapura Murthy[SUP] 5 [/SUP], Juan Nanez[SUP] 8 [/SUP], William F Fadel[SUP] 3 16 [/SUP], Sarah W Ball[SUP] 2 [/SUP], Palak Patel[SUP] 1 [/SUP], Julie Arndorfer[SUP] 10 [/SUP], Mufaddal Mamawala[SUP] 5 [/SUP], Nimish R Valvi[SUP] 3 [/SUP], Margaret M Dunne[SUP] 2 [/SUP], Eric P Griggs[SUP] 18 [/SUP], Peter J Embi[SUP] 3 19 [/SUP], Mark G Thompson[SUP] 1 [/SUP], Ruth Link-Gelles[SUP] 18 [/SUP], Mark W Tenforde[SUP] 1 [/SUP]
Affiliations
- PMID: 37333688
- PMCID: PMC10266334
- DOI: 10.1016/j.lana.2023.100530
Background: Understanding the usefulness of additional COVID-19 vaccine doses-particularly given varying disease incidence-is needed to support public health policy. We characterize the benefits of COVID-19 booster doses using number needed to vaccinate (NNV) to prevent one COVID-19-associated hospitalization or emergency department encounter.
Methods: We conducted a retrospective cohort study of immunocompetent adults at five health systems in four U.S. states during SARS-CoV-2 Omicron BA.1 predominance (December 2021-February 2022). Included patients completed a primary mRNA COVID-19 vaccine series and were either eligible to or received a booster dose. NNV were estimated using hazard ratios for each outcome (hospitalization and emergency department encounters), with results stratified by three 25-day periods and site.
Findings: 1,285,032 patients contributed 938 hospitalizations and 2076 emergency department encounters. 555,729 (43.2%) patients were aged 18-49 years, 363,299 (28.3%) 50-64 years, and 366,004 (28.5%) ≥65 years. Most patients were female (n = 765,728, 59.6%), White (n = 990,224, 77.1%), and non-Hispanic (n = 1,063,964, 82.8%). 37.2% of patients received a booster and 62.8% received only two doses. Median estimated NNV to prevent one hospitalization was 205 (range 44-615) and NNV was lower across study periods for adults aged ≥65 years (110, 46, and 88, respectively) and those with underlying medical conditions (163, 69, and 131, respectively). Median estimated NNV to prevent one emergency department encounter was 156 (range 75-592).
Interpretation: The number of patients needed to receive a booster dose was highly dependent on local disease incidence, outcome severity, and patient risk factors for moderate-to-severe disease.
Funding: Funding was provided by the Centers for Disease Control and Prevention though contract 75D30120C07986 to Westat, Inc. and contract 75D30120C07765 to Kaiser Foundation Hospitals.
Keywords: Boosters; COVID-19; Hospitalization; Number needed to vaccinate; mRNA vaccines.