tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2022 Dec 31;10(1)
fac698.
doi: 10.1093/ofid/ofac698. eCollection 2023 Jan.
Absolute and Relative Vaccine Effectiveness of Primary and Booster Series of COVID-19 Vaccines (mRNA and Adenovirus Vector) Against COVID-19 Hospitalizations in the United States, December 2021-April 2022
Nathaniel M Lewis[SUP] 1 [/SUP], Nancy Murray[SUP] 1 [/SUP], Katherine Adams[SUP] 1 [/SUP], Diya Surie[SUP] 1 [/SUP], Manjusha Gaglani[SUP] 2 [/SUP], Adit A Ginde[SUP] 3 [/SUP], Tresa McNeal[SUP] 2 [/SUP], Shekhar Ghamande[SUP] 2 [/SUP], David J Douin[SUP] 4 [/SUP], H Keipp Talbot[SUP] 5 [/SUP], Jonathan D Casey[SUP] 6 [/SUP], Nicholas M Mohr[SUP] 7 [/SUP], Anne Zepeski[SUP] 7 [/SUP], Nathan I Shapiro[SUP] 8 [/SUP], Kevin W Gibbs[SUP] 9 [/SUP], D Clark Files[SUP] 9 [/SUP], David N Hager[SUP] 10 [/SUP], Harith Ali[SUP] 10 [/SUP], Matthew E Prekker[SUP] 11 [/SUP], Anne E Frosch[SUP] 12 [/SUP], Matthew C Exline[SUP] 13 [/SUP], Michelle N Gong[SUP] 14 [/SUP], Amira Mohamed[SUP] 15 [/SUP], Nicholas J Johnson[SUP] 16 [/SUP], Vasisht Srinivasan[SUP] 17 [/SUP], Jay S Steingrub[SUP] 18 [/SUP], Ithan D Peltan[SUP] 19 [/SUP], Samuel M Brown[SUP] 19 [/SUP], Emily T Martin[SUP] 20 [/SUP], Arnold S Monto[SUP] 20 [/SUP], Adam S Lauring[SUP] 21 [/SUP], Akram Khan[SUP] 22 [/SUP], Catherine L Hough[SUP] 22 [/SUP], Laurence W Busse[SUP] 23 [/SUP], William Bender[SUP] 23 [/SUP], Abhijit Duggal[SUP] 24 [/SUP], Jennifer G Wilson[SUP] 25 [/SUP], Alexandra June Gordon[SUP] 25 [/SUP], Nida Qadir[SUP] 26 [/SUP], Steven Y Chang[SUP] 26 [/SUP], Christopher Mallow[SUP] 27 [/SUP], Carolina Rivas[SUP] 27 [/SUP], Hilary M Babcock[SUP] 28 [/SUP], Jennie H Kwon[SUP] 28 [/SUP], James D Chappell[SUP] 29 [/SUP], Natasha Halasa[SUP] 29 [/SUP], Carlos G Grijalva[SUP] 30 [/SUP], Todd W Rice[SUP] 6 [/SUP], William B Stubblefield[SUP] 31 [/SUP], Adrienne Baughman[SUP] 31 [/SUP], Christopher J Lindsell[SUP] 32 [/SUP], Kimberly W Hart[SUP] 32 [/SUP], Jillian P Rhoads[SUP] 33 [/SUP], Meredith L McMorrow[SUP] 1 [/SUP], Mark W Tenforde[SUP] 1 [/SUP], Wesley H Self[SUP] 34 [/SUP], Manish M Patel[SUP] 1 [/SUP]; Influenza and Other Viruses in the Acutely Ill (IVY) Network
Collaborators, Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) vaccine effectiveness (VE) studies are increasingly reporting relative VE (rVE) comparing a primary series plus booster doses with a primary series only. Interpretation of rVE differs from traditional studies measuring absolute VE (aVE) of a vaccine regimen against an unvaccinated referent group. We estimated aVE and rVE against COVID-19 hospitalization in primary-series plus first-booster recipients of COVID-19 vaccines.
Methods: Booster-eligible immunocompetent adults hospitalized at 21 medical centers in the United States during December 25, 2021-April 4, 2022 were included. In a test-negative design, logistic regression with case status as the outcome and completion of primary vaccine series or primary series plus 1 booster dose as the predictors, adjusted for potential confounders, were used to estimate aVE and rVE.
Results: A total of 2060 patients were analyzed, including 1104 COVID-19 cases and 956 controls. Relative VE against COVID-19 hospitalization in boosted mRNA vaccine recipients versus primary series only was 66% (95% confidence interval [CI], 55%-74%); aVE was 81% (95% CI, 75%-86%) for boosted versus 46% (95% CI, 30%-58%) for primary. For boosted Janssen vaccine recipients versus primary series, rVE was 49% (95% CI, -9% to 76%); aVE was 62% (95% CI, 33%-79%) for boosted versus 36% (95% CI, -4% to 60%) for primary.
Conclusions: Vaccine booster doses increased protection against COVID-19 hospitalization compared with a primary series. Comparing rVE measures across studies can lead to flawed interpretations of the added value of a new vaccination regimen, whereas difference in aVE, when available, may be a more useful metric.
Keywords: COVID-19; absolute vaccine effectiveness; booster vaccine series; primary vaccine series; relative vaccine effectiveness.
. 2022 Dec 31;10(1)
fac698.doi: 10.1093/ofid/ofac698. eCollection 2023 Jan.
Absolute and Relative Vaccine Effectiveness of Primary and Booster Series of COVID-19 Vaccines (mRNA and Adenovirus Vector) Against COVID-19 Hospitalizations in the United States, December 2021-April 2022
Nathaniel M Lewis[SUP] 1 [/SUP], Nancy Murray[SUP] 1 [/SUP], Katherine Adams[SUP] 1 [/SUP], Diya Surie[SUP] 1 [/SUP], Manjusha Gaglani[SUP] 2 [/SUP], Adit A Ginde[SUP] 3 [/SUP], Tresa McNeal[SUP] 2 [/SUP], Shekhar Ghamande[SUP] 2 [/SUP], David J Douin[SUP] 4 [/SUP], H Keipp Talbot[SUP] 5 [/SUP], Jonathan D Casey[SUP] 6 [/SUP], Nicholas M Mohr[SUP] 7 [/SUP], Anne Zepeski[SUP] 7 [/SUP], Nathan I Shapiro[SUP] 8 [/SUP], Kevin W Gibbs[SUP] 9 [/SUP], D Clark Files[SUP] 9 [/SUP], David N Hager[SUP] 10 [/SUP], Harith Ali[SUP] 10 [/SUP], Matthew E Prekker[SUP] 11 [/SUP], Anne E Frosch[SUP] 12 [/SUP], Matthew C Exline[SUP] 13 [/SUP], Michelle N Gong[SUP] 14 [/SUP], Amira Mohamed[SUP] 15 [/SUP], Nicholas J Johnson[SUP] 16 [/SUP], Vasisht Srinivasan[SUP] 17 [/SUP], Jay S Steingrub[SUP] 18 [/SUP], Ithan D Peltan[SUP] 19 [/SUP], Samuel M Brown[SUP] 19 [/SUP], Emily T Martin[SUP] 20 [/SUP], Arnold S Monto[SUP] 20 [/SUP], Adam S Lauring[SUP] 21 [/SUP], Akram Khan[SUP] 22 [/SUP], Catherine L Hough[SUP] 22 [/SUP], Laurence W Busse[SUP] 23 [/SUP], William Bender[SUP] 23 [/SUP], Abhijit Duggal[SUP] 24 [/SUP], Jennifer G Wilson[SUP] 25 [/SUP], Alexandra June Gordon[SUP] 25 [/SUP], Nida Qadir[SUP] 26 [/SUP], Steven Y Chang[SUP] 26 [/SUP], Christopher Mallow[SUP] 27 [/SUP], Carolina Rivas[SUP] 27 [/SUP], Hilary M Babcock[SUP] 28 [/SUP], Jennie H Kwon[SUP] 28 [/SUP], James D Chappell[SUP] 29 [/SUP], Natasha Halasa[SUP] 29 [/SUP], Carlos G Grijalva[SUP] 30 [/SUP], Todd W Rice[SUP] 6 [/SUP], William B Stubblefield[SUP] 31 [/SUP], Adrienne Baughman[SUP] 31 [/SUP], Christopher J Lindsell[SUP] 32 [/SUP], Kimberly W Hart[SUP] 32 [/SUP], Jillian P Rhoads[SUP] 33 [/SUP], Meredith L McMorrow[SUP] 1 [/SUP], Mark W Tenforde[SUP] 1 [/SUP], Wesley H Self[SUP] 34 [/SUP], Manish M Patel[SUP] 1 [/SUP]; Influenza and Other Viruses in the Acutely Ill (IVY) Network
Collaborators, Affiliations
- PMID: 36695662
- PMCID: PMC9868348
- DOI: 10.1093/ofid/ofac698
Abstract
Background: Coronavirus disease 2019 (COVID-19) vaccine effectiveness (VE) studies are increasingly reporting relative VE (rVE) comparing a primary series plus booster doses with a primary series only. Interpretation of rVE differs from traditional studies measuring absolute VE (aVE) of a vaccine regimen against an unvaccinated referent group. We estimated aVE and rVE against COVID-19 hospitalization in primary-series plus first-booster recipients of COVID-19 vaccines.
Methods: Booster-eligible immunocompetent adults hospitalized at 21 medical centers in the United States during December 25, 2021-April 4, 2022 were included. In a test-negative design, logistic regression with case status as the outcome and completion of primary vaccine series or primary series plus 1 booster dose as the predictors, adjusted for potential confounders, were used to estimate aVE and rVE.
Results: A total of 2060 patients were analyzed, including 1104 COVID-19 cases and 956 controls. Relative VE against COVID-19 hospitalization in boosted mRNA vaccine recipients versus primary series only was 66% (95% confidence interval [CI], 55%-74%); aVE was 81% (95% CI, 75%-86%) for boosted versus 46% (95% CI, 30%-58%) for primary. For boosted Janssen vaccine recipients versus primary series, rVE was 49% (95% CI, -9% to 76%); aVE was 62% (95% CI, 33%-79%) for boosted versus 36% (95% CI, -4% to 60%) for primary.
Conclusions: Vaccine booster doses increased protection against COVID-19 hospitalization compared with a primary series. Comparing rVE measures across studies can lead to flawed interpretations of the added value of a new vaccination regimen, whereas difference in aVE, when available, may be a more useful metric.
Keywords: COVID-19; absolute vaccine effectiveness; booster vaccine series; primary vaccine series; relative vaccine effectiveness.