TY - JOUR
T1 - Effectiveness of a bivalent mRNA vaccine dose against symptomatic SARS-CoV-2 infection among U.S. Healthcare personnel, September 2022–May 2023
AU - the Vaccine Effectiveness among Healthcare Personnel Study Team
AU - Plumb, Ian D.
AU - Briggs Hagen, Melissa
AU - Wiegand, Ryan
AU - Dumyati, Ghinwa
AU - Myers, Christopher
AU - Harland, Karisa K.
AU - Krishnadasan, Anusha
AU - James Gist, Jade
AU - Abedi, Glen
AU - Fleming-Dutra, Katherine E.
AU - Chea, Nora
AU - Lee, Jane E.
AU - Kellogg, Melissa
AU - Edmundson, Alexandra
AU - Britton, Amber
AU - Wilson, Lucy E.
AU - Lovett, Sara A.
AU - Ocampo, Valerie
AU - Markus, Tiffanie M.
AU - Smithline, Howard A.
AU - Hou, Peter C.
AU - Lee, Lilly C.
AU - Mower, William
AU - Rwamwejo, Fernand
AU - Steele, Mark T.
AU - Lim, Stephen C.
AU - Schrading, Walter A.
AU - Chinnock, Brian
AU - Beiser, David G.
AU - Faine, Brett
AU - Haran, John P.
AU - Nandi, Utsav
AU - Chipman, Anne K.
AU - LoVecchio, Frank
AU - Eucker, Stephanie
AU - Femling, Jon
AU - Fuller, Matthew
AU - Rothman, Richard E.
AU - Curlin, Marcel E.
AU - Talan, David A.
AU - Mohr, Nicholas M.
N1 - Publisher Copyright:
© 2023
PY - 2024/4/11
Y1 - 2024/4/11
N2 - Background: 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. 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: 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: 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.
AB - Background: 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. 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: 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: 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.
KW - Bivalent
KW - COVID-19
KW - COVID-19 vaccines
KW - Healthcare personnel
KW - SARS-CoV-2
KW - Vaccine effectiveness
KW - mRNA vaccines
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U2 - 10.1016/j.vaccine.2023.10.072
DO - 10.1016/j.vaccine.2023.10.072
M3 - Article
AN - SCOPUS:85176930433
SN - 0264-410X
VL - 42
SP - 2543
EP - 2552
JO - Vaccine
JF - Vaccine
IS - 10
ER -