TY - JOUR
T1 - 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
AU - Influenza and Other Viruses in the Acutely Ill (IVY) Network
AU - Lewis, Nathaniel M.
AU - Murray, Nancy
AU - Adams, Katherine
AU - Surie, Diya
AU - Gaglani, Manjusha
AU - Ginde, Adit A.
AU - Mcneal, Tresa
AU - Ghamande, Shekhar
AU - Douin, David J.
AU - Talbot, H. Keipp
AU - Casey, Jonathan D.
AU - Mohr, Nicholas M.
AU - Zepeski, Anne
AU - Shapiro, Nathan I.
AU - Gibbs, Kevin W.
AU - Files, D. Clark
AU - Hager, David N.
AU - Ali, Harith
AU - Prekker, Matthew E.
AU - Frosch, Anne E.
AU - Exline, Matthew C.
AU - Gong, Michelle N.
AU - Mohamed, Amira
AU - Johnson, Nicholas J.
AU - Srinivasan, Vasisht
AU - Steingrub, Jay S.
AU - Peltan, Ithan D.
AU - Brown, Samuel M.
AU - Martin, Emily T.
AU - Monto, Arnold S.
AU - Lauring, Adam S.
AU - Khan, Akram
AU - Hough, Catherine L.
AU - Busse, Laurence W.
AU - Bender, William
AU - Duggal, Abhijit
AU - Wilson, Jennifer G.
AU - Gordon, Alexandra June
AU - Qadir, Nida
AU - Chang, Steven Y.
AU - Mallow, Christopher
AU - Rivas, Carolina
AU - Babcock, Hilary M.
AU - Kwon, Jennie H.
AU - Chappell, James D.
AU - Halasa, Natasha
AU - Grijalva, Carlos G.
AU - Rice, Todd W.
AU - Stubblefield, William B.
AU - Baughman, Adrienne
AU - Lindsell, Christopher J.
AU - Hart, Kimberly W.
AU - Rhoads, Jillian P.
AU - Mcmorrow, Meredith L.
AU - Tenforde, Mark W.
AU - Self, Wesley H.
AU - Patel, Manish M.
AU - Calhoun, Nicole
AU - Murthy, Kempapura
AU - Herrick, Judy
AU - Mckillop, Amanda
AU - Hoffman, Eric
AU - Zayed, Martha
AU - Smith, Michael
AU - Steingrub, Jay
AU - Kozikowski, Lori Ann
AU - De Souza, Lesley
AU - Ouellette, Scott
AU - Bolstad, Michael
AU - Coviello, Brianna
AU - Ciottone, Robert
AU - Devilla, Arnaldo
AU - Grafals, Ana
AU - Higgins, Conor
AU - Ottanelli, Carlo
AU - Redman, Kimberly
AU - Scaffidi, Douglas
AU - Weingart, Alexander
AU - Patel, Manish
AU - Tenforde, Mark
AU - Lewis, Nathaniel
AU - Olson, Samantha
AU - Stephenson, Meagan
AU - Mcmorrow, Meredith
AU - Tremarelli, Maraia
AU - Turbyfill, Caitlin
AU - Mehkri, Omar
AU - Mitchell, Megan
AU - Griffith, Zachary
AU - Brennan, Connery
AU - Ashok, Kiran
AU - Poynter, Bryan
AU - Busse, Laurence
AU - ten Lohuis, Caitlin
AU - Stanley, Nicholas
AU - Zhang, Sophia
AU - Prekker, Matthew
AU - Erickson, Heidi
AU - Frosch, Anne
AU - Hendrickson, Audrey
AU - Caspers, Sean
AU - Tordsen, Walker
AU - Kaus, Olivia
AU - Scharber, Tyler
AU - Peltan, Ithan
AU - Brown, Samuel
AU - Lumpkin, Jenna
AU - Smith, Cassie
AU - Marshall, Hunter
AU - Shehu, Arber
AU - Rothman, Richard E.
AU - Gong, Michelle
AU - Nair, Rahul
AU - Chen, Jen Ting
AU - Exline, Matthew
AU - Karow, Sarah
AU - Khan, Maryiam
AU - So, Preston
AU - So, Madison
AU - Schwartz, Elizabeth
AU - Botros, Mena
AU - Jung, Haeun
AU - Martinez, Jesus
AU - Luong, Andrea
AU - Huynh, Bao
AU - Ibrahim, Habiba
AU - Villanueva-Vargas, Cynthia
AU - Villanueva-Vargas, Juliana
AU - Quadri, Suha
AU - Perez, Cynthia
AU - Chang, Steven
AU - Frankel, Trevor
AU - Garner, Omai
AU - Chandrasekaran, Sukantha
AU - Ginde, Adit
AU - Douin, David
AU - Huynh, David
AU - Steinwand, Aimee
AU - Withers, Cori
AU - Driver, Conner
AU - Wright, Shelby
AU - Mohr, Nicholas
AU - Nassar, Paul
AU - Landers, Shannon
AU - Nielsen, Karin
AU - Briggs, Noble
AU - Fairfield, Cathy
AU - Mallow, Chris
AU - Gershengorn, Hayley
AU - Martin, Emily
AU - Monto, Arnold
AU - Lauring, Adam
AU - Mcspadden, E. J.
AU - Truscon, Rachel
AU - Kaniclides, Anne
AU - Thomas, Lara
AU - Bielak, Ramsay
AU - Valvano, Weronika Damek
AU - Fong, Rebecca
AU - Fitzsimmons, William J.
AU - Blair, Christopher
AU - Gilbert, Julie
AU - Baker, Leigh
AU - Johnson, Nicholas
AU - Crider, Christine D.
AU - Steinbock, Kyle A.
AU - Paulsen, Thomas C.
AU - Anderson, Layla A.
AU - Lindsell, Chris
AU - Grijalva, Carlos
AU - Jones, Ian
AU - Chappell, James
AU - Womack, Kelsey
AU - Kampe, Christy
AU - Johnson, Jakea
AU - Sturgill, Jake
AU - Hart, Kim
AU - Mcclellan, Robert
AU - Rice, Todd
AU - Casey, Jonathan
AU - Zhu, Yuwei
AU - Short, Laura L.
AU - Ezzell, Lauren J.
AU - Whitsett, Margaret E.
AU - Mchenry, Rendie E.
AU - Hargrave, Samarian J.
AU - Blair, Marcia
AU - Luther, Jennifer L.
AU - Pulido, Claudia Guevara
AU - Peterson, Bryan P.M.
AU - Gibbs, Kevin
AU - Larose, Mary
AU - Landreth, Leigha
AU - Hicks, Madeline
AU - Parks, Lisa
AU - Babcock, Hilary
AU - Bongu, Jahnavi
AU - Mcdonald, David
AU - Cass, Candice
AU - Burnham, Carey Ann
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - 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.
AB - 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.
KW - COVID-19
KW - absolute vaccine effectiveness
KW - booster vaccine series
KW - primary vaccine series
KW - relative vaccine effectiveness
UR - http://www.scopus.com/inward/record.url?scp=85194268711&partnerID=8YFLogxK
U2 - 10.1093/ofid/ofac698
DO - 10.1093/ofid/ofac698
M3 - Article
AN - SCOPUS:85194268711
SN - 2328-8957
VL - 10
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 1
M1 - ofac698
ER -