Effectiveness of Severe Acute Respiratory Syndrome Coronavirus 2 Messenger RNA Vaccines for Preventing Coronavirus Disease 2019 Hospitalizations in the United States.
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Tenforde Mark W, Patel Manish M, Ginde Adit A, Douin David J, Talbot H Keipp, Casey Jonathan D, Mohr Nicholas M, Zepeski Anne, Gaglani Manjusha, McNeal Tresa, Ghamande Shekhar, Shapiro Nathan I, Gibbs Kevin W, Files D Clark, Hager David N, Shehu Arber, Prekker Matthew E, Erickson Heidi L, Exline Matthew C, Gong Michelle N, Mohamed Amira, Henning Daniel J, Steingrub Jay S, Peltan Ithan D, Brown Samuel M, Martin Emily T, Monto Arnold S, Khan Akram, Hough Catherine L, Busse Laurence W, Ten Lohuis Caitlin C, Duggal Abhijit, Wilson Jennifer G, Gordon Alexandra June, Qadir Nida, Chang Steven Y, Mallow Christopher, Gershengorn Hayley B, Babcock Hilary M, Kwon Jennie H, Halasa Natasha, Chappell James D, Lauring Adam S, Grijalva Carlos G, Rice Todd W, Jones Ian D, Stubblefield William B, Baughman Adrienne, Womack Kelsey N, Lindsell Christopher J, Hart Kimberly W, Zhu Yuwei, Olson Samantha M, Stephenson Meagan, Schrag Stephanie J, Kobayashi Miwako, Verani Jennifer R, Self Wesley H, Influenza and Other Viruses in the Acutely Ill (IVY) Network
Аннотация
METHODS: In a multicenter case-control analysis of US adults hospitalized March 11-May 5, 2021, we evaluated vaccine effectiveness to prevent COVID-19 hospitalizations by comparing odds of prior vaccination with a messenger RNA (mRNA) vaccine (Pfizer-BioNTech or Moderna) between cases hospitalized with COVID-19 and hospital-based controls who tested negative for SARS-CoV-2.
RESULTS: Among 1212 participants, including 593 cases and 619 controls, median age was 58 years, 22.8% were Black, 13.9% were Hispanic, and 21.0% had immunosuppression. SARS-CoV-2 lineage B0.1.1.7 (Alpha) was the most common variant (67.9% of viruses with lineage determined). Full vaccination (receipt of 2 vaccine doses ≥14 days before illness onset) had been received by 8.2% of cases and 36.4% of controls. Overall vaccine effectiveness was 87.1% (95% confidence interval [CI], 80.7-91.3). Vaccine effectiveness was similar for Pfizer-BioNTech and Moderna vaccines, and highest in adults aged 18-49 years (97.4%; 95% CI, 79.3-9.7). Among 45 patients with vaccine-breakthrough COVID hospitalizations, 44 (97.8%) were ≥50 years old and 20 (44.4%) had immunosuppression. Vaccine effectiveness was lower among patients with immunosuppression (62.9%; 95% CI,20.8-82.6) than without immunosuppression (91.3%; 95% CI, 85.6-94.8).
CONCLUSION: During March-May 2021, SARS-CoV-2 mRNA vaccines were highly effective for preventing COVID-19 hospitalizations among US adults. SARS-CoV-2 vaccination was beneficial for patients with immunosuppression, but effectiveness was lower in the immunosuppressed population.