Covid-19 Vaccine Effectiveness Against General SARS-CoV-2 Infection from the Omicron Variant: A Retrospective Cohort Study

Overview

Journal PLOS Glob Public Health

Specialty Public Health

Date 2023 Feb 13

PMID 36777314

Authors

Lior Rennert

Zichen Ma

Christopher S McMahan

Delphine Dean

Affiliations

Soon will be listed here.

Abstract

We aim to estimate the effectiveness of 2-dose and 3-dose mRNA vaccination (BNT162b2 and mRNA-1273) against general Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection (asymptomatic or symptomatic) caused by the omicron BA.1 variant. This propensity-score matched retrospective cohort study takes place in a large public university undergoing weekly Coronavirus Disease 2019 (Covid-19) testing in South Carolina, USA. The population consists of 24,145 university students and employees undergoing weekly Covid-19 testing between January 3 and January 31, 2022. The analytic sample was constructed via propensity score matching on vaccination status: unvaccinated, completion of 2-dose mRNA series (BNT162b2 or mRNA-1273) within the previous 5 months, and receipt of mRNA booster dose (BNT162b2 or mRNA-1273) within the previous 5 months. The resulting analytic sample consists of 1,944 university students (mean [SD] age, 19.64 [1.42] years, 66.4% female, 81.3% non-Hispanic White) and 658 university employees (mean [SD] age, 43.05 [12.22] years, 64.7% female, 83.3% non-Hispanic White). Booster protection against any SARS-CoV-2 infection was 66.4% among employees (95% CI: 46.1-79.0%; <.001) and 45.4% among students (95% CI: 30.0-57.4%; <.001). Compared to the 2-dose mRNA series, estimated increase in protection from the booster dose was 40.8% among employees (=.024) and 37.7% among students (=.001). We did not have enough evidence to conclude a statistically significant protective effect of the 2-dose mRNA vaccination series, nor did we have enough evidence to conclude that protection waned in the 5-month period after receipt of the 2 or 3 mRNA dose. Furthermore, we did not find evidence that protection varied by manufacturer. We conclude that in adults 18-65 years of age, Covid-19 mRNA booster doses offer moderate protection against general SARS-CoV-2 infection caused by the omicron variant and provide a substantial increase in protection relative to the 2-dose mRNA vaccination series.

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References

Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y . Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020; 382(13):1199-1207. PMC: 7121484. DOI: 10.1056/NEJMoa2001316. View

Barda N, Dagan N, Cohen C, Hernan M, Lipsitch M, Kohane I . Effectiveness of a third dose of the BNT162b2 mRNA COVID-19 vaccine for preventing severe outcomes in Israel: an observational study. Lancet. 2021; 398(10316):2093-2100. PMC: 8555967. DOI: 10.1016/S0140-6736(21)02249-2. View

Collie S, Champion J, Moultrie H, Bekker L, Gray G . Effectiveness of BNT162b2 Vaccine against Omicron Variant in South Africa. N Engl J Med. 2021; 386(5):494-496. PMC: 8757569. DOI: 10.1056/NEJMc2119270. View

Nemet I, Kliker L, Lustig Y, Zuckerman N, Erster O, Cohen C . Third BNT162b2 Vaccination Neutralization of SARS-CoV-2 Omicron Infection. N Engl J Med. 2021; 386(5):492-494. PMC: 8823651. DOI: 10.1056/NEJMc2119358. View

Griffith G, Morris T, Tudball M, Herbert A, Mancano G, Pike L . Collider bias undermines our understanding of COVID-19 disease risk and severity. Nat Commun. 2020; 11(1):5749. PMC: 7665028. DOI: 10.1038/s41467-020-19478-2. View

Rennert L, McMahan C . Risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection in a University Student Population. Clin Infect Dis. 2021; 74(4):719-722. PMC: 8241413. DOI: 10.1093/cid/ciab454. View

He X, Lau E, Wu P, Deng X, Wang J, Hao X . Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med. 2020; 26(5):672-675. DOI: 10.1038/s41591-020-0869-5. View

Ranzani O, Hitchings M, Dorion M, DAgostini T, Paula R, de Paula O . Effectiveness of the CoronaVac vaccine in older adults during a gamma variant associated epidemic of covid-19 in Brazil: test negative case-control study. BMJ. 2021; 374:n2015. PMC: 8377801. DOI: 10.1136/bmj.n2015. View

Little P, Read R, Amlot R, Chadborn T, Rice C, Bostock J . Reducing risks from coronavirus transmission in the home-the role of viral load. BMJ. 2020; 369:m1728. DOI: 10.1136/bmj.m1728. View

10.

Thompson M, Stenehjem E, Grannis S, Ball S, Naleway A, Ong T . Effectiveness of Covid-19 Vaccines in Ambulatory and Inpatient Care Settings. N Engl J Med. 2021; 385(15):1355-1371. PMC: 8451184. DOI: 10.1056/NEJMoa2110362. View

11.

Austin P . Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies. Pharm Stat. 2010; 10(2):150-61. PMC: 3120982. DOI: 10.1002/pst.433. View

12.

Chemaitelly H, Tang P, Hasan M, Almukdad S, Yassine H, Benslimane F . Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar. N Engl J Med. 2021; 385(24):e83. PMC: 8522799. DOI: 10.1056/NEJMoa2114114. View

13.

Heinze G, Schemper M . A solution to the problem of monotone likelihood in Cox regression. Biometrics. 2001; 57(1):114-9. DOI: 10.1111/j.0006-341x.2001.00114.x. View

14.

Accorsi E, Britton A, Fleming-Dutra K, Smith Z, Shang N, Derado G . Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants. JAMA. 2022; 327(7):639-651. PMC: 8848203. DOI: 10.1001/jama.2022.0470. View

15.

Taylor L . Covid-19: Omicron drives weekly record high in global infections. BMJ. 2022; 376:o66. DOI: 10.1136/bmj.o66. View

16.

Austin P . Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples. Stat Med. 2009; 28(25):3083-107. PMC: 3472075. DOI: 10.1002/sim.3697. View

17.

Hodgson S, Mansatta K, Mallett G, Harris V, Emary K, Pollard A . What defines an efficacious COVID-19 vaccine? A review of the challenges assessing the clinical efficacy of vaccines against SARS-CoV-2. Lancet Infect Dis. 2020; 21(2):e26-e35. PMC: 7837315. DOI: 10.1016/S1473-3099(20)30773-8. View

18.

Johansson M, Quandelacy T, Kada S, Prasad P, Steele M, Brooks J . SARS-CoV-2 Transmission From People Without COVID-19 Symptoms. JAMA Netw Open. 2021; 4(1):e2035057. PMC: 7791354. DOI: 10.1001/jamanetworkopen.2020.35057. View

19.

Vogels C, Watkins A, Harden C, Brackney D, Shafer J, Wang J . SalivaDirect: A simplified and flexible platform to enhance SARS-CoV-2 testing capacity. Med. 2021; 2(3):263-280.e6. PMC: 7836249. DOI: 10.1016/j.medj.2020.12.010. View

20.

Byrne K, Six S, Ghaiumy Anaraky R, Harris M, Winterlind E . Risk-taking unmasked: Using risky choice and temporal discounting to explain COVID-19 preventative behaviors. PLoS One. 2021; 16(5):e0251073. PMC: 8118306. DOI: 10.1371/journal.pone.0251073. View