Effectiveness of a bivalent mRNA vaccine dose against symptomatic SARS-CoV-2 infection among U.S. Healthcare personnel, September 2022-May 2023
Plumb, Ian D Briggs Hagen, Melissa Wiegand, Ryan Dumyati, Ghinwa Myers, Christopher Harland, Karisa K Krishnadasan, Anusha James Gist, Jade Abedi, Glen Fleming-Dutra, Katherine E
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Authors
Briggs Hagen, Melissa
Wiegand, Ryan
Dumyati, Ghinwa
Myers, Christopher
Harland, Karisa K
Krishnadasan, Anusha
James Gist, Jade
Abedi, Glen
Fleming-Dutra, Katherine E
Chea, Nora
Lee, Jane E
Kellogg, Melissa
Edmundson, Alexandra
Britton, Amber
Wilson, Lucy E
Lovett, Sara A
Ocampo, Valerie
Markus, Tiffanie M
Smithline, Howard A
Hou, Peter C
Lee, Lilly C
Mower, William
Rwamwejo, Fernand
Steele, Mark T
Lim, Stephen C
Schrading, Walter A
Chinnock, Brian
Beiser, David G
Faine, Brett
Haran, John P
Nandi, Utsav
Chipman, Anne K
LoVecchio, Frank
Eucker, Stephanie
Femling, Jon
Fuller, Matthew
Rothman, Richard E
Curlin, Marcel E
Talan, David A
Mohr, Nicholas M
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Faculty Advisor
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UMass Chan Affiliations
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Abstract
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.
Source
Plumb ID, Briggs Hagen M, Wiegand R, Dumyati G, Myers C, Harland KK, Krishnadasan A, James Gist J, Abedi G, Fleming-Dutra KE, Chea N, Lee JE, Kellogg M, Edmundson A, Britton A, Wilson LE, Lovett SA, Ocampo V, Markus TM, Smithline HA, Hou PC, Lee LC, Mower W, Rwamwejo F, Steele MT, Lim SC, Schrading WA, Chinnock B, Beiser DG, Faine B, Haran JP, Nandi U, Chipman AK, LoVecchio F, Eucker S, Femling J, Fuller M, Rothman RE, Curlin ME, Talan DA, Mohr NM; Vaccine Effectiveness among Healthcare Personnel Study Team. Effectiveness of a bivalent mRNA vaccine dose against symptomatic SARS-CoV-2 infection among U.S. Healthcare personnel, September 2022-May 2023. Vaccine. 2023 Nov 14:S0264-410X(23)01287-2. doi: 10.1016/j.vaccine.2023.10.072. Epub ahead of print. PMID: 37973512.