Protection of Messenger RNA Vaccines Against Hospitalized Coronavirus Disease 2019 in Adults Over the First Year Following Authorization in the United States

Mark W. Tenforde; Wesley H. Self; Yuwei Zhu; Eric A. Naioti; Manjusha Gaglani; Adit A. Ginde; Kelly Jensen; H. Keipp Talbot; Jonathan D. Casey; Nicholas M. Mohr; Anne Zepeski; Tresa McNeal; Shekhar Ghamande; Kevin W. Gibbs; D. Clark Files; David N. Hager; Arber Shehu; Matthew E. Prekker; Heidi L. Erickson; Michelle N. Gong; Amira Mohamed; Nicholas J. Johnson; Vasisht Srinivasan; Jay S. Steingrub; Ithan D. Peltan; Samuel M. Brown; Emily T. Martin; Arnold S. Monto; Akram Khan; Catherine L. Hough; Laurence W. Busse; Caitlin Ten Lohuis; Abhijit Duggal; Jennifer G. Wilson; Nida Qadir; Steven Y. Chang; Christopher Mallow; Carolina Rivas; Hilary M. Babcock; Jennie H. Kwon; Matthew C. Exline; Mena M. Botros; Adam S. Lauring; Nathan I. Shapiro; Natasha Halasa; James D. Chappell; Carlos G. Grijalva; Todd W. Rice; Ian D. Jones; William B. Stubblefield; Adrienne Baughman; Kelsey N. Womack; Jillian P. Rhoads; Christopher J. Lindsell; Kimberly W. Hart; Caitlin Turbyfill; Samantha Olson; Nancy Murray; Katherine Adams; Manish M. Patel

doi:10.1093/cid/ciac381

Protection of Messenger RNA Vaccines Against Hospitalized Coronavirus Disease 2019 in Adults Over the First Year Following Authorization in the United States

Mark W. Tenforde, Wesley H. Self, Yuwei Zhu, Eric A. Naioti, Manjusha Gaglani, Adit A. Ginde, Kelly Jensen, H. Keipp Talbot, Jonathan D. Casey, Nicholas M. Mohr, Anne Zepeski, Tresa McNeal, Shekhar Ghamande, Kevin W. Gibbs, D. Clark Files, David N. Hager, Arber Shehu, Matthew E. Prekker, Heidi L. Erickson, Michelle N. GongAmira Mohamed, Nicholas J. Johnson, Vasisht Srinivasan, Jay S. Steingrub, Ithan D. Peltan, Samuel M. Brown, Emily T. Martin, Arnold S. Monto, Akram Khan, Catherine L. Hough, Laurence W. Busse, Caitlin Ten Lohuis, Abhijit Duggal, Jennifer G. Wilson, Nida Qadir, Steven Y. Chang, Christopher Mallow, Carolina Rivas, Hilary M. Babcock, Jennie H. Kwon, Matthew C. Exline, Mena M. Botros, Adam S. Lauring, Nathan I. Shapiro, Natasha Halasa, James D. Chappell, Carlos G. Grijalva, Todd W. Rice, Ian D. Jones, William B. Stubblefield, Adrienne Baughman, Kelsey N. Womack, Jillian P. Rhoads, Christopher J. Lindsell, Kimberly W. Hart, Caitlin Turbyfill, Samantha Olson, Nancy Murray, Katherine Adams, Manish M. Patel

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines were authorized in the United States in December 2020. Although vaccine effectiveness (VE) against mild infection declines markedly after several months, limited understanding exists on the long-term durability of protection against COVID-19-associated hospitalization. Methods: Case-control analysis of adults (≥18 years) hospitalized at 21 hospitals in 18 states 11 March-15 December 2021, including COVID-19 case patients and reverse transcriptase-polymerase chain reaction-negative controls. We included adults who were unvaccinated or vaccinated with 2 doses of a mRNA vaccine before the date of illness onset. VE over time was assessed using logistic regression comparing odds of vaccination in cases versus controls, adjusting for confounders. Models included dichotomous time (<180 vs ≥180 days since dose 2) and continuous time modeled using restricted cubic splines. Results: A total of 10 078 patients were included, 4906 cases (23% vaccinated) and 5172 controls (62% vaccinated). Median age was 60 years (interquartile range, 46-70), 56% were non-Hispanic White, and 81% had ≥1 medical condition. Among immunocompetent adults, VE <180 days was 90% (95% confidence interval [CI], 88-91) versus 82% (95% CI, 79-85) at ≥180 days (P <. 001). VE declined for Pfizer-BioNTech (88% to 79%, P <. 001) and Moderna (93% to 87%, P <. 001) products, for younger adults (18-64 years) (91% to 87%, P =. 005), and for adults ≥65 years of age (87% to 78%, P <. 001). In models using restricted cubic splines, similar changes were observed. Conclusions: In a period largely predating Omicron variant circulation, effectiveness of 2 mRNA doses against COVID-19-associated hospitalization was largely sustained through 9 months.

Original language	English (US)
Pages (from-to)	E460-E468
Journal	Clinical Infectious Diseases
Volume	76
Issue number	3
DOIs	https://doi.org/10.1093/cid/ciac381
State	Published - Feb 1 2023

Keywords

COVID-19
duration of protection
mRNA
vaccine effectiveness
waning

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

Access to Document

10.1093/cid/ciac381

Cite this

Tenforde, M. W., Self, W. H., Zhu, Y., Naioti, E. A., Gaglani, M., Ginde, A. A., Jensen, K., Keipp Talbot, H., Casey, J. D., Mohr, N. M., Zepeski, A., McNeal, T., Ghamande, S., Gibbs, K. W., Files, D. C., Hager, D. N., Shehu, A., Prekker, M. E., Erickson, H. L., ... Patel, M. M. (2023). Protection of Messenger RNA Vaccines Against Hospitalized Coronavirus Disease 2019 in Adults Over the First Year Following Authorization in the United States. Clinical Infectious Diseases, 76(3), E460-E468. https://doi.org/10.1093/cid/ciac381

Tenforde, MW, Self, WH, Zhu, Y, Naioti, EA, Gaglani, M, Ginde, AA, Jensen, K, Keipp Talbot, H, Casey, JD, Mohr, NM, Zepeski, A, McNeal, T, Ghamande, S, Gibbs, KW, Files, DC, Hager, DN, Shehu, A, Prekker, ME, Erickson, HL, Gong, MN, Mohamed, A, Johnson, NJ, Srinivasan, V, Steingrub, JS, Peltan, ID, Brown, SM, Martin, ET, Monto, AS, Khan, A, Hough, CL, Busse, LW, Lohuis, CT, Duggal, A, Wilson, JG, Qadir, N, Chang, SY, Mallow, C, Rivas, C, Babcock, HM, Kwon, JH, Exline, MC, Botros, MM, Lauring, AS, Shapiro, NI, Halasa, N, Chappell, JD, Grijalva, CG, Rice, TW, Jones, ID, Stubblefield, WB, Baughman, A, Womack, KN, Rhoads, JP, Lindsell, CJ, Hart, KW, Turbyfill, C, Olson, S, Murray, N, Adams, K & Patel, MM 2023, 'Protection of Messenger RNA Vaccines Against Hospitalized Coronavirus Disease 2019 in Adults Over the First Year Following Authorization in the United States', Clinical Infectious Diseases, vol. 76, no. 3, pp. E460-E468. https://doi.org/10.1093/cid/ciac381

@article{550cb0668831416bb341805c35ce76ad,

title = "Protection of Messenger RNA Vaccines Against Hospitalized Coronavirus Disease 2019 in Adults Over the First Year Following Authorization in the United States",

abstract = "Background: Coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines were authorized in the United States in December 2020. Although vaccine effectiveness (VE) against mild infection declines markedly after several months, limited understanding exists on the long-term durability of protection against COVID-19-associated hospitalization. Methods: Case-control analysis of adults (≥18 years) hospitalized at 21 hospitals in 18 states 11 March-15 December 2021, including COVID-19 case patients and reverse transcriptase-polymerase chain reaction-negative controls. We included adults who were unvaccinated or vaccinated with 2 doses of a mRNA vaccine before the date of illness onset. VE over time was assessed using logistic regression comparing odds of vaccination in cases versus controls, adjusting for confounders. Models included dichotomous time (<180 vs ≥180 days since dose 2) and continuous time modeled using restricted cubic splines. Results: A total of 10 078 patients were included, 4906 cases (23% vaccinated) and 5172 controls (62% vaccinated). Median age was 60 years (interquartile range, 46-70), 56% were non-Hispanic White, and 81% had ≥1 medical condition. Among immunocompetent adults, VE <180 days was 90% (95% confidence interval [CI], 88-91) versus 82% (95% CI, 79-85) at ≥180 days (P <. 001). VE declined for Pfizer-BioNTech (88% to 79%, P <. 001) and Moderna (93% to 87%, P <. 001) products, for younger adults (18-64 years) (91% to 87%, P =. 005), and for adults ≥65 years of age (87% to 78%, P <. 001). In models using restricted cubic splines, similar changes were observed. Conclusions: In a period largely predating Omicron variant circulation, effectiveness of 2 mRNA doses against COVID-19-associated hospitalization was largely sustained through 9 months.",

keywords = "COVID-19, duration of protection, mRNA, vaccine effectiveness, waning",

author = "Tenforde, {Mark W.} and Self, {Wesley H.} and Yuwei Zhu and Naioti, {Eric A.} and Manjusha Gaglani and Ginde, {Adit A.} and Kelly Jensen and {Keipp Talbot}, H. and Casey, {Jonathan D.} and Mohr, {Nicholas M.} and Anne Zepeski and Tresa McNeal and Shekhar Ghamande and Gibbs, {Kevin W.} and Files, {D. Clark} and Hager, {David N.} and Arber Shehu and Prekker, {Matthew E.} and Erickson, {Heidi L.} and Gong, {Michelle N.} and Amira Mohamed and Johnson, {Nicholas J.} and Vasisht Srinivasan and Steingrub, {Jay S.} and Peltan, {Ithan D.} and Brown, {Samuel M.} and Martin, {Emily T.} and Monto, {Arnold S.} and Akram Khan and Hough, {Catherine L.} and Busse, {Laurence W.} and Lohuis, {Caitlin Ten} and Abhijit Duggal and Wilson, {Jennifer G.} and Nida Qadir and Chang, {Steven Y.} and Christopher Mallow and Carolina Rivas and Babcock, {Hilary M.} and Kwon, {Jennie H.} and Exline, {Matthew C.} and Botros, {Mena M.} and Lauring, {Adam S.} and Shapiro, {Nathan I.} and Natasha Halasa and Chappell, {James D.} and Grijalva, {Carlos G.} and Rice, {Todd W.} and Jones, {Ian D.} and Stubblefield, {William B.} and Adrienne Baughman and Womack, {Kelsey N.} and Rhoads, {Jillian P.} and Lindsell, {Christopher J.} and Hart, {Kimberly W.} and Caitlin Turbyfill and Samantha Olson and Nancy Murray and Katherine Adams and Patel, {Manish M.}",

note = "Publisher Copyright: {\textcopyright} 2022 Published by Oxford University Press on behalf of the Infectious Diseases Society of America.",

year = "2023",

month = feb,

day = "1",

doi = "10.1093/cid/ciac381",

language = "English (US)",

volume = "76",

pages = "E460--E468",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "3",

}

TY - JOUR

T1 - Protection of Messenger RNA Vaccines Against Hospitalized Coronavirus Disease 2019 in Adults Over the First Year Following Authorization in the United States

AU - Tenforde, Mark W.

AU - Self, Wesley H.

AU - Zhu, Yuwei

AU - Naioti, Eric A.

AU - Gaglani, Manjusha

AU - Ginde, Adit A.

AU - Jensen, Kelly

AU - Keipp Talbot, H.

AU - Casey, Jonathan D.

AU - Mohr, Nicholas M.

AU - Zepeski, Anne

AU - McNeal, Tresa

AU - Ghamande, Shekhar

AU - Gibbs, Kevin W.

AU - Files, D. Clark

AU - Hager, David N.

AU - Shehu, Arber

AU - Prekker, Matthew E.

AU - Erickson, Heidi L.

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 - Khan, Akram

AU - Hough, Catherine L.

AU - Busse, Laurence W.

AU - Lohuis, Caitlin Ten

AU - Duggal, Abhijit

AU - Wilson, Jennifer G.

AU - Qadir, Nida

AU - Chang, Steven Y.

AU - Mallow, Christopher

AU - Rivas, Carolina

AU - Babcock, Hilary M.

AU - Kwon, Jennie H.

AU - Exline, Matthew C.

AU - Botros, Mena M.

AU - Lauring, Adam S.

AU - Shapiro, Nathan I.

AU - Halasa, Natasha

AU - Chappell, James D.

AU - Grijalva, Carlos G.

AU - Rice, Todd W.

AU - Jones, Ian D.

AU - Stubblefield, William B.

AU - Baughman, Adrienne

AU - Womack, Kelsey N.

AU - Rhoads, Jillian P.

AU - Lindsell, Christopher J.

AU - Hart, Kimberly W.

AU - Turbyfill, Caitlin

AU - Olson, Samantha

AU - Murray, Nancy

AU - Adams, Katherine

AU - Patel, Manish M.

PY - 2023/2/1

Y1 - 2023/2/1

N2 - Background: Coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines were authorized in the United States in December 2020. Although vaccine effectiveness (VE) against mild infection declines markedly after several months, limited understanding exists on the long-term durability of protection against COVID-19-associated hospitalization. Methods: Case-control analysis of adults (≥18 years) hospitalized at 21 hospitals in 18 states 11 March-15 December 2021, including COVID-19 case patients and reverse transcriptase-polymerase chain reaction-negative controls. We included adults who were unvaccinated or vaccinated with 2 doses of a mRNA vaccine before the date of illness onset. VE over time was assessed using logistic regression comparing odds of vaccination in cases versus controls, adjusting for confounders. Models included dichotomous time (<180 vs ≥180 days since dose 2) and continuous time modeled using restricted cubic splines. Results: A total of 10 078 patients were included, 4906 cases (23% vaccinated) and 5172 controls (62% vaccinated). Median age was 60 years (interquartile range, 46-70), 56% were non-Hispanic White, and 81% had ≥1 medical condition. Among immunocompetent adults, VE <180 days was 90% (95% confidence interval [CI], 88-91) versus 82% (95% CI, 79-85) at ≥180 days (P <. 001). VE declined for Pfizer-BioNTech (88% to 79%, P <. 001) and Moderna (93% to 87%, P <. 001) products, for younger adults (18-64 years) (91% to 87%, P =. 005), and for adults ≥65 years of age (87% to 78%, P <. 001). In models using restricted cubic splines, similar changes were observed. Conclusions: In a period largely predating Omicron variant circulation, effectiveness of 2 mRNA doses against COVID-19-associated hospitalization was largely sustained through 9 months.

AB - Background: Coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines were authorized in the United States in December 2020. Although vaccine effectiveness (VE) against mild infection declines markedly after several months, limited understanding exists on the long-term durability of protection against COVID-19-associated hospitalization. Methods: Case-control analysis of adults (≥18 years) hospitalized at 21 hospitals in 18 states 11 March-15 December 2021, including COVID-19 case patients and reverse transcriptase-polymerase chain reaction-negative controls. We included adults who were unvaccinated or vaccinated with 2 doses of a mRNA vaccine before the date of illness onset. VE over time was assessed using logistic regression comparing odds of vaccination in cases versus controls, adjusting for confounders. Models included dichotomous time (<180 vs ≥180 days since dose 2) and continuous time modeled using restricted cubic splines. Results: A total of 10 078 patients were included, 4906 cases (23% vaccinated) and 5172 controls (62% vaccinated). Median age was 60 years (interquartile range, 46-70), 56% were non-Hispanic White, and 81% had ≥1 medical condition. Among immunocompetent adults, VE <180 days was 90% (95% confidence interval [CI], 88-91) versus 82% (95% CI, 79-85) at ≥180 days (P <. 001). VE declined for Pfizer-BioNTech (88% to 79%, P <. 001) and Moderna (93% to 87%, P <. 001) products, for younger adults (18-64 years) (91% to 87%, P =. 005), and for adults ≥65 years of age (87% to 78%, P <. 001). In models using restricted cubic splines, similar changes were observed. Conclusions: In a period largely predating Omicron variant circulation, effectiveness of 2 mRNA doses against COVID-19-associated hospitalization was largely sustained through 9 months.

KW - COVID-19

KW - duration of protection

KW - mRNA

KW - vaccine effectiveness

KW - waning

UR - http://www.scopus.com/inward/record.url?scp=85147783273&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85147783273&partnerID=8YFLogxK

U2 - 10.1093/cid/ciac381

DO - 10.1093/cid/ciac381

M3 - Article

C2 - 35580849

AN - SCOPUS:85147783273

SN - 1058-4838

VL - 76

SP - E460-E468

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 3

ER -

Protection of Messenger RNA Vaccines Against Hospitalized Coronavirus Disease 2019 in Adults Over the First Year Following Authorization in the United States

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this