Effectiveness of a Messenger RNA Vaccine Booster Dose Against Coronavirus Disease 2019 Among US Healthcare Personnel, October 2021–July 2022

Author:

Plumb Ian D1ORCID,Mohr Nicholas M2,Hagen Melissa1,Wiegand Ryan1,Dumyati Ghinwa3ORCID,Harland Karisa K2ORCID,Krishnadasan Anusha4,Gist Jade James1,Abedi Glen1,Fleming-Dutra Katherine E1ORCID,Chea Nora5,Lee Jane6,Barter Devra7,Brackney Monica8,Fridkin Scott K9,Wilson Lucy E10,Lovett Sara A11,Ocampo Valerie12,Phipps Erin C13,Marcus Tiffanie M14,Smithline Howard A15,Hou Peter C16,Lee Lilly C17,Moran Gregory J18,Krebs Elizabeth19,Steele Mark T20,Lim Stephen C21,Schrading Walter A22,Chinnock Brian23,Beiser David G24,Faine Brett2,Haran John P25,Nandi Utsav26,Chipman Anne K27,LoVecchio Frank28,Talan David A18ORCID,Pilishvili Tamara1

Affiliation:

1. National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA

2. Department of Emergency Medicine, University of Iowa , Iowa City, Iowa , USA

3. New York State Emerging Infections Program, University of Rochester Medical Center , Rochester, New York , USA

4. Department of Emergency Medicine, Olive View–UCLA Education and Research Institute , Los Angeles, California , USA

5. National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA

6. Healthcare-Associated Infections, California Emerging Infections Program , Oakland, California , USA

7. Healthcare-associated Infections / Antimicrobial Resistance Program, Colorado Department of Public Health & Environment , Denver, Colorado , USA

8. Connecticut Emerging Infections Program, Yale School of Public Health , New Haven, Connecticut , USA

9. Georgia Emerging Infections Program and Emory University School of Medicine , Atlanta, Georgia , USA

10. Maryland Emerging Infections Program, Maryland Department of Health, and University of Maryland, Baltimore County, Baltimore, Maryland , USA

11. Infectious Disease Epidemiology, Prevention and Control Divison, Minnesota Department of Health , St. Paul, Minnesota , USA

12. Public Health Division, Oregon Health Authority , Portland, Oregon , USA

13. New Mexico Emerging Infections Program, University of New Mexico , Albuquerque, New Mexico , USA

14. Department of Health Policy, Vanderbilt University Medical Center , Nashville, Tennessee , USA

15. Department of Emergency Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield, Massachusetts , USA

16. Department of Emergency Medicine, Brigham and Women's Hospital , Boston, Massachusetts , USA

17. Emergency Medicine, Jackson Memorial Hospital , Miami, Florida , USA

18. David Geffen School of Medicine, UCLA , Los Angeles, California , USA

19. Emergency Medicine, Thomas Jefferson University Hospital , Philadelphia, Pennsylvania , USA

20. Department of Emergency Medicine, University of Missouri–Kansas City , Kansas City, Missouri , USA

21. Section of Emergency Medicine, University Medical Center New Orleans, LSU Health Sciences Center , New Orleans, Louisiana , USA

22. Department of Emergency Medicine, University of Alabama at Birmingham , Birmingham, Alabama , USA

23. Department of Emergency Medicine, University of California San Francisco , Fresno, California , USA

24. Section of Emergency Medicine, University of Chicago , Chicago, Illinois , USA

25. Department of Emergency Medicine, University of Massachusetts Chan Medical School , Worcester, Massachusetts , USA

26. Department of Emergency Medicine, University of Mississippi Medical Center , Jackson, Mississippi , USA

27. Emergency Department, University of Washington , Seattle, Washington , USA

28. Emergency Medicine, Valleywise Health Medical Center , Phoenix, Arizona , USA

Abstract

Abstract Background Protection against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease 2019 [COVID-19]) can limit transmission and the risk of post-COVID conditions, and is particularly important among healthcare personnel. However, lower vaccine effectiveness (VE) has been reported since predominance of the Omicron SARS-CoV-2 variant. Methods We evaluated the VE of a monovalent messenger RNA (mRNA) booster dose against COVID-19 from October 2021 to June 2022 among US healthcare personnel. After matching case-participants with COVID-19 to control-participants by 2-week period and site, we used conditional logistic regression to estimate the VE of a booster dose compared with completing only 2 mRNA doses >150 days previously, adjusted for multiple covariates. Results Among 3279 case-participants and 3998 control-participants who had completed 2 mRNA doses, we estimated that the VE of a booster dose against COVID-19 declined from 86% (95% confidence interval, 81%–90%) during Delta predominance to 65% (58%–70%) during Omicron predominance. During Omicron predominance, VE declined from 73% (95% confidence interval, 67%–79%) 14–60 days after the booster dose, to 32% (4%–52%) ≥120 days after a booster dose. We found that VE was similar by age group, presence of underlying health conditions, and pregnancy status on the test date, as well as among immunocompromised participants. Conclusions A booster dose conferred substantial protection against COVID-19 among healthcare personnel. However, VE was lower during Omicron predominance, and waning effectiveness was observed 4 months after booster dose receipt during this period. Our findings support recommendations to stay up to date on recommended doses of COVID-19 vaccines for all those eligible.

Funder

Centers for Disease Control and Prevention

Institute for Clinical and Translational Science

University of Iowa

National Center for Advancing Translational Sciences

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

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