Effectiveness of the Ad26.COV2.S (Johnson & Johnson) Coronavirus Disease 2019 (COVID-19) Vaccine for Preventing COVID-19 Hospitalizations and Progression to High Disease Severity in the United States

Author:

Lewis Nathaniel M1ORCID,Self Wesley H2,Gaglani Manjusha34,Ginde Adit A5,Douin David J5,Keipp Talbot H2,Casey Jonathan D2,Mohr Nicholas M6,Zepeski Anne6,Ghamande Shekhar A3,McNeal Tresa A3,Shapiro Nathan I7,Gibbs Kevin W8,Files D Clark8,Hager David N9,Shehu Arber9,Prekker Matthew E10,Erickson Heidi L10,Gong Michelle N11,Mohamed Amira11,Johnson Nicholas J12,Srinivasan Vasisht12,Steingrub Jay S13,Peltan Ithan D14,Brown Samuel M14,Martin Emily T15,Monto Arnold S15,Khan Akram15,Busse Laurence W16,Lohuis Caitlin C ten16,Duggal Abhijit17,Wilson Jennifer G18,Gordon Alexandra June18,Qadir Nida19,Chang Steven Y19,Mallow Christopher20,Rivas Carolina20,Babcock Hilary M21,Kwon Jennie H21,Exline Matthew C22,Lauring Adam S23,Halasa Natasha2,Chappell James D2,Grijalva Carlos G2,Rice Todd W2,Rhoads Jillian P2,Jones Ian D2,Stubblefield William B2,Baughman Adrienne2,Womack Kelsey N2,Lindsell Christopher J2,Hart Kimberly W2,Zhu Yuwei2,Adams Katherine1,Patel Manish M1,Tenforde Mark W1,

Affiliation:

1. Centers for Disease Control and Prevention (CDC) COVID-19 Response Team , Atlanta, Georgia , USA

2. Vanderbilt University Medical Center , Nashville, Tennessee , USA

3. Baylor Scott & White Health , Temple, Texas , USA

4. Texas A&M University College of Medicine , Temple, Texas , USA

5. School of Medicine, University of Colorado , Aurora, Colorado , USA

6. University of Iowa , Iowa City, Iowa , USA

7. Beth Israel Deaconess Medical Center , Boston, Massachusetts , USA

8. Wake Forest University Baptist Medical Center , Winston-Salem, North Carolina , USA

9. Johns Hopkins Hospital , Baltimore, Maryland , USA

10. Hennepin County Medical Center , Minneapolis, Minnesota , USA

11. Montefiore Healthcare Center, Albert Einstein College of Medicine , Bronx, New York , USA

12. University of Washington School of Medicine , Seattle, Washington , USA

13. Baystate Medical Center , Springfield, Massachusetts , USA

14. Intermountain Medical Center and University of Utah , Salt Lake City, Utah , USA

15. School of Public Health, University of Michigan , Ann Arbor, Michigan , USA

16. Emory University School of Medicine , Atlanta, Georgia , USA

17. Cleveland Clinic , Cleveland, Ohio , USA

18. Stanford University School of Medicine , Palo Alto, California , USA

19. David Geffen School of Medicine at UCLA, Ronald Reagan-UCLA Medical Center , Los Angeles, California , USA

20. University of Miami , Miami, Florida , USA

21. Washington University , St. Louis, Missouri , USA

22. Ohio State University Wexner Medical Center , Columbus, Ohio , USA

23. School of Medicine, University of Michigan , Ann Arbor, Michigan , USA

Abstract

Abstract Background . Adults in the United States (US) began receiving the adenovirus vector coronavirus disease 2019 (COVID-19) vaccine, Ad26.COV2.S (Johnson & Johnson [Janssen]), in February 2021. We evaluated Ad26.COV2.S vaccine effectiveness (VE) against COVID-19 hospitalization and high disease severity during the first 10 months of its use. Methods . In a multicenter case-control analysis of US adults (≥18 years) hospitalized 11 March to 15 December 2021, we estimated VE against susceptibility to COVID-19 hospitalization (VEs), comparing odds of prior vaccination with a single dose Ad26.COV2.S vaccine between hospitalized cases with COVID-19 and controls without COVID-19. Among hospitalized patients with COVID-19, we estimated VE against disease progression (VEp) to death or invasive mechanical ventilation (IMV), comparing odds of prior vaccination between patients with and without progression. Results . After excluding patients receiving mRNA vaccines, among 3979 COVID-19 case-patients (5% vaccinated with Ad26.COV2.S) and 2229 controls (13% vaccinated with Ad26.COV2.S), VEs of Ad26.COV2.S against COVID-19 hospitalization was 70% (95% confidence interval [CI]: 63–75%) overall, including 55% (29–72%) among immunocompromised patients, and 72% (64–77%) among immunocompetent patients, for whom VEs was similar at 14–90 days (73% [59–82%]), 91–180 days (71% [60–80%]), and 181–274 days (70% [54–81%]) postvaccination. Among hospitalized COVID-19 case-patients, VEp was 46% (18–65%) among immunocompetent patients. Conclusions . The Ad26.COV2.S COVID-19 vaccine reduced the risk of COVID-19 hospitalization by 72% among immunocompetent adults without waning through 6 months postvaccination. After hospitalization for COVID-19, vaccinated immunocompetent patients were less likely to require IMV or die compared to unvaccinated immunocompetent patients.

Funder

Centers for Disease Control and Prevention

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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