tetano
Editor, Senior Moderator
Am J Emerg Med
. 2022 Feb 3;54:97-101.
doi: 10.1016/j.ajem.2022.01.066. Online ahead of print.
Real world SARS-COV-2 vaccine effectiveness in a Miami academic institution
Christopher Mallow[SUP] 1 [/SUP], Tanira Ferreira[SUP] 2 [/SUP], Bhavarth Shukla[SUP] 3 [/SUP], Prem Warde[SUP] 4 [/SUP], Marie Anne Sosa[SUP] 5 [/SUP], Dipen J Parekh[SUP] 6 [/SUP], Hayley B Gershengorn[SUP] 2 [/SUP]
Affiliations
Abstract
Background: To assess the effectiveness of messenger RNA vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) in preventing emergency department (ED) presentations for acute respiratory illness.
Basic procedures: We conducted a retrospective study assessing adult presentations (age ≥ 18) to the University of Miami Hospital's ED from January 1st through August 25th, 2021, with a SARS-COV-2 PCR test and acute respiratory infection symptoms. Vaccine effectiveness was calculated using a test-negative design. Both univariable and multivariable (adjusted for age, gender, race, insurance status, imputed body mass index [BMI], vaccine type, week of presentation) regression analyses were conducted for the full cohort and subgroups.
Main findings: The cohort consisted of 13,203 ED presentations-3134 (23.7%) fully vaccinated and SARS-COV-2 negative, 108 (0.8%) fully vaccinated and SARS-COV-2 positive, 8817 (66.8%) unvaccinated and SARS-COV-2 negative, and 1144 (8.7%) unvaccinated and SARS-COV-2 positive. Unadjusted vaccination effectiveness was 73.4% (95% confidence interval: 67.5%,78.3%) and, after adjustment, 73.8% (66.2%,79.7%). The Moderna vaccine's effectiveness was numerically higher (unadjusted: 78.2% [68.8%, 84.7%]; adjusted: 78.0% [68.1%, 84.9%]) than the Pfizer vaccine's (unadjusted: 70.8% [62.9%, 76.9%]; adjusted: 73.9% [66.3%,79.8%]). We found a significant difference in adjusted vaccine effectiveness across categories was BMI (p < 0.001)-BMI <25: 66.3% (45.3%,79.2%); BMI 25-29: 71.3% (56.1%, 81.2%); BMI 30-34: 84.5% (71.7%, 91.5%); and BMI ≥35: 72.7% (50.5%, 84.9%).
Principal conclusions: We demonstrated excellent real-world effectiveness of mRNA vaccines in preventing ED presentation for SARS-COV-2 in a diverse U.S. cohort. Notably, vaccine effectiveness improved with increasing BMI (until class 2 obesity).
Keywords: COVID-19; Emergency medicine; Vaccines.
. 2022 Feb 3;54:97-101.
doi: 10.1016/j.ajem.2022.01.066. Online ahead of print.
Real world SARS-COV-2 vaccine effectiveness in a Miami academic institution
Christopher Mallow[SUP] 1 [/SUP], Tanira Ferreira[SUP] 2 [/SUP], Bhavarth Shukla[SUP] 3 [/SUP], Prem Warde[SUP] 4 [/SUP], Marie Anne Sosa[SUP] 5 [/SUP], Dipen J Parekh[SUP] 6 [/SUP], Hayley B Gershengorn[SUP] 2 [/SUP]
Affiliations
- PMID: 35151018
- DOI: 10.1016/j.ajem.2022.01.066
Abstract
Background: To assess the effectiveness of messenger RNA vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) in preventing emergency department (ED) presentations for acute respiratory illness.
Basic procedures: We conducted a retrospective study assessing adult presentations (age ≥ 18) to the University of Miami Hospital's ED from January 1st through August 25th, 2021, with a SARS-COV-2 PCR test and acute respiratory infection symptoms. Vaccine effectiveness was calculated using a test-negative design. Both univariable and multivariable (adjusted for age, gender, race, insurance status, imputed body mass index [BMI], vaccine type, week of presentation) regression analyses were conducted for the full cohort and subgroups.
Main findings: The cohort consisted of 13,203 ED presentations-3134 (23.7%) fully vaccinated and SARS-COV-2 negative, 108 (0.8%) fully vaccinated and SARS-COV-2 positive, 8817 (66.8%) unvaccinated and SARS-COV-2 negative, and 1144 (8.7%) unvaccinated and SARS-COV-2 positive. Unadjusted vaccination effectiveness was 73.4% (95% confidence interval: 67.5%,78.3%) and, after adjustment, 73.8% (66.2%,79.7%). The Moderna vaccine's effectiveness was numerically higher (unadjusted: 78.2% [68.8%, 84.7%]; adjusted: 78.0% [68.1%, 84.9%]) than the Pfizer vaccine's (unadjusted: 70.8% [62.9%, 76.9%]; adjusted: 73.9% [66.3%,79.8%]). We found a significant difference in adjusted vaccine effectiveness across categories was BMI (p < 0.001)-BMI <25: 66.3% (45.3%,79.2%); BMI 25-29: 71.3% (56.1%, 81.2%); BMI 30-34: 84.5% (71.7%, 91.5%); and BMI ≥35: 72.7% (50.5%, 84.9%).
Principal conclusions: We demonstrated excellent real-world effectiveness of mRNA vaccines in preventing ED presentation for SARS-COV-2 in a diverse U.S. cohort. Notably, vaccine effectiveness improved with increasing BMI (until class 2 obesity).
Keywords: COVID-19; Emergency medicine; Vaccines.