tetano
Editor, Senior Moderator
BMC Med
. 2024 Jun 5;22(1):227.
doi: 10.1186/s12916-024-03444-6. How effective is the BNT162b2 mRNA vaccine against SARS-CoV-2 transmission and infection? A national programme analysis in Monaco, July 2021 to September 2022
Thomas Althaus[SUP] #[/SUP][SUP] 1 [/SUP], Christopher E Overton[SUP] #[/SUP][SUP] 2 3 [/SUP], Isabelle Devaux[SUP] 4 [/SUP], Thomas House[SUP] 5 [/SUP], Arnaud Lapouze[SUP] 6 [/SUP], Alexa Troel[SUP] 7 [/SUP], Bertrand Vanzo[SUP] 7 [/SUP], Margaux Laroche[SUP] 6 [/SUP], Alexandre Bordero[SUP] 6 [/SUP], Pernille Jorgensen[SUP] 4 [/SUP], Richard Pebody[SUP] 4 [/SUP], Eric J Voiglio[SUP] 6 [/SUP]
Affiliations
Background: We quantified SARS-CoV-2 dynamics in different community settings and the direct and indirect effect of the BNT162b2 mRNA vaccine in Monaco for different variants of concern (VOC).
Methods: Between July 2021 and September 2022, we prospectively investigated 20,443 contacts from 6320 index cases using data from the Monaco COVID-19 Public Health Programme. We calculated secondary attack rates (SARs) in households (n = 13,877), schools (n = 2508) and occupational (n = 6499) settings. We used binomial regression with a complementary log-log link function to measure adjusted hazard ratios (aHR) and vaccine effectiveness (aVE) for index cases to infect contacts and contacts to be infected in households.
Results: In households, the SAR was 55% (95% CI 54-57) and 50% (48-51) among unvaccinated and vaccinated contacts, respectively. The SAR was 32% (28-36) and 12% (10-13) in workplaces, and 7% (6-9) and 6% (3-10) in schools, among unvaccinated and vaccinated contacts respectively. In household, the aHR was lower in contacts than in index cases (aHR 0.68 [0.55-0.83] and 0.93 [0.74-1.1] for delta; aHR 0.73 [0.66-0.81] and 0.89 [0.80-0.99] for omicron BA.1&2, respectively). Vaccination had no significant effect on either direct or indirect aVE for omicron BA.4&5. The direct aVE in contacts was 32% (17, 45) and 27% (19, 34), and for index cases the indirect aVE was 7% (- 17, 26) and 11% (1, 20) for delta and omicron BA.1&2, respectively. The greatest aVE was in contacts with a previous SARS-CoV-2 infection and a single vaccine dose during the omicron BA.1&2 period (45% [27, 59]), while the lowest were found in contacts with either three vaccine doses (aVE - 24% [- 63, 6]) or one single dose and a previous SARS-CoV-2 infection (aVE - 36% [- 198, 38]) during the omicron BA.4&5 period.
Conclusions: Protection conferred by the BNT162b2 mRNA vaccine against transmission and infection was low for delta and omicron BA.1&2, regardless of the number of vaccine doses and previous SARS-CoV-2 infection. There was no significant vaccine effect for omicron BA.4&5. Health authorities carrying out vaccination campaigns should bear in mind that the current generation of COVID-19 vaccines may not represent an effective tool in protecting individuals from either transmitting or acquiring SARS-CoV-2 infection.
Keywords: SARS-CoV-2; COVID-19; Vaccine effectiveness; Transmission.
. 2024 Jun 5;22(1):227.
doi: 10.1186/s12916-024-03444-6. How effective is the BNT162b2 mRNA vaccine against SARS-CoV-2 transmission and infection? A national programme analysis in Monaco, July 2021 to September 2022
Thomas Althaus[SUP] #[/SUP][SUP] 1 [/SUP], Christopher E Overton[SUP] #[/SUP][SUP] 2 3 [/SUP], Isabelle Devaux[SUP] 4 [/SUP], Thomas House[SUP] 5 [/SUP], Arnaud Lapouze[SUP] 6 [/SUP], Alexa Troel[SUP] 7 [/SUP], Bertrand Vanzo[SUP] 7 [/SUP], Margaux Laroche[SUP] 6 [/SUP], Alexandre Bordero[SUP] 6 [/SUP], Pernille Jorgensen[SUP] 4 [/SUP], Richard Pebody[SUP] 4 [/SUP], Eric J Voiglio[SUP] 6 [/SUP]
Affiliations
- PMID: 38840159
- DOI: 10.1186/s12916-024-03444-6
Background: We quantified SARS-CoV-2 dynamics in different community settings and the direct and indirect effect of the BNT162b2 mRNA vaccine in Monaco for different variants of concern (VOC).
Methods: Between July 2021 and September 2022, we prospectively investigated 20,443 contacts from 6320 index cases using data from the Monaco COVID-19 Public Health Programme. We calculated secondary attack rates (SARs) in households (n = 13,877), schools (n = 2508) and occupational (n = 6499) settings. We used binomial regression with a complementary log-log link function to measure adjusted hazard ratios (aHR) and vaccine effectiveness (aVE) for index cases to infect contacts and contacts to be infected in households.
Results: In households, the SAR was 55% (95% CI 54-57) and 50% (48-51) among unvaccinated and vaccinated contacts, respectively. The SAR was 32% (28-36) and 12% (10-13) in workplaces, and 7% (6-9) and 6% (3-10) in schools, among unvaccinated and vaccinated contacts respectively. In household, the aHR was lower in contacts than in index cases (aHR 0.68 [0.55-0.83] and 0.93 [0.74-1.1] for delta; aHR 0.73 [0.66-0.81] and 0.89 [0.80-0.99] for omicron BA.1&2, respectively). Vaccination had no significant effect on either direct or indirect aVE for omicron BA.4&5. The direct aVE in contacts was 32% (17, 45) and 27% (19, 34), and for index cases the indirect aVE was 7% (- 17, 26) and 11% (1, 20) for delta and omicron BA.1&2, respectively. The greatest aVE was in contacts with a previous SARS-CoV-2 infection and a single vaccine dose during the omicron BA.1&2 period (45% [27, 59]), while the lowest were found in contacts with either three vaccine doses (aVE - 24% [- 63, 6]) or one single dose and a previous SARS-CoV-2 infection (aVE - 36% [- 198, 38]) during the omicron BA.4&5 period.
Conclusions: Protection conferred by the BNT162b2 mRNA vaccine against transmission and infection was low for delta and omicron BA.1&2, regardless of the number of vaccine doses and previous SARS-CoV-2 infection. There was no significant vaccine effect for omicron BA.4&5. Health authorities carrying out vaccination campaigns should bear in mind that the current generation of COVID-19 vaccines may not represent an effective tool in protecting individuals from either transmitting or acquiring SARS-CoV-2 infection.
Keywords: SARS-CoV-2; COVID-19; Vaccine effectiveness; Transmission.