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Front Immunol . XBB.1.5 mRNA COVID-19 vaccine protection against inpatient or emergency department visits among adults infected with SARS-CoV-2 JN.

tetano

Editor, Senior Moderator
Front Immunol


. 2025 Feb 17:16:1470609.
doi: 10.3389/fimmu.2025.1470609. eCollection 2025. XBB.1.5 mRNA COVID-19 vaccine protection against inpatient or emergency department visits among adults infected with SARS-CoV-2 JN.1 and XBB-lineage variants

Matthew E Levy[SUP] 1 [/SUP], Vanessa Chilunda[SUP] 1 [/SUP], Phillip R Heaton[SUP] 2 [/SUP], Deran McKeen[SUP] 3 [/SUP], Jason D Goldman[SUP] 4 5 [/SUP], Richard E Davis[SUP] 6 [/SUP], Cynthia A Schandl[SUP] 7 [/SUP], William B Glen[SUP] 7 [/SUP], Lisa M McEwen[SUP] 1 [/SUP], Elizabeth T Cirulli[SUP] 1 [/SUP], Dana Wyman[SUP] 1 [/SUP], Andrew Dei Rossi[SUP] 1 [/SUP], Hang Dai[SUP] 1 [/SUP], Magnus Isaksson[SUP] 1 [/SUP], Nicole L Washington[SUP] 1 [/SUP], Tracy Basler[SUP] 1 [/SUP], Kevin Tsan[SUP] 1 [/SUP], Jason Nguyen[SUP] 1 [/SUP], Jimmy Ramirez[SUP] 1 [/SUP], Efren Sandoval[SUP] 1 [/SUP], William Lee[SUP] 1 [/SUP], James Lu[SUP] 1 [/SUP], Shishi Luo[SUP] 1 [/SUP]



Affiliations
Abstract

As part of a multi-state viral genomic surveillance program, we conducted a case-only analysis to evaluate the effectiveness of XBB.1.5-adapated mRNA vaccines in preventing severe illness among individuals with medically attended SARS-CoV-2 infection. We compared prior receipt of an XBB.1.5-adapted mRNA vaccine between SARS-CoV-2-infected adults with inpatient or emergency department (ED) visits (as a proxy for severe illness) vs those with outpatient visits (as a proxy for mild illness). Among 6,551 patients between September 2023 and January 2024, 6.1% with inpatient or ED visits vs 12.0% with outpatient visits had received XBB.1.5 vaccination (adjusted odds ratio [aOR]=0.41; 95% confidence interval [CI]: 0.32-0.53). This protective association was weaker among JN.1 (aOR=0.62; 95% CI: 0.40-0.96) vs XBB-lineage (aOR=0.28; 95% CI: 0.18-0.43) variant infections (interaction, p=0.003). XBB.1.5 vaccines protect against severe illness, but protection may be weaker against JN.1 vs XBB-lineage variants. This study highlights the need for COVID-19 vaccines to be routinely updated to align with circulating strains and for individuals to stay up to date with recommended vaccines.

Keywords: COVID-19 vaccines; SARS-COV-2 variants; emergency room visits; epidemiology; hospitalization.

 
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