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Influenza Other Respir Viruses . Effectiveness of Original Monovalent and Bivalent COVID-19 Vaccines Against COVID-19-Associated Hospitalization an

tetano

Editor, Senior Moderator
Influenza Other Respir Viruses


. 2024 Nov;18(11):e70027.
doi: 10.1111/irv.70027. Effectiveness of Original Monovalent and Bivalent COVID-19 Vaccines Against COVID-19-Associated Hospitalization and Severe In-Hospital Outcomes Among Adults in the United States, September 2022-August 2023

Jennifer DeCuir[SUP] 1 [/SUP], Diya Surie[SUP] 1 [/SUP], Yuwei Zhu[SUP] 2 [/SUP], Adam S Lauring[SUP] 3 [/SUP], Manjusha Gaglani[SUP] 4 [/SUP], Tresa McNeal[SUP] 5 [/SUP], Shekhar Ghamande[SUP] 5 [/SUP], Ithan D Peltan[SUP] 6 [/SUP], Samuel M Brown[SUP] 6 [/SUP], Adit A Ginde[SUP] 7 [/SUP], Aimee Steinwand[SUP] 7 [/SUP], Nicholas M Mohr[SUP] 8 [/SUP], Kevin W Gibbs[SUP] 9 [/SUP], David N Hager[SUP] 10 [/SUP], Harith Ali[SUP] 10 [/SUP], Anne Frosch[SUP] 11 [/SUP], Michelle N Gong[SUP] 12 [/SUP], Amira Mohamed[SUP] 12 [/SUP], Nicholas J Johnson[SUP] 13 [/SUP], Vasisht Srinivasan[SUP] 14 [/SUP], Jay S Steingrub[SUP] 15 [/SUP], Akram Khan[SUP] 16 [/SUP], Laurence W Busse[SUP] 17 [/SUP], Abhijit Duggal[SUP] 18 [/SUP], Jennifer G Wilson[SUP] 19 [/SUP], Nida Qadir[SUP] 20 [/SUP], Steven Y Chang[SUP] 20 [/SUP], Christopher Mallow[SUP] 21 [/SUP], Jennie H Kwon[SUP] 22 [/SUP], Matthew C Exline[SUP] 23 [/SUP], Nathan I Shapiro[SUP] 24 [/SUP], Cristie Columbus[SUP] 25 [/SUP], Ivana A Vaughn[SUP] 26 [/SUP], Mayur Ramesh[SUP] 27 [/SUP], Basmah Safdar[SUP] 28 [/SUP], Jarrod M Mosier[SUP] 29 [/SUP], Jonathan D Casey[SUP] 30 [/SUP], H Keipp Talbot[SUP] 31 [/SUP], Todd W Rice[SUP] 30 [/SUP], Natasha Halasa[SUP] 32 [/SUP], James D Chappell[SUP] 32 [/SUP], Carlos G Grijalva[SUP] 33 [/SUP], Adrienne Baughman[SUP] 34 [/SUP], Kelsey N Womack[SUP] 35 [/SUP], Jillian P Rhoads[SUP] 35 [/SUP], Sydney A Swan[SUP] 2 [/SUP], Cassandra Johnson[SUP] 2 [/SUP], Nathaniel Lewis[SUP] 1 [/SUP], Sascha Ellington[SUP] 1 [/SUP], Fatimah S Dawood[SUP] 1 [/SUP], Meredith McMorrow[SUP] 1 [/SUP], Wesley H Self[SUP] 36 [/SUP]; Investigating Respiratory Viruses in the Acutely Ill (IVY) Network



Affiliations
Abstract

Background: Assessments of COVID-19 vaccine effectiveness are needed to monitor the protection provided by updated vaccines against severe COVID-19. We evaluated the effectiveness of original monovalent and bivalent (ancestral strain and Omicron BA.4/5) COVID-19 vaccination against COVID-19-associated hospitalization and severe in-hospital outcomes.
Methods: During September 8, 2022 to August 31, 2023, adults aged ≥ 18 years hospitalized with COVID-19-like illness were enrolled at 26 hospitals in 20 US states. Using a test-negative case-control design, we estimated vaccine effectiveness (VE) with multivariable logistic regression adjusted for age, sex, race/ethnicity, admission date, and geographic region.
Results: Among 7028 patients, 2924 (41.6%) were COVID-19 case patients, and 4104 (58.4%) were control patients. Compared to unvaccinated patients, absolute VE against COVID-19-associated hospitalization was 6% (-7%-17%) for original monovalent doses only (median time since last dose [IQR] = 421 days [304-571]), 52% (39%-61%) for a bivalent dose received 7-89 days earlier, and 13% (-10%-31%) for a bivalent dose received 90-179 days earlier. Absolute VE against COVID-19-associated invasive mechanical ventilation or death was 51% (34%-63%) for original monovalent doses only, 61% (35%-77%) for a bivalent dose received 7-89 days earlier, and 50% (11%-71%) for a bivalent dose received 90-179 days earlier.
Conclusion: Bivalent vaccination provided protection against COVID-19-associated hospitalization and severe in-hospital outcomes within 3 months of receipt, followed by a decline in protection to a level similar to that remaining from previous original monovalent vaccination by 3-6 months. These results underscore the benefit of remaining up to date with recommended COVID-19 vaccines.

Keywords: COVID‐19; COVID‐19 vaccines; United States; adult; hospitalization.

 
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