Authors

Ian D. Plumb, National Center for Immunization and Respiratory Diseases
Melissa Briggs Hagen, National Center for Immunization and Respiratory Diseases
Ryan Wiegand, National Center for Immunization and Respiratory Diseases
Ghinwa Dumyati, University of Rochester Medical Center
Christopher Myers, University of Rochester Medical Center
Karisa K. Harland, University of Iowa
Anusha Krishnadasan, Olive View- UCLA Education and Research Institute
Jade James Gist, National Center for Immunization and Respiratory Diseases
Glen Abedi, National Center for Immunization and Respiratory Diseases
Katherine E. Fleming-Dutra, National Center for Immunization and Respiratory Diseases
Nora Chea, Centers for Disease Control and Prevention
Jane E. Lee, California Emerging Infections Program
Melissa Kellogg, Colorado Department of Public Health and Environment
Alexandra Edmundson, Yale University
Amber Britton, Emory University School of Medicine
Lucy E. Wilson, University of Maryland, Baltimore (UMB)
Sara A. Lovett, Minnesota Department of Health
Valerie Ocampo, Oregon Health Authority
Tiffanie M. Markus, Vanderbilt University Medical Center
Howard A. Smithline, Baystate Medical Center
Peter C. Hou, Brigham and Women's Hospital
Lilly C. Lee, Jackson Memorial Hospital
William Mower, David Geffen School of Medicine at UCLA
Fernand Rwamwejo, Thomas Jefferson University Hospital
Mark T. Steele, University of Missouri-Kansas City
Stephen C. Lim, LSU Health Sciences Center - New OrleansFollow
Walter A. Schrading, The University of Alabama at Birmingham
Brian Chinnock, University of California, San Francisco

Document Type

Article

Publication Date

11-14-2023

Publication Title

Vaccine

Abstract

Background: Bivalent mRNA vaccines were recommended since September 2022. However, coverage with a recent vaccine dose has been limited, and there are few robust estimates of bivalent VE against symptomatic SARS-CoV-2 infection (COVID-19). We estimated VE of a bivalent mRNA vaccine dose against COVID-19 among eligible U.S. healthcare personnel who had previously received monovalent mRNA vaccine doses. Methods: We conducted a case-control study in 22 U.S. states, and enrolled healthcare personnel with COVID-19 (case-participants) or without COVID-19 (control-participants) during September 2022–May 2023. Participants were considered eligible for a bivalent mRNA dose if they had received 2–4 monovalent (ancestral-strain) mRNA vaccine doses, and were ≥67 days after the most recent vaccine dose. We estimated VE of a bivalent mRNA dose using conditional logistic regression, accounting for matching by region and four-week calendar period. We adjusted estimates for age group, sex, race and ethnicity, educational level, underlying health conditions, community COVID-19 exposure, prior SARS-CoV-2 infection, and days since the last monovalent mRNA dose. Results: Among 3,647 healthcare personnel, 1,528 were included as case-participants and 2,119 as control-participants. Participants received their last monovalent mRNA dose a median of 404 days previously; 1,234 (33.8%) also received a bivalent mRNA dose a median of 93 days previously. Overall, VE of a bivalent dose was 34.1% (95% CI, 22.6%–43.9%) against COVID-19 and was similar by product, days since last monovalent dose, number of prior doses, age group, and presence of underlying health conditions. However, VE declined from 54.8% (95% CI, 40.7%–65.6%) after 7–59 days to 21.6% (95% CI 5.6%–34.9%) after ≥60 days. Conclusions: Bivalent mRNA COVID-19 vaccines initially conferred approximately 55% protection against COVID-19 among U.S. healthcare personnel. However, protection waned after two months. These findings indicate moderate initial protection against symptomatic SARS-CoV-2 infection by remaining up-to-date with COVID-19 vaccines.

PubMed ID

37973512

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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