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
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Plumb, Ian D.; Briggs Hagen, Melissa; Wiegand, Ryan; Dumyati, Ghinwa; Myers, Christopher; Harland, Karisa K.; Krishnadasan, Anusha; James Gist, Jade; Abedi, Glen; Fleming-Dutra, Katherine E.; Chea, Nora; Lee, Jane E.; Kellogg, Melissa; Edmundson, Alexandra; Britton, Amber; Wilson, Lucy E.; Lovett, Sara A.; Ocampo, Valerie; Markus, Tiffanie M.; Smithline, Howard A.; Hou, Peter C.; Lee, Lilly C.; Mower, William; Rwamwejo, Fernand; Steele, Mark T.; Lim, Stephen C.; Schrading, Walter A.; and Chinnock, Brian, "Effectiveness of a bivalent mRNA vaccine dose against symptomatic SARS-CoV-2 infection among U.S. Healthcare personnel, September 2022–May 2023" (2023). School of Medicine Faculty Publications. 1631.
https://digitalscholar.lsuhsc.edu/som_facpubs/1631
10.1016/j.vaccine.2023.10.072