Effectiveness of SARS-CoV-2 mRNA Vaccines for Preventing Covid-19 Hospitalizations in the United States
Tenforde, M. W.; Patel, M. M.; Ginde, A. A.; Douin, D. J.; Talbot, H. K.; Casey, J. D.; Mohr, N. M.; Zepeski, A.; Gaglani, M.; McNeal, T.; Ghamande, S.; Shapiro, N. I.; Gibbs, K. W.; Files, D. C.; Hager, D. N.; Shehu, A.; Prekker, M. E.; Erickson, H. L.; Exline, M. C.; Gong, M. N.; Mohamed, A.; Henning, D. J.; Steingrub, J. S.; Peltan, I. D.; Brown, S. M.; Martin, E. T.; Monto, A. S.; Khan, A.; Hough, C. T.; Busse, L.; ten Lohuis, C. C.; Duggal, A.; Wilson, J. G.; Gordon, A. J.; Qadir, N.; Chang, S. Y.; Mallow, C.; Gershengorn, H. B.; Babcock, H. M.; Kwon, J. H.; Halasa, N.; Chappell, J. D.; L
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BackgroundAs SARS-CoV-2 vaccination coverage increases in the United States (US), there is a need to understand the real-world effectiveness against severe Covid-19 and among people at increased risk for poor outcomes. MethodsIn a multicenter case-control analysis of US adults hospitalized March 11 - May 5, 2021, we evaluated vaccine effectiveness to prevent Covid-19 hospitalizations by comparing odds of prior vaccination with an mRNA vaccine (Pfizer-BioNTech or Moderna) between cases hospitalized with Covid-19 and hospital-based controls who tested negative for SARS-CoV-2. ResultsAmong 1210 participants, median age was 58 years, 22.8% were Black, 13.8% were Hispanic, and 20.6% had immunosuppression. SARS-CoV-2 lineage B.1.1.7 was most common variant (59.7% of sequenced viruses). Full vaccination (receipt of two vaccine doses [≥]14 days before illness onset) had been received by 45/590 (7.6%) cases and 215/620 (34.7%) controls. Overall vaccine effectiveness was 86.9% (95% CI: 80.4 to 91.2%). Vaccine effectiveness was similar for Pfizer-BioNTech and Moderna vaccines, and highest in adults aged 18-49 years (97.3%; 95% CI: 78.9 to 99.7%). Among 45 patients with vaccine-breakthrough Covid hospitalizations, 44 (97.8%) were [≥]50 years old and 20 (44.4%) had immunosuppression. Vaccine effectiveness was lower among patients with immunosuppression (59.2%; 95% CI: 11.9 to 81.1%) than without immunosuppression (91.3%; 95% CI: 85.5 to 94.7%). ConclusionDuring March-May 2021, SARS-CoV-2 mRNA vaccines were highly effective for preventing Covid-19 hospitalizations among US adults. SARS-CoV-2 vaccination was beneficial for patients with immunosuppression, but effectiveness was lower in the immunosuppressed population.
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