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. 2023 Sep 20;18(9):e0291678.
doi: 10.1371/journal.pone.0291678. eCollection 2023.

Application of a life table approach to assess duration of BNT162b2 vaccine-derived immunity by age using COVID-19 case surveillance data during the Omicron variant period

Maya R Sternberg  1 , Amelia Johnson  1 , Justice King  1 , Akilah R Ali  1 , Lauren Linde  1 , Abiola O Awofeso  2 , Jodee S Baker  3 , Nagla S Bayoumi  4 , Steven Broadway  5 , Katherine Busen  6 , Carolyn Chang  7 , Iris Cheng  8 , Mike Cima  9 , Abi Collingwood  3 , Vajeera Dorabawila  10 , Cherie Drenzek  11 , Aaron Fleischauer  1 , Ashley Gent  5 , Amanda Hartley  12 , Liam Hicks  13 , Mikhail Hoskins  14 , Amanda Jara  11 , Amanda Jones  1 , Saadiah I Khan  4 , Ishrat Kamal-Ahmed  15 , Sarah Kangas  16 , Fnu Kanishka  15 , Alison Kleppinger  17 , Anna Kocharian  16 , Tomás M León  18 , Ruth Link-Gelles  1 , B Casey Lyons  1 , John Masarik  2 , Andrea May  19 , Donald McCormick  9 , Stephanie Meyer  20 , Lauren Milroy  21 , Keeley J Morris  20 , Lauren Nelson  18 , Enaholo Omoike  6 , Komal Patel  11 , Michael Pietrowski  22 , Melissa A Pike  23 , Tamara Pilishvili  1 , Xandy Peterson Pompa  13 , Charles Powell  17 , Kevin Praetorius  24 , Eli Rosenberg  10 , Adam Schiller  1 , Mayra L Smith-Coronado  23 , Emma Stanislawski  25 , Kyle Strand  15 , Buddhi P Tilakaratne  2 , Hailey Vest  21 , Caleb Wiedeman  12 , Allison Zaldivar  19 , Benjamin Silk  1 , Heather M Scobie  1
Affiliations

Application of a life table approach to assess duration of BNT162b2 vaccine-derived immunity by age using COVID-19 case surveillance data during the Omicron variant period

Maya R Sternberg et al. PLoS One. .

Abstract

Background: SARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S. multi-jurisdictional COVID-19 vaccine breakthrough surveillance data to examine potential waning of protection against SARS-CoV-2 infection for the Pfizer-BioNTech (BNT162b) primary vaccination series by age.

Methods: Weekly numbers of SARS-CoV-2 infections during January 16, 2022-May 28, 2022 were analyzed by age group from 22 U.S. jurisdictions that routinely linked COVID-19 case surveillance and immunization data. A life table approach incorporating line-listed and aggregated COVID-19 case datasets with vaccine administration and U.S. Census data was used to estimate hazard rates of SARS-CoV-2 infections, hazard rate ratios (HRR) and percent reductions in hazard rate comparing unvaccinated people to people vaccinated with a Pfizer-BioNTech primary series only, by age group and time since vaccination.

Results: The percent reduction in hazard rates for persons 2 weeks after vaccination with a Pfizer-BioNTech primary series compared with unvaccinated persons was lowest among children aged 5-11 years at 35.5% (95% CI: 33.3%, 37.6%) compared to the older age groups, which ranged from 68.7%-89.6%. By 19 weeks after vaccination, all age groups showed decreases in the percent reduction in the hazard rates compared with unvaccinated people; with the largest declines observed among those aged 5-11 and 12-17 years and more modest declines observed among those 18 years and older.

Conclusions: The decline in vaccine protection against SARS-CoV-2 infection observed in this study is consistent with other studies and demonstrates that national case surveillance data were useful for assessing early signals in age-specific waning of vaccine protection during the initial period of SARS-CoV-2 Omicron variant predominance. The potential for waning immunity during the Omicron period emphasizes the importance of continued monitoring and consideration of optimal timing and provision of booster doses in the future.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Weekly trends in log COVID-19 hazard rates—22 U.S. jurisdictions, January 16 to May 28, 2022.
Log hazard rates (with 95% confidence intervals) among unvaccinated persons compared persons vaccinated with a Pfizer-BioNTech primary series by vaccination cohort and age group. Vaccination cohorts 1–4 reached ≥14 days after vaccination with a Pfizer-BioNTech primary series during: January 16–February 5, February 6–26, February 27–April 2, April 3–30, 2022, respectively.
Fig 2
Fig 2. COVID-19 hazard rates and 95% confidence intervals—22 U.S. jurisdictions, May 1–28, 2022.
Vaccination cohorts 1–4 reached ≥14 days after vaccination with a Pfizer-BioNTech primary series during: January 16–February 5, February 6–26, February 27–April 2, April 3–30, 2022, respectively.
Fig 3
Fig 3. Standardized percent reduction in hazard rate for COVID-19 cases—22 U.S. jurisdictions, January 16 to May 28, 2022.
Shaded area are 95% confidence intervals among persons vaccinated with a Pfizer-BioNTech primary series as compared to unvaccinated persons by age group and weeks since completing vaccination.
Fig 4
Fig 4. Sensitivity analysis for standardized percent reduction in hazard rate for COVID-19 cases.
Adjusted by an estimate of differential prior infection based on seroprevalence data among the unvaccinated. Shaded area are 95% confidence intervals. A dashed reference line is plotted at a VE of 80%.
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