Effectiveness of a Messenger RNA Vaccine Booster Dose Against Coronavirus Disease 2019 Among US Healthcare Personnel, October 2021-July 2022

Ian D Plumb¹, Nicholas M Mohr², Melissa Hagen¹, Ryan Wiegand¹, Ghinwa Dumyati³, Karisa K Harland², Anusha Krishnadasan⁴, Jade James Gist¹, Glen Abedi¹, Katherine E Fleming-Dutra¹, Nora Chea⁵, Jane Lee⁶, Devra Barter⁷, Monica Brackney⁸, Scott K Fridkin⁹, Lucy E Wilson¹⁰, Sara A Lovett¹¹, Valerie Ocampo¹², Erin C Phipps¹³, Tiffanie M Marcus¹⁴, Howard A Smithline¹⁵, Peter C Hou¹⁶, Lilly C Lee¹⁷, Gregory J Moran¹⁸, Elizabeth Krebs¹⁹, Mark T Steele²⁰, Stephen C Lim²¹, Walter A Schrading²², Brian Chinnock²³, David G Beiser²⁴, Brett Faine², John P Haran²⁵, Utsav Nandi²⁶, Anne K Chipman²⁷, Frank LoVecchio²⁸, David A Talan¹⁸, Tamara Pilishvili¹

Affiliations

¹ National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
² Department of Emergency Medicine, University of Iowa, Iowa City, Iowa, USA.
³ New York State Emerging Infections Program, University of Rochester Medical Center, Rochester, New York, USA.
⁴ Department of Emergency Medicine, Olive View-UCLA Education and Research Institute, Los Angeles, California, USA.
⁵ National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
⁶ Healthcare-Associated Infections, California Emerging Infections Program, Oakland, California, USA.
⁷ Healthcare-associated Infections / Antimicrobial Resistance Program, Colorado Department of Public Health & Environment, Denver, Colorado, USA.
⁸ Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, USA.
⁹ Georgia Emerging Infections Program and Emory University School of Medicine, Atlanta, Georgia, USA.
¹⁰ Maryland Emerging Infections Program, Maryland Department of Health, and University of Maryland, Baltimore County, Baltimore, Maryland, USA.
¹¹ Infectious Disease Epidemiology, Prevention and Control Divison, Minnesota Department of Health, St. Paul, Minnesota, USA.
¹² Public Health Division, Oregon Health Authority, Portland, Oregon, USA.
¹³ New Mexico Emerging Infections Program, University of New Mexico, Albuquerque, New Mexico, USA.
¹⁴ Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
¹⁵ Department of Emergency Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield, Massachusetts, USA.
¹⁶ Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
¹⁷ Emergency Medicine, Jackson Memorial Hospital, Miami, Florida, USA.
¹⁸ David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
¹⁹ Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
²⁰ Department of Emergency Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA.
²¹ Section of Emergency Medicine, University Medical Center New Orleans, LSU Health Sciences Center, New Orleans, Louisiana, USA.
²² Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
²³ Department of Emergency Medicine, University of California San Francisco, Fresno, California, USA.
²⁴ Section of Emergency Medicine, University of Chicago, Chicago, Illinois, USA.
²⁵ Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
²⁶ Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
²⁷ Emergency Department, University of Washington, Seattle, Washington, USA.
²⁸ Emergency Medicine, Valleywise Health Medical Center, Phoenix, Arizona, USA.

PMID: 37799130
PMCID: PMC10549208
DOI: 10.1093/ofid/ofad457

Effectiveness of a Messenger RNA Vaccine Booster Dose Against Coronavirus Disease 2019 Among US Healthcare Personnel, October 2021-July 2022

Ian D Plumb et al. Open Forum Infect Dis. 2023.

. 2023 Sep 8;10(10):ofad457.

doi: 10.1093/ofid/ofad457. eCollection 2023 Oct.

Authors

Affiliations

¹ National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
² Department of Emergency Medicine, University of Iowa, Iowa City, Iowa, USA.
³ New York State Emerging Infections Program, University of Rochester Medical Center, Rochester, New York, USA.
⁴ Department of Emergency Medicine, Olive View-UCLA Education and Research Institute, Los Angeles, California, USA.
⁵ National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
⁶ Healthcare-Associated Infections, California Emerging Infections Program, Oakland, California, USA.
⁷ Healthcare-associated Infections / Antimicrobial Resistance Program, Colorado Department of Public Health & Environment, Denver, Colorado, USA.
⁸ Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, USA.
⁹ Georgia Emerging Infections Program and Emory University School of Medicine, Atlanta, Georgia, USA.
¹⁰ Maryland Emerging Infections Program, Maryland Department of Health, and University of Maryland, Baltimore County, Baltimore, Maryland, USA.
¹¹ Infectious Disease Epidemiology, Prevention and Control Divison, Minnesota Department of Health, St. Paul, Minnesota, USA.
¹² Public Health Division, Oregon Health Authority, Portland, Oregon, USA.
¹³ New Mexico Emerging Infections Program, University of New Mexico, Albuquerque, New Mexico, USA.
¹⁴ Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
¹⁵ Department of Emergency Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield, Massachusetts, USA.
¹⁶ Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
¹⁷ Emergency Medicine, Jackson Memorial Hospital, Miami, Florida, USA.
¹⁸ David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
¹⁹ Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
²⁰ Department of Emergency Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA.
²¹ Section of Emergency Medicine, University Medical Center New Orleans, LSU Health Sciences Center, New Orleans, Louisiana, USA.
²² Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
²³ Department of Emergency Medicine, University of California San Francisco, Fresno, California, USA.
²⁴ Section of Emergency Medicine, University of Chicago, Chicago, Illinois, USA.
²⁵ Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
²⁶ Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
²⁷ Emergency Department, University of Washington, Seattle, Washington, USA.
²⁸ Emergency Medicine, Valleywise Health Medical Center, Phoenix, Arizona, USA.

PMID: 37799130
PMCID: PMC10549208
DOI: 10.1093/ofid/ofad457

Abstract

Background: Protection against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease 2019 [COVID-19]) can limit transmission and the risk of post-COVID conditions, and is particularly important among healthcare personnel. However, lower vaccine effectiveness (VE) has been reported since predominance of the Omicron SARS-CoV-2 variant.

Methods: We evaluated the VE of a monovalent messenger RNA (mRNA) booster dose against COVID-19 from October 2021 to June 2022 among US healthcare personnel. After matching case-participants with COVID-19 to control-participants by 2-week period and site, we used conditional logistic regression to estimate the VE of a booster dose compared with completing only 2 mRNA doses >150 days previously, adjusted for multiple covariates.

Results: Among 3279 case-participants and 3998 control-participants who had completed 2 mRNA doses, we estimated that the VE of a booster dose against COVID-19 declined from 86% (95% confidence interval, 81%-90%) during Delta predominance to 65% (58%-70%) during Omicron predominance. During Omicron predominance, VE declined from 73% (95% confidence interval, 67%-79%) 14-60 days after the booster dose, to 32% (4%-52%) ≥120 days after a booster dose. We found that VE was similar by age group, presence of underlying health conditions, and pregnancy status on the test date, as well as among immunocompromised participants.

Conclusions: A booster dose conferred substantial protection against COVID-19 among healthcare personnel. However, VE was lower during Omicron predominance, and waning effectiveness was observed 4 months after booster dose receipt during this period. Our findings support recommendations to stay up to date on recommended doses of COVID-19 vaccines for all those eligible.

Keywords: COVID-19; Omicron; SARS-CoV-2; healthcare personnel; vaccine effectiveness.

Published by Oxford University Press on behalf of Infectious Diseases Society of America 2023.

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Conflict of interest statement

Potential conflicts of interest. M. B. owned stock in Moderna from November 2022 to April 2023, as part of portfolio managed by Parametric Investments Portfolio. All other authors report no potential conflicts.

References

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Effectiveness of a Messenger RNA Vaccine Booster Dose Against Coronavirus Disease 2019 Among US Healthcare Personnel, October 2021-July 2022

Affiliations

Effectiveness of a Messenger RNA Vaccine Booster Dose Against Coronavirus Disease 2019 Among US Healthcare Personnel, October 2021-July 2022

Authors

Affiliations

Abstract

Conflict of interest statement

References

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous