Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccination Against SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 Lineage Hospitalization and a Comparison of Clinical Severity-IVY Network, 26 Hospitals, October 18, 2023-March 9, 2024

Kevin C Ma¹, Diya Surie¹, Adam S Lauring², Emily T Martin², Aleda M Leis², Leigh Papalambros², Manjusha Gaglani^{3

4}, Christie Columbus³, Robert L Gottlieb³, Shekhar Ghamande⁴, Ithan D Peltan⁵, Samuel M Brown⁵, Adit A Ginde⁶, Nicholas M Mohr⁷, Kevin W Gibbs⁸, David N Hager⁹, Safa Saeed⁹, Matthew E Prekker¹⁰, Michelle Ng Gong¹¹, Amira Mohamed¹¹, Nicholas J Johnson¹², Vasisht Srinivasan¹², Jay S Steingrub¹³, Akram Khan¹⁴, Catherine L Hough¹⁴, Abhijit Duggal¹⁵, Jennifer G Wilson¹⁶, Nida Qadir¹⁷, Steven Y Chang¹⁷, Christopher Mallow¹⁸, Jennie H Kwon¹⁹, Bijal Parikh¹⁹, Matthew C Exline²⁰, Ivana A Vaughn²¹, Mayur Ramesh²¹, Basmah Safdar²², Jarrod Mosier²³, Estelle S Harris²⁴, Nathan I Shapiro²⁵, Jamie Felzer²⁶, Yuwei Zhu²⁷, Carlos G Grijalva²⁷, Natasha Halasa²⁷, James D Chappell²⁷, Kelsey N Womack²⁷, Jillian P Rhoads²⁷, Adrienne Baughman²⁷, Sydney A Swan²⁷, Cassandra A Johnson²⁷, Todd W Rice²⁷, Jonathan D Casey²⁷, Paul W Blair²⁷, Jin H Han²⁷, Sascha Ellington¹, Nathaniel M Lewis¹, Natalie Thornburg¹, Clinton R Paden¹, Lydia J Atherton¹, Wesley H Self²⁷, Fatimah S Dawood¹, Jennifer DeCuir¹

Affiliations

¹ Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
² University of Michigan, Ann Arbor, Michigan, USA.
³ Baylor Scott & White Health, Dallas, Texas, USA.
⁴ Baylor Scott & White, Temple, Texas, USA.
⁵ Intermountain Medical Center, Murray, Utah, USA.
⁶ University of Colorado, Aurora, Colorado, USA.
⁷ University of Iowa, Iowa City, Iowa, USA.
⁸ Wake Forest University, Winston-Salem, North Carolina, USA.
⁹ Johns Hopkins University, Baltimore, Maryland, USA.
¹⁰ Hennepin County Medical Center, Minneapolis, Minnesota, USA.
¹¹ Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
¹² University of Washington, Seattle, Washington.
¹³ Baystate Medical Center, Springfield, Massachusetts.
¹⁴ Oregon Health & Science University, Portland, Oregon, USA.
¹⁵ Cleveland Clinic, Cleveland, Ohio, USA.
¹⁶ Stanford University, Stanford, California, USA.
¹⁷ University of California-Los Angeles, Los Angeles, California, USA.
¹⁸ University of Miami, Miami, Florida, USA.
¹⁹ Washington University, St. Louis, Missouri, USA.
²⁰ The Ohio State Medical Center, Columbus, Ohio, USA.
²¹ Henry Ford Health, Detroit, Michigan, USA.
²² Yale University, New Haven, Connecticut, USA.
²³ University of Arizona, Tuscon, Arizona, USA.
²⁴ University of Utah, Salt Lake City, Utah, USA.
²⁵ Beth Israel Medical Center, Boston, Massachusetts, USA.
²⁶ Emory University, Atlanta, Georgia, USA.
²⁷ Vanderbilt University Medical Center, Nashville, Tennessee, USA.

PMID: 39107255
DOI: 10.1093/cid/ciae405

Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccination Against SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 Lineage Hospitalization and a Comparison of Clinical Severity-IVY Network, 26 Hospitals, October 18, 2023-March 9, 2024

Kevin C Ma et al. Clin Infect Dis. 2024.

. 2024 Aug 6:ciae405.

doi: 10.1093/cid/ciae405. Online ahead of print.

Authors

Affiliations

¹ Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
² University of Michigan, Ann Arbor, Michigan, USA.
³ Baylor Scott & White Health, Dallas, Texas, USA.
⁴ Baylor Scott & White, Temple, Texas, USA.
⁵ Intermountain Medical Center, Murray, Utah, USA.
⁶ University of Colorado, Aurora, Colorado, USA.
⁷ University of Iowa, Iowa City, Iowa, USA.
⁸ Wake Forest University, Winston-Salem, North Carolina, USA.
⁹ Johns Hopkins University, Baltimore, Maryland, USA.
¹⁰ Hennepin County Medical Center, Minneapolis, Minnesota, USA.
¹¹ Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
¹² University of Washington, Seattle, Washington.
¹³ Baystate Medical Center, Springfield, Massachusetts.
¹⁴ Oregon Health & Science University, Portland, Oregon, USA.
¹⁵ Cleveland Clinic, Cleveland, Ohio, USA.
¹⁶ Stanford University, Stanford, California, USA.
¹⁷ University of California-Los Angeles, Los Angeles, California, USA.
¹⁸ University of Miami, Miami, Florida, USA.
¹⁹ Washington University, St. Louis, Missouri, USA.
²⁰ The Ohio State Medical Center, Columbus, Ohio, USA.
²¹ Henry Ford Health, Detroit, Michigan, USA.
²² Yale University, New Haven, Connecticut, USA.
²³ University of Arizona, Tuscon, Arizona, USA.
²⁴ University of Utah, Salt Lake City, Utah, USA.
²⁵ Beth Israel Medical Center, Boston, Massachusetts, USA.
²⁶ Emory University, Atlanta, Georgia, USA.
²⁷ Vanderbilt University Medical Center, Nashville, Tennessee, USA.

PMID: 39107255
DOI: 10.1093/cid/ciae405

Abstract

Background: Assessing variant-specific COVID-19 vaccine effectiveness (VE) and severity can inform public health risk assessments and decisions about vaccine composition. BA.2.86 and its descendants, including JN.1 (referred to collectively as "JN lineages"), emerged in late 2023 and exhibited substantial divergence from co-circulating XBB lineages.

Methods: We analyzed patients hospitalized with COVID-19-like illness at 26 hospitals in 20 U.S. states admitted October 18, 2023-March 9, 2024. Using a test-negative, case-control design, we estimated effectiveness of an updated 2023-2024 (Monovalent XBB.1.5) COVID-19 vaccine dose against sequence-confirmed XBB and JN lineage hospitalization using logistic regression. Odds of severe outcomes, including intensive care unit (ICU) admission and invasive mechanical ventilation (IMV) or death, were compared for JN versus XBB lineage hospitalizations using logistic regression.

Results: 585 case-patients with XBB lineages, 397 case-patients with JN lineages, and 4,580 control-patients were included. VE in the first 7-89 days after receipt of an updated dose was 54.2% (95% CI = 36.1%-67.1%) against XBB lineage hospitalization and 32.7% (95% CI = 1.9%-53.8%) against JN lineage hospitalization. Odds of ICU admission (adjusted odds ratio [aOR] 0.80; 95% CI = 0.46-1.38) and IMV or death (aOR 0.69; 95% CI = 0.34-1.40) were not significantly different among JN compared to XBB lineage hospitalizations.

Conclusions: Updated 2023-2024 COVID-19 vaccination provided protection against both XBB and JN lineage hospitalization, but protection against the latter may be attenuated by immune escape. Clinical severity of JN lineage hospitalizations was not higher relative to XBB.

Keywords: COVID-19 severity; COVID-19 vaccine effectiveness; JN.1 and BA.2.86; SARS-COV-2 variants; test-negative design.

Published by Oxford University Press on behalf of Infectious Diseases Society of America 2024.

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Update of

Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccination Against SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 Lineage Hospitalization and a Comparison of Clinical Severity - IVY Network, 26 Hospitals, October 18, 2023-March 9, 2024.
Ma KC, Surie D, Lauring AS, Martin ET, Leis AM, Papalambros L, Gaglani M, Columbus C, Gottlieb RL, Ghamande S, Peltan ID, Brown SM, Ginde AA, Mohr NM, Gibbs KW, Hager DN, Saeed S, Prekker ME, Gong MN, Mohamed A, Johnson NJ, Srinivasan V, Steingrub JS, Khan A, Hough CL, Duggal A, Wilson JG, Qadir N, Chang SY, Mallow C, Kwon JH, Parikh B, Exline MC, Vaughn IA, Ramesh M, Safdar B, Mosier J, Harris ES, Shapiro NI, Felzer J, Zhu Y, Grijalva CG, Halasa N, Chappell JD, Womack KN, Rhoads JP, Baughman A, Swan SA, Johnson CA, Rice TW, Casey JD, Blair PW, Han JH, Ellington S, Lewis NM, Thornburg N, Paden CR, Atherton LJ, Self WH, Dawood FS, DeCuir J. Ma KC, et al. medRxiv [Preprint]. 2024 Jun 5:2024.06.04.24308470. doi: 10.1101/2024.06.04.24308470. medRxiv. 2024. Update in: Clin Infect Dis. 2024 Aug 06:ciae405. doi: 10.1093/cid/ciae405. PMID: 38883802 Free PMC article. Updated. Preprint.

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Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccination Against SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 Lineage Hospitalization and a Comparison of Clinical Severity-IVY Network, 26 Hospitals, October 18, 2023-March 9, 2024

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Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccination Against SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 Lineage Hospitalization and a Comparison of Clinical Severity-IVY Network, 26 Hospitals, October 18, 2023-March 9, 2024

Authors

Affiliations

Abstract

Update of

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Miscellaneous