Tags

Type your tag names separated by a space and hit enter

Effectiveness of Covid-19 Vaccines over a 9-Month Period in North Carolina.
N Engl J Med. 2022 03 10; 386(10):933-941.NEJM

Abstract

BACKGROUND

The duration of protection afforded by coronavirus disease 2019 (Covid-19) vaccines in the United States is unclear. Whether the increase in postvaccination infections during the summer of 2021 was caused by declining immunity over time, the emergence of the B.1.617.2 (delta) variant, or both is unknown.

METHODS

We extracted data regarding Covid-19-related vaccination and outcomes during a 9-month period (December 11, 2020, to September 8, 2021) for approximately 10.6 million North Carolina residents by linking data from the North Carolina Covid-19 Surveillance System and the Covid-19 Vaccine Management System. We used a Cox regression model to estimate the effectiveness of the BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), and Ad26.COV2.S (Johnson & Johnson-Janssen) vaccines in reducing the current risks of Covid-19, hospitalization, and death, as a function of time elapsed since vaccination.

RESULTS

For the two-dose regimens of messenger RNA (mRNA) vaccines BNT162b2 (30 μg per dose) and mRNA-1273 (100 μg per dose), vaccine effectiveness against Covid-19 was 94.5% (95% confidence interval [CI], 94.1 to 94.9) and 95.9% (95% CI, 95.5 to 96.2), respectively, at 2 months after the first dose and decreased to 66.6% (95% CI, 65.2 to 67.8) and 80.3% (95% CI, 79.3 to 81.2), respectively, at 7 months. Among early recipients of BNT162b2 and mRNA-1273, effectiveness decreased by approximately 15 and 10 percentage points, respectively, from mid-June to mid-July, when the delta variant became dominant. For the one-dose regimen of Ad26.COV2.S (5 × 1010 viral particles), effectiveness against Covid-19 was 74.8% (95% CI, 72.5 to 76.9) at 1 month and decreased to 59.4% (95% CI, 57.2 to 61.5) at 5 months. All three vaccines maintained better effectiveness in preventing hospitalization and death than in preventing infection over time, although the two mRNA vaccines provided higher levels of protection than Ad26.COV2.S.

CONCLUSIONS

All three Covid-19 vaccines had durable effectiveness in reducing the risks of hospitalization and death. Waning protection against infection over time was due to both declining immunity and the emergence of the delta variant. (Funded by a Dennis Gillings Distinguished Professorship and the National Institutes of Health.).

Authors+Show Affiliations

From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh.From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh.From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh.From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh.From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh.From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh.From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh.From the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill (D.-Y.L., Y.G., D.Z.), and the North Carolina Department of Health and Human Services (B.W., H.Y., Z.M.), North Carolina State University (S.H.), and the CDC Foundation, North Carolina Department of Health and Human Services (S.-K.S.), Raleigh.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

35020982

Citation

Lin, Dan-Yu, et al. "Effectiveness of Covid-19 Vaccines Over a 9-Month Period in North Carolina." The New England Journal of Medicine, vol. 386, no. 10, 2022, pp. 933-941.
Lin DY, Gu Y, Wheeler B, et al. Effectiveness of Covid-19 Vaccines over a 9-Month Period in North Carolina. N Engl J Med. 2022;386(10):933-941.
Lin, D. Y., Gu, Y., Wheeler, B., Young, H., Holloway, S., Sunny, S. K., Moore, Z., & Zeng, D. (2022). Effectiveness of Covid-19 Vaccines over a 9-Month Period in North Carolina. The New England Journal of Medicine, 386(10), 933-941. https://doi.org/10.1056/NEJMoa2117128
Lin DY, et al. Effectiveness of Covid-19 Vaccines Over a 9-Month Period in North Carolina. N Engl J Med. 2022 03 10;386(10):933-941. PubMed PMID: 35020982.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of Covid-19 Vaccines over a 9-Month Period in North Carolina. AU - Lin,Dan-Yu, AU - Gu,Yu, AU - Wheeler,Bradford, AU - Young,Hayley, AU - Holloway,Shannon, AU - Sunny,Shadia-Khan, AU - Moore,Zack, AU - Zeng,Donglin, Y1 - 2022/01/12/ PY - 2022/1/13/pubmed PY - 2022/3/23/medline PY - 2022/1/12/entrez SP - 933 EP - 941 JF - The New England journal of medicine JO - N Engl J Med VL - 386 IS - 10 N2 - BACKGROUND: The duration of protection afforded by coronavirus disease 2019 (Covid-19) vaccines in the United States is unclear. Whether the increase in postvaccination infections during the summer of 2021 was caused by declining immunity over time, the emergence of the B.1.617.2 (delta) variant, or both is unknown. METHODS: We extracted data regarding Covid-19-related vaccination and outcomes during a 9-month period (December 11, 2020, to September 8, 2021) for approximately 10.6 million North Carolina residents by linking data from the North Carolina Covid-19 Surveillance System and the Covid-19 Vaccine Management System. We used a Cox regression model to estimate the effectiveness of the BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), and Ad26.COV2.S (Johnson & Johnson-Janssen) vaccines in reducing the current risks of Covid-19, hospitalization, and death, as a function of time elapsed since vaccination. RESULTS: For the two-dose regimens of messenger RNA (mRNA) vaccines BNT162b2 (30 μg per dose) and mRNA-1273 (100 μg per dose), vaccine effectiveness against Covid-19 was 94.5% (95% confidence interval [CI], 94.1 to 94.9) and 95.9% (95% CI, 95.5 to 96.2), respectively, at 2 months after the first dose and decreased to 66.6% (95% CI, 65.2 to 67.8) and 80.3% (95% CI, 79.3 to 81.2), respectively, at 7 months. Among early recipients of BNT162b2 and mRNA-1273, effectiveness decreased by approximately 15 and 10 percentage points, respectively, from mid-June to mid-July, when the delta variant became dominant. For the one-dose regimen of Ad26.COV2.S (5 × 1010 viral particles), effectiveness against Covid-19 was 74.8% (95% CI, 72.5 to 76.9) at 1 month and decreased to 59.4% (95% CI, 57.2 to 61.5) at 5 months. All three vaccines maintained better effectiveness in preventing hospitalization and death than in preventing infection over time, although the two mRNA vaccines provided higher levels of protection than Ad26.COV2.S. CONCLUSIONS: All three Covid-19 vaccines had durable effectiveness in reducing the risks of hospitalization and death. Waning protection against infection over time was due to both declining immunity and the emergence of the delta variant. (Funded by a Dennis Gillings Distinguished Professorship and the National Institutes of Health.). SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/35020982/full_citation L2 - https://www.nejm.org/doi/10.1056/NEJMoa2117128?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -