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Effectiveness of a Third Dose of Pfizer-BioNTech and Moderna Vaccines in Preventing COVID-19 Hospitalization Among Immunocompetent and Immunocompromised Adults - United States, August-December 2021.
MMWR Morb Mortal Wkly Rep. 2022 Jan 28; 71(4):118-124.MM

Abstract

COVID-19 mRNA vaccines (BNT162b2 [Pfizer-BioNTech] and mRNA-1273 [Moderna]) provide protection against infection with SARS-CoV-2, the virus that causes COVID-19, and are highly effective against COVID-19-associated hospitalization among eligible persons who receive 2 doses (1,2). However, vaccine effectiveness (VE) among persons with immunocompromising conditions* is lower than that among immunocompetent persons (2), and VE declines after several months among all persons (3). On August 12, 2021, the Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for a third mRNA vaccine dose as part of a primary series ≥28 days after dose 2 for persons aged ≥12 years with immunocompromising conditions, and, on November 19, 2021, as a booster dose for all adults aged ≥18 years at least 6 months after dose 2, changed to ≥5 months after dose 2 on January 3, 2022 (4,5,6). Among 2,952 adults (including 1,385 COVID-19 case-patients and 1,567 COVID-19-negative controls) hospitalized at 21 U.S. hospitals during August 19-December 15, 2021, effectiveness of mRNA vaccines against COVID-19-associated hospitalization was compared between adults eligible for but who had not received a third vaccine dose (1,251) and vaccine-eligible adults who received a third dose ≥7 days before illness onset (312). Among 1,875 adults without immunocompromising conditions (including 1,065 [57%] unvaccinated, 679 [36%] 2-dose recipients, and 131 [7%] 3-dose [booster] recipients), VE against COVID-19 hospitalization was higher among those who received a booster dose (97%; 95% CI = 95%-99%) compared with that among 2-dose recipients (82%; 95% CI = 77%-86%) (p <0.001). Among 1,077 adults with immunocompromising conditions (including 324 [30%] unvaccinated, 572 [53%] 2-dose recipients, and 181 [17%] 3-dose recipients), VE was higher among those who received a third dose to complete a primary series (88%; 95% CI = 81%-93%) compared with 2-dose recipients (69%; 95% CI = 57%-78%) (p <0.001). Administration of a third COVID-19 mRNA vaccine dose as part of a primary series among immunocompromised adults, or as a booster dose among immunocompetent adults, provides improved protection against COVID-19-associated hospitalization.

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

35085218

Citation

Tenforde, Mark W., et al. "Effectiveness of a Third Dose of Pfizer-BioNTech and Moderna Vaccines in Preventing COVID-19 Hospitalization Among Immunocompetent and Immunocompromised Adults - United States, August-December 2021." MMWR. Morbidity and Mortality Weekly Report, vol. 71, no. 4, 2022, pp. 118-124.
Tenforde MW, Patel MM, Gaglani M, et al. Effectiveness of a Third Dose of Pfizer-BioNTech and Moderna Vaccines in Preventing COVID-19 Hospitalization Among Immunocompetent and Immunocompromised Adults - United States, August-December 2021. MMWR Morb Mortal Wkly Rep. 2022;71(4):118-124.
Tenforde, M. W., Patel, M. M., Gaglani, M., Ginde, A. A., Douin, D. J., Talbot, H. K., Casey, J. D., Mohr, N. M., Zepeski, A., McNeal, T., Ghamande, S., Gibbs, K. W., Files, D. C., Hager, D. N., Shehu, A., Prekker, M. E., Erickson, H. L., Gong, M. N., Mohamed, A., ... Self, W. H. (2022). Effectiveness of a Third Dose of Pfizer-BioNTech and Moderna Vaccines in Preventing COVID-19 Hospitalization Among Immunocompetent and Immunocompromised Adults - United States, August-December 2021. MMWR. Morbidity and Mortality Weekly Report, 71(4), 118-124. https://doi.org/10.15585/mmwr.mm7104a2
Tenforde MW, et al. Effectiveness of a Third Dose of Pfizer-BioNTech and Moderna Vaccines in Preventing COVID-19 Hospitalization Among Immunocompetent and Immunocompromised Adults - United States, August-December 2021. MMWR Morb Mortal Wkly Rep. 2022 Jan 28;71(4):118-124. PubMed PMID: 35085218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of a Third Dose of Pfizer-BioNTech and Moderna Vaccines in Preventing COVID-19 Hospitalization Among Immunocompetent and Immunocompromised Adults - United States, August-December 2021. AU - Tenforde,Mark W, AU - Patel,Manish M, AU - Gaglani,Manjusha, AU - Ginde,Adit A, AU - Douin,David J, AU - Talbot,H Keipp, AU - Casey,Jonathan D, AU - Mohr,Nicholas M, AU - Zepeski,Anne, AU - McNeal,Tresa, AU - Ghamande,Shekhar, AU - Gibbs,Kevin W, AU - Files,D Clark, AU - Hager,David N, AU - Shehu,Arber, AU - Prekker,Matthew E, AU - Erickson,Heidi L, AU - Gong,Michelle N, AU - Mohamed,Amira, AU - Johnson,Nicholas J, AU - Srinivasan,Vasisht, AU - Steingrub,Jay S, AU - Peltan,Ithan D, AU - Brown,Samuel M, AU - Martin,Emily T, AU - Monto,Arnold S, AU - Khan,Akram, AU - Hough,Catherine L, AU - Busse,Laurence W, AU - Duggal,Abhijit, AU - Wilson,Jennifer G, AU - Qadir,Nida, AU - Chang,Steven Y, AU - Mallow,Christopher, AU - Rivas,Carolina, AU - Babcock,Hilary M, AU - Kwon,Jennie H, AU - Exline,Matthew C, AU - Botros,Mena, AU - Lauring,Adam S, AU - Shapiro,Nathan I, AU - Halasa,Natasha, AU - Chappell,James D, AU - Grijalva,Carlos G, AU - Rice,Todd W, AU - Jones,Ian D, AU - Stubblefield,William B, AU - Baughman,Adrienne, AU - Womack,Kelsey N, AU - Rhoads,Jillian P, AU - Lindsell,Christopher J, AU - Hart,Kimberly W, AU - Zhu,Yuwei, AU - Naioti,Eric A, AU - Adams,Katherine, AU - Lewis,Nathaniel M, AU - Surie,Diya, AU - McMorrow,Meredith L, AU - Self,Wesley H, AU - ,, Y1 - 2022/01/28/ PY - 2022/1/27/entrez PY - 2022/1/28/pubmed PY - 2022/2/8/medline SP - 118 EP - 124 JF - MMWR. Morbidity and mortality weekly report JO - MMWR Morb Mortal Wkly Rep VL - 71 IS - 4 N2 - COVID-19 mRNA vaccines (BNT162b2 [Pfizer-BioNTech] and mRNA-1273 [Moderna]) provide protection against infection with SARS-CoV-2, the virus that causes COVID-19, and are highly effective against COVID-19-associated hospitalization among eligible persons who receive 2 doses (1,2). However, vaccine effectiveness (VE) among persons with immunocompromising conditions* is lower than that among immunocompetent persons (2), and VE declines after several months among all persons (3). On August 12, 2021, the Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for a third mRNA vaccine dose as part of a primary series ≥28 days after dose 2 for persons aged ≥12 years with immunocompromising conditions, and, on November 19, 2021, as a booster dose for all adults aged ≥18 years at least 6 months after dose 2, changed to ≥5 months after dose 2 on January 3, 2022 (4,5,6). Among 2,952 adults (including 1,385 COVID-19 case-patients and 1,567 COVID-19-negative controls) hospitalized at 21 U.S. hospitals during August 19-December 15, 2021, effectiveness of mRNA vaccines against COVID-19-associated hospitalization was compared between adults eligible for but who had not received a third vaccine dose (1,251) and vaccine-eligible adults who received a third dose ≥7 days before illness onset (312). Among 1,875 adults without immunocompromising conditions (including 1,065 [57%] unvaccinated, 679 [36%] 2-dose recipients, and 131 [7%] 3-dose [booster] recipients), VE against COVID-19 hospitalization was higher among those who received a booster dose (97%; 95% CI = 95%-99%) compared with that among 2-dose recipients (82%; 95% CI = 77%-86%) (p <0.001). Among 1,077 adults with immunocompromising conditions (including 324 [30%] unvaccinated, 572 [53%] 2-dose recipients, and 181 [17%] 3-dose recipients), VE was higher among those who received a third dose to complete a primary series (88%; 95% CI = 81%-93%) compared with 2-dose recipients (69%; 95% CI = 57%-78%) (p <0.001). Administration of a third COVID-19 mRNA vaccine dose as part of a primary series among immunocompromised adults, or as a booster dose among immunocompetent adults, provides improved protection against COVID-19-associated hospitalization. SN - 1545-861X UR - https://www.unboundmedicine.com/medline/citation/35085218/Effectiveness_of_a_Third_Dose_of_Pfizer_BioNTech_and_Moderna_Vaccines_in_Preventing_COVID_19_Hospitalization_Among_Immunocompetent_and_Immunocompromised_Adults___United_States_August_December_2021_ DB - PRIME DP - Unbound Medicine ER -