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

Ian D Plumb; Nicholas M Mohr; Melissa Hagen; Ryan Wiegand; Ghinwa Dumyati; Karisa K Harland; Anusha Krishnadasan; Jade James Gist; Glen Abedi; Katherine E Fleming-Dutra; Nora Chea; Jane Lee; Devra Barter; Monica Brackney; Scott K Fridkin; Lucy E Wilson; Sara A Lovett; Valerie Ocampo; Erin C Phipps; Tiffanie M Marcus; Howard A Smithline; Peter C Hou; Lilly C Lee; Gregory J Moran; Elizabeth Krebs; Mark T Steele; Stephen C Lim; Walter A Schrading; Brian Chinnock; David G Beiser; Brett Faine; John P Haran; Utsav Nandi; Anne K Chipman; Frank LoVecchio; David A Talan; Tamara Pilishvili

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

Open Forum Infect Dis. 2023 Sep 8;10(10):ofad457. doi: 10.1093/ofid/ofad457. eCollection 2023 Oct.

Authors

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.

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.

Abstract

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