Covid-19 Rates by Time since Vaccination during Delta Variant Predominance

With the emergence of the delta variant, the United States experienced a rapid increase in Covid-19 cases in 2021. We estimated the risk of breakthrough infection and death by month of vaccination as a proxy for waning immunity during a period of delta variant predominance. Covid-19 case and death d...

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Vydané v:	NEJM evidence Ročník 1; číslo 3
Hlavní autori:	Paz-Bailey, Gabriela, Sternberg, Maya, Kugeler, Kiersten, Hoots, Brooke, Amin, Avnika B., Johnson, Amelia G., Barbeau, Bree, Bayoumi, Nagla S., Bertolino, Daniel, Boulton, Rachelle, Brown, Catherine M., Busen, Katherine, Cima, Michael, Drenzek, Cherie, Gent, Ashley, Haney, Gillian, Hicks, Liam, Hook, Sarah, Jara, Amanda, Jones, Amanda, Kamal-Ahmed, Ishrat, Kangas, Sarah, Kanishka, F.N.U., Khan, Saadiah I., Kirkendall, Samantha K., Kocharian, Anna, Lyons, B. Casey, Lauro, Priscilla, McCormick, Donald, McMullen, Chelsea, Milroy, Lauren, Reese, Heather E., Sell, Jessica, Sierocki, Allison, Smith, Elizabeth, Sosin, Daniel, Stanislawski, Emma, Strand, Kyle, Troelstrup, Thomas, Turner, Kathryn A., Vest, Hailey, Warner, Sydni, Wiedeman, Caleb, Silk, Benjamin, Scobie, Heather M.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States 10.01.2022
ISSN:	2766-5526, 2766-5526
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Abstract	With the emergence of the delta variant, the United States experienced a rapid increase in Covid-19 cases in 2021. We estimated the risk of breakthrough infection and death by month of vaccination as a proxy for waning immunity during a period of delta variant predominance. Covid-19 case and death data from 15 U.S. jurisdictions during January 3 to September 4, 2021 were used to estimate weekly hazard rates among fully vaccinated persons, stratified by age group and vaccine product. Case and death rates during August 1 to September 4, 2021 were presented across four cohorts defined by month of vaccination. Poisson models were used to estimate adjusted rate ratios comparing the earlier cohorts to July rates. During August 1 to September 4, 2021, case rates per 100,000 person-weeks among all vaccine recipients for the January to February, March to April, May to June, and July cohorts were 168.8 (95% confidence interval [CI], 167.5 to 170.1), 123.5 (95% CI, 122.8 to 124.1), 83.6 (95% CI, 82.9 to 84.3), and 63.1 (95% CI, 61.6 to 64.6), respectively. Similar trends were observed by age group for BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccine recipients. Rates for the Ad26.COV2.S (Janssen-Johnson & Johnson) vaccine were higher; however, trends were inconsistent. BNT162b2 vaccine recipients 65 years of age or older had higher death rates among those vaccinated earlier in the year. Protection against death was sustained for the mRNA-1273 vaccine recipients. Across age groups and vaccine types, people who were vaccinated 6 months ago or longer (January-February) were 3.44 (3.36 to 3.53) times more likely to be infected and 1.70 (1.29 to 2.23) times more likely to die from COVID-19 than people vaccinated recently in July 2021. Our study suggests that protection from SARS-CoV-2 infection among all ages or death among older adults waned with increasing time since vaccination during a period of delta predominance. These results add to the evidence base that supports U.S. booster recommendations, especially for older adults vaccinated with BNT162b2 and recipients of the Ad26.COV2.S vaccine. (Funded by the Centers for Disease Control and Prevention.).
AbstractList	With the emergence of the delta variant, the United States experienced a rapid increase in Covid-19 cases in 2021. We estimated the risk of breakthrough infection and death by month of vaccination as a proxy for waning immunity during a period of delta variant predominance.BACKGROUNDWith the emergence of the delta variant, the United States experienced a rapid increase in Covid-19 cases in 2021. We estimated the risk of breakthrough infection and death by month of vaccination as a proxy for waning immunity during a period of delta variant predominance.Covid-19 case and death data from 15 U.S. jurisdictions during January 3 to September 4, 2021 were used to estimate weekly hazard rates among fully vaccinated persons, stratified by age group and vaccine product. Case and death rates during August 1 to September 4, 2021 were presented across four cohorts defined by month of vaccination. Poisson models were used to estimate adjusted rate ratios comparing the earlier cohorts to July rates.METHODSCovid-19 case and death data from 15 U.S. jurisdictions during January 3 to September 4, 2021 were used to estimate weekly hazard rates among fully vaccinated persons, stratified by age group and vaccine product. Case and death rates during August 1 to September 4, 2021 were presented across four cohorts defined by month of vaccination. Poisson models were used to estimate adjusted rate ratios comparing the earlier cohorts to July rates.During August 1 to September 4, 2021, case rates per 100,000 person-weeks among all vaccine recipients for the January to February, March to April, May to June, and July cohorts were 168.8 (95% confidence interval [CI], 167.5 to 170.1), 123.5 (95% CI, 122.8 to 124.1), 83.6 (95% CI, 82.9 to 84.3), and 63.1 (95% CI, 61.6 to 64.6), respectively. Similar trends were observed by age group for BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccine recipients. Rates for the Ad26.COV2.S (Janssen-Johnson & Johnson) vaccine were higher; however, trends were inconsistent. BNT162b2 vaccine recipients 65 years of age or older had higher death rates among those vaccinated earlier in the year. Protection against death was sustained for the mRNA-1273 vaccine recipients. Across age groups and vaccine types, people who were vaccinated 6 months ago or longer (January-February) were 3.44 (3.36 to 3.53) times more likely to be infected and 1.70 (1.29 to 2.23) times more likely to die from COVID-19 than people vaccinated recently in July 2021.RESULTSDuring August 1 to September 4, 2021, case rates per 100,000 person-weeks among all vaccine recipients for the January to February, March to April, May to June, and July cohorts were 168.8 (95% confidence interval [CI], 167.5 to 170.1), 123.5 (95% CI, 122.8 to 124.1), 83.6 (95% CI, 82.9 to 84.3), and 63.1 (95% CI, 61.6 to 64.6), respectively. Similar trends were observed by age group for BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccine recipients. Rates for the Ad26.COV2.S (Janssen-Johnson & Johnson) vaccine were higher; however, trends were inconsistent. BNT162b2 vaccine recipients 65 years of age or older had higher death rates among those vaccinated earlier in the year. Protection against death was sustained for the mRNA-1273 vaccine recipients. Across age groups and vaccine types, people who were vaccinated 6 months ago or longer (January-February) were 3.44 (3.36 to 3.53) times more likely to be infected and 1.70 (1.29 to 2.23) times more likely to die from COVID-19 than people vaccinated recently in July 2021.Our study suggests that protection from SARS-CoV-2 infection among all ages or death among older adults waned with increasing time since vaccination during a period of delta predominance. These results add to the evidence base that supports U.S. booster recommendations, especially for older adults vaccinated with BNT162b2 and recipients of the Ad26.COV2.S vaccine. (Funded by the Centers for Disease Control and Prevention.).CONCLUSIONSOur study suggests that protection from SARS-CoV-2 infection among all ages or death among older adults waned with increasing time since vaccination during a period of delta predominance. These results add to the evidence base that supports U.S. booster recommendations, especially for older adults vaccinated with BNT162b2 and recipients of the Ad26.COV2.S vaccine. (Funded by the Centers for Disease Control and Prevention.). With the emergence of the delta variant, the United States experienced a rapid increase in Covid-19 cases in 2021. We estimated the risk of breakthrough infection and death by month of vaccination as a proxy for waning immunity during a period of delta variant predominance. Covid-19 case and death data from 15 U.S. jurisdictions during January 3 to September 4, 2021 were used to estimate weekly hazard rates among fully vaccinated persons, stratified by age group and vaccine product. Case and death rates during August 1 to September 4, 2021 were presented across four cohorts defined by month of vaccination. Poisson models were used to estimate adjusted rate ratios comparing the earlier cohorts to July rates. During August 1 to September 4, 2021, case rates per 100,000 person-weeks among all vaccine recipients for the January to February, March to April, May to June, and July cohorts were 168.8 (95% confidence interval [CI], 167.5 to 170.1), 123.5 (95% CI, 122.8 to 124.1), 83.6 (95% CI, 82.9 to 84.3), and 63.1 (95% CI, 61.6 to 64.6), respectively. Similar trends were observed by age group for BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccine recipients. Rates for the Ad26.COV2.S (Janssen-Johnson & Johnson) vaccine were higher; however, trends were inconsistent. BNT162b2 vaccine recipients 65 years of age or older had higher death rates among those vaccinated earlier in the year. Protection against death was sustained for the mRNA-1273 vaccine recipients. Across age groups and vaccine types, people who were vaccinated 6 months ago or longer (January-February) were 3.44 (3.36 to 3.53) times more likely to be infected and 1.70 (1.29 to 2.23) times more likely to die from COVID-19 than people vaccinated recently in July 2021. Our study suggests that protection from SARS-CoV-2 infection among all ages or death among older adults waned with increasing time since vaccination during a period of delta predominance. These results add to the evidence base that supports U.S. booster recommendations, especially for older adults vaccinated with BNT162b2 and recipients of the Ad26.COV2.S vaccine. (Funded by the Centers for Disease Control and Prevention.).
Author	Khan, Saadiah I. Scobie, Heather M. Jara, Amanda McCormick, Donald Warner, Sydni Brown, Catherine M. Kanishka, F.N.U. Kugeler, Kiersten Johnson, Amelia G. Kamal-Ahmed, Ishrat Sosin, Daniel Vest, Hailey Kocharian, Anna Milroy, Lauren Sternberg, Maya Sierocki, Allison Smith, Elizabeth Hoots, Brooke Barbeau, Bree Sell, Jessica Boulton, Rachelle Hicks, Liam Wiedeman, Caleb Strand, Kyle Kirkendall, Samantha K. McMullen, Chelsea Amin, Avnika B. Bayoumi, Nagla S. Cima, Michael Silk, Benjamin Stanislawski, Emma Turner, Kathryn A. Kangas, Sarah Hook, Sarah Paz-Bailey, Gabriela Drenzek, Cherie Haney, Gillian Jones, Amanda Busen, Katherine Gent, Ashley Lyons, B. Casey Troelstrup, Thomas Reese, Heather E. Lauro, Priscilla Bertolino, Daniel
AuthorAffiliation	5 Massachusetts Department of Public Health, Boston 6 Michigan Department of Health and Human Services, Lansing 12 Nebraska Department of Health and Human Services, Lincoln 1 Epidemiology Task Force, COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta 8 Georgia Department of Health, Atlanta 16 New Mexico Department of Health, Santa Fe 9 Florida Department of Health, Tallahassee 10 Arizona Department of Health Services, Phoenix 11 Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta 17 Indiana Department of Health, Indianapolis 3 New Jersey Department of Health, Trenton 7 Arkansas Department of Health, Little Rock 15 Data Analytics and Visualization Task Force, COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta 2 Utah Department of Health, Salt Lake City 18 Tennessee Department of Health, Nashville 4 New York City Department of Health and Mental Hygiene, Long Island City 13 Wisconsin Departme
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Snippet	With the emergence of the delta variant, the United States experienced a rapid increase in Covid-19 cases in 2021. We estimated the risk of breakthrough...
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Title	Covid-19 Rates by Time since Vaccination during Delta Variant Predominance
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