Application of a life table approach to assess duration of BNT162b2 vaccine-derived immunity by age using COVID-19 case surveillance data during the Omicron variant period

Background SARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S. multi-jurisdictional COVID-19 vaccine breakthrough surveillance data to examine potential waning of protection against SARS-CoV-2 infection for the Pfi...

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Published in:	PloS one Vol. 18; no. 9; p. e0291678
Main Authors:	Sternberg, Maya R., Johnson, Amelia, King, Justice, Ali, Akilah R., Linde, Lauren, Awofeso, Abiola O., Baker, Jodee S., Bayoumi, Nagla S., Broadway, Steven, Busen, Katherine, Chang, Carolyn, Cheng, Iris, Cima, Mike, Collingwood, Abi, Dorabawila, Vajeera, Drenzek, Cherie, Fleischauer, Aaron, Gent, Ashley, Hartley, Amanda, Hicks, Liam, Hoskins, Mikhail, Jara, Amanda, Jones, Amanda, Khan, Saadiah I., Kamal-Ahmed, Ishrat, Kangas, Sarah, Kanishka, FNU, Kleppinger, Alison, Kocharian, Anna, León, Tomás M., Link-Gelles, Ruth, Lyons, B. Casey, Masarik, John, May, Andrea, McCormick, Donald, Meyer, Stephanie, Milroy, Lauren, Morris, Keeley J., Nelson, Lauren, Omoike, Enaholo, Patel, Komal, Pietrowski, Michael, Pike, Melissa A., Pilishvili, Tamara, Peterson Pompa, Xandy, Powell, Charles, Praetorius, Kevin, Rosenberg, Eli, Schiller, Adam, Smith-Coronado, Mayra L., Stanislawski, Emma, Strand, Kyle, Tilakaratne, Buddhi P., Vest, Hailey, Wiedeman, Caleb, Zaldivar, Allison, Silk, Benjamin, Scobie, Heather M.
Format:	Journal Article
Language:	English
Published:	San Francisco Public Library of Science 20.09.2023 Public Library of Science (PLoS)
Subjects:	Age Age groups Biology and Life Sciences COVID-19 COVID-19 vaccines Disease control Disease prevention FDA approval Health surveillance Immunity Immunization Infections Jurisdiction Medicine and Health Sciences People and Places Public health Reduction Severe acute respiratory syndrome coronavirus 2 Surveillance Survival analysis Tables (data) Vaccine efficacy Vaccines United States > US
ISSN:	1932-6203, 1932-6203
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Abstract	Background SARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S. multi-jurisdictional COVID-19 vaccine breakthrough surveillance data to examine potential waning of protection against SARS-CoV-2 infection for the Pfizer-BioNTech (BNT162b) primary vaccination series by age. Methods Weekly numbers of SARS-CoV-2 infections during January 16, 2022–May 28, 2022 were analyzed by age group from 22 U.S. jurisdictions that routinely linked COVID-19 case surveillance and immunization data. A life table approach incorporating line-listed and aggregated COVID-19 case datasets with vaccine administration and U.S. Census data was used to estimate hazard rates of SARS-CoV-2 infections, hazard rate ratios (HRR) and percent reductions in hazard rate comparing unvaccinated people to people vaccinated with a Pfizer-BioNTech primary series only, by age group and time since vaccination. Results The percent reduction in hazard rates for persons 2 weeks after vaccination with a Pfizer-BioNTech primary series compared with unvaccinated persons was lowest among children aged 5–11 years at 35.5% (95% CI: 33.3%, 37.6%) compared to the older age groups, which ranged from 68.7%–89.6%. By 19 weeks after vaccination, all age groups showed decreases in the percent reduction in the hazard rates compared with unvaccinated people; with the largest declines observed among those aged 5–11 and 12–17 years and more modest declines observed among those 18 years and older. Conclusions The decline in vaccine protection against SARS-CoV-2 infection observed in this study is consistent with other studies and demonstrates that national case surveillance data were useful for assessing early signals in age-specific waning of vaccine protection during the initial period of SARS-CoV-2 Omicron variant predominance. The potential for waning immunity during the Omicron period emphasizes the importance of continued monitoring and consideration of optimal timing and provision of booster doses in the future.
AbstractList	Background SARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S. multi-jurisdictional COVID-19 vaccine breakthrough surveillance data to examine potential waning of protection against SARS-CoV-2 infection for the Pfizer-BioNTech (BNT162b) primary vaccination series by age. Methods Weekly numbers of SARS-CoV-2 infections during January 16, 2022–May 28, 2022 were analyzed by age group from 22 U.S. jurisdictions that routinely linked COVID-19 case surveillance and immunization data. A life table approach incorporating line-listed and aggregated COVID-19 case datasets with vaccine administration and U.S. Census data was used to estimate hazard rates of SARS-CoV-2 infections, hazard rate ratios (HRR) and percent reductions in hazard rate comparing unvaccinated people to people vaccinated with a Pfizer-BioNTech primary series only, by age group and time since vaccination. Results The percent reduction in hazard rates for persons 2 weeks after vaccination with a Pfizer-BioNTech primary series compared with unvaccinated persons was lowest among children aged 5–11 years at 35.5% (95% CI: 33.3%, 37.6%) compared to the older age groups, which ranged from 68.7%–89.6%. By 19 weeks after vaccination, all age groups showed decreases in the percent reduction in the hazard rates compared with unvaccinated people; with the largest declines observed among those aged 5–11 and 12–17 years and more modest declines observed among those 18 years and older. Conclusions The decline in vaccine protection against SARS-CoV-2 infection observed in this study is consistent with other studies and demonstrates that national case surveillance data were useful for assessing early signals in age-specific waning of vaccine protection during the initial period of SARS-CoV-2 Omicron variant predominance. The potential for waning immunity during the Omicron period emphasizes the importance of continued monitoring and consideration of optimal timing and provision of booster doses in the future. SARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S. multi-jurisdictional COVID-19 vaccine breakthrough surveillance data to examine potential waning of protection against SARS-CoV-2 infection for the Pfizer-BioNTech (BNT162b) primary vaccination series by age.BACKGROUNDSARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S. multi-jurisdictional COVID-19 vaccine breakthrough surveillance data to examine potential waning of protection against SARS-CoV-2 infection for the Pfizer-BioNTech (BNT162b) primary vaccination series by age.Weekly numbers of SARS-CoV-2 infections during January 16, 2022-May 28, 2022 were analyzed by age group from 22 U.S. jurisdictions that routinely linked COVID-19 case surveillance and immunization data. A life table approach incorporating line-listed and aggregated COVID-19 case datasets with vaccine administration and U.S. Census data was used to estimate hazard rates of SARS-CoV-2 infections, hazard rate ratios (HRR) and percent reductions in hazard rate comparing unvaccinated people to people vaccinated with a Pfizer-BioNTech primary series only, by age group and time since vaccination.METHODSWeekly numbers of SARS-CoV-2 infections during January 16, 2022-May 28, 2022 were analyzed by age group from 22 U.S. jurisdictions that routinely linked COVID-19 case surveillance and immunization data. A life table approach incorporating line-listed and aggregated COVID-19 case datasets with vaccine administration and U.S. Census data was used to estimate hazard rates of SARS-CoV-2 infections, hazard rate ratios (HRR) and percent reductions in hazard rate comparing unvaccinated people to people vaccinated with a Pfizer-BioNTech primary series only, by age group and time since vaccination.The percent reduction in hazard rates for persons 2 weeks after vaccination with a Pfizer-BioNTech primary series compared with unvaccinated persons was lowest among children aged 5-11 years at 35.5% (95% CI: 33.3%, 37.6%) compared to the older age groups, which ranged from 68.7%-89.6%. By 19 weeks after vaccination, all age groups showed decreases in the percent reduction in the hazard rates compared with unvaccinated people; with the largest declines observed among those aged 5-11 and 12-17 years and more modest declines observed among those 18 years and older.RESULTSThe percent reduction in hazard rates for persons 2 weeks after vaccination with a Pfizer-BioNTech primary series compared with unvaccinated persons was lowest among children aged 5-11 years at 35.5% (95% CI: 33.3%, 37.6%) compared to the older age groups, which ranged from 68.7%-89.6%. By 19 weeks after vaccination, all age groups showed decreases in the percent reduction in the hazard rates compared with unvaccinated people; with the largest declines observed among those aged 5-11 and 12-17 years and more modest declines observed among those 18 years and older.The decline in vaccine protection against SARS-CoV-2 infection observed in this study is consistent with other studies and demonstrates that national case surveillance data were useful for assessing early signals in age-specific waning of vaccine protection during the initial period of SARS-CoV-2 Omicron variant predominance. The potential for waning immunity during the Omicron period emphasizes the importance of continued monitoring and consideration of optimal timing and provision of booster doses in the future.CONCLUSIONSThe decline in vaccine protection against SARS-CoV-2 infection observed in this study is consistent with other studies and demonstrates that national case surveillance data were useful for assessing early signals in age-specific waning of vaccine protection during the initial period of SARS-CoV-2 Omicron variant predominance. The potential for waning immunity during the Omicron period emphasizes the importance of continued monitoring and consideration of optimal timing and provision of booster doses in the future. Background SARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S. multi-jurisdictional COVID-19 vaccine breakthrough surveillance data to examine potential waning of protection against SARS-CoV-2 infection for the Pfizer-BioNTech (BNT162b) primary vaccination series by age. Methods Weekly numbers of SARS-CoV-2 infections during January 16, 2022–May 28, 2022 were analyzed by age group from 22 U.S. jurisdictions that routinely linked COVID-19 case surveillance and immunization data. A life table approach incorporating line-listed and aggregated COVID-19 case datasets with vaccine administration and U.S. Census data was used to estimate hazard rates of SARS-CoV-2 infections, hazard rate ratios (HRR) and percent reductions in hazard rate comparing unvaccinated people to people vaccinated with a Pfizer-BioNTech primary series only, by age group and time since vaccination. Results The percent reduction in hazard rates for persons 2 weeks after vaccination with a Pfizer-BioNTech primary series compared with unvaccinated persons was lowest among children aged 5–11 years at 35.5% (95% CI: 33.3%, 37.6%) compared to the older age groups, which ranged from 68.7%–89.6%. By 19 weeks after vaccination, all age groups showed decreases in the percent reduction in the hazard rates compared with unvaccinated people; with the largest declines observed among those aged 5–11 and 12–17 years and more modest declines observed among those 18 years and older. Conclusions The decline in vaccine protection against SARS-CoV-2 infection observed in this study is consistent with other studies and demonstrates that national case surveillance data were useful for assessing early signals in age-specific waning of vaccine protection during the initial period of SARS-CoV-2 Omicron variant predominance. The potential for waning immunity during the Omicron period emphasizes the importance of continued monitoring and consideration of optimal timing and provision of booster doses in the future. BackgroundSARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S. multi-jurisdictional COVID-19 vaccine breakthrough surveillance data to examine potential waning of protection against SARS-CoV-2 infection for the Pfizer-BioNTech (BNT162b) primary vaccination series by age.MethodsWeekly numbers of SARS-CoV-2 infections during January 16, 2022-May 28, 2022 were analyzed by age group from 22 U.S. jurisdictions that routinely linked COVID-19 case surveillance and immunization data. A life table approach incorporating line-listed and aggregated COVID-19 case datasets with vaccine administration and U.S. Census data was used to estimate hazard rates of SARS-CoV-2 infections, hazard rate ratios (HRR) and percent reductions in hazard rate comparing unvaccinated people to people vaccinated with a Pfizer-BioNTech primary series only, by age group and time since vaccination.ResultsThe percent reduction in hazard rates for persons 2 weeks after vaccination with a Pfizer-BioNTech primary series compared with unvaccinated persons was lowest among children aged 5-11 years at 35.5% (95% CI: 33.3%, 37.6%) compared to the older age groups, which ranged from 68.7%-89.6%. By 19 weeks after vaccination, all age groups showed decreases in the percent reduction in the hazard rates compared with unvaccinated people; with the largest declines observed among those aged 5-11 and 12-17 years and more modest declines observed among those 18 years and older.ConclusionsThe decline in vaccine protection against SARS-CoV-2 infection observed in this study is consistent with other studies and demonstrates that national case surveillance data were useful for assessing early signals in age-specific waning of vaccine protection during the initial period of SARS-CoV-2 Omicron variant predominance. The potential for waning immunity during the Omicron period emphasizes the importance of continued monitoring and consideration of optimal timing and provision of booster doses in the future.
Author	Meyer, Stephanie Pietrowski, Michael Khan, Saadiah I. Scobie, Heather M. Omoike, Enaholo Smith-Coronado, Mayra L. King, Justice León, Tomás M. Collingwood, Abi Baker, Jodee S. Ali, Akilah R. Kocharian, Anna Milroy, Lauren Pilishvili, Tamara Praetorius, Kevin Masarik, John Hicks, Liam May, Andrea Strand, Kyle Cheng, Iris Silk, Benjamin Hoskins, Mikhail Linde, Lauren Kangas, Sarah Drenzek, Cherie Hartley, Amanda Jones, Amanda Busen, Katherine Gent, Ashley Patel, Komal Cima, Mike Jara, Amanda McCormick, Donald Awofeso, Abiola O. Morris, Keeley J. Chang, Carolyn Tilakaratne, Buddhi P. Kamal-Ahmed, Ishrat Vest, Hailey Kleppinger, Alison Nelson, Lauren Zaldivar, Allison Rosenberg, Eli Wiedeman, Caleb Bayoumi, Nagla S. Link-Gelles, Ruth Broadway, Steven Peterson Pompa, Xandy Sternberg, Maya R. Dorabawila, Vajeera Fleischauer, Aaron Pike, Melissa A. Stanislawski, Emma Kanishka, FNU Schiller, Adam Lyons, B. Casey Powell, Charles Johnson, Amelia
AuthorAffiliation	15 Division of Public Health, Nebraska Department of Health and Human Services, Lincoln, Nebraska, United States of America 17 Epidemiology and Infectious Disease Section, Connecticut Department of Public Health, Hartford, Connecticut, United States of America 24 CDC Foundation, Atlanta, Georgia, United States of America 23 Disease Control and Public Health Response Division, Colorado Department of Public Health and Environment, Denver, Colorado, United States of America 4 Communicable Disease Service, New Jersey Department of Health, Trenton, New Jersey, United States of America 25 Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, New Mexico, United States of America 21 Disease Epidemiology and Prevention Division, Indiana Department of Health, Indianapolis, Indiana, United States of America 22 Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, Pennsylvania, United States of America Touro University, UNITED STATES 19 Bureau of Epid
AuthorAffiliation_xml	– name: 7 Communicable Disease Service, New York City Department of Health and Mental Hygiene, Long Island City, New York, United States of America – name: 15 Division of Public Health, Nebraska Department of Health and Human Services, Lincoln, Nebraska, United States of America – name: 10 Bureau of Surveillance and Data Systems, Division of Epidemiology, Albany, New York State Department of Health, New York, NY, United States of America – name: 11 Acute Epidemiology, Georgia Department of Public Health, Atlanta, Georgia, United States of America – name: 12 Communicable and Environmental Diseases and Emergency Preparedness, Nashville, Tennessee Department of Health, Nashville, Tennessee, United States of America – name: 14 Communicable Disease, North Carolina Department of Health and Human Services, Raleigh, North Carolina, United States of America – name: 5 Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, Florida, United States of America – name: 23 Disease Control and Public Health Response Division, Colorado Department of Public Health and Environment, Denver, Colorado, United States of America – name: 2 Community Health Administration, DC Department of Health, Washington, District of Columbia, United States of America – name: 3 Division of Population Health, Utah Department of Health and Human Services, Salt Lake City, Utah, United States of America – name: 6 Division of Communicable Disease, Michigan Department of Health and Human Services, Lansing, Michigan, United States of America – name: 1 COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America – name: 13 Bureau of Infectious Disease and Services, Arizona Department of Health Services, Phoenix, Arizona, United States of America – name: Touro University, UNITED STATES – name: 8 Bureau of Immunization, New York City Department of Health and Mental Hygiene, Long Island City, New York, United States of America – name: 25 Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, New Mexico, United States of America – name: 16 COVID-19 Data and Surveillance Unit, Wisconsin Department of Health Services, Madison, Wisconsin, United States of America – name: 19 Bureau of Epidemiology and Public Health Informatics, Kansas Department of Health and Environment, Kansas, Missouri, United States of America – name: 24 CDC Foundation, Atlanta, Georgia, United States of America – name: 18 Center for Infectious Diseases, California Department of Public Health, Sacramento, California, United States of America – name: 4 Communicable Disease Service, New Jersey Department of Health, Trenton, New Jersey, United States of America – name: 17 Epidemiology and Infectious Disease Section, Connecticut Department of Public Health, Hartford, Connecticut, United States of America – name: 20 Infectious Disease Epidemiology, Prevention and Control Division, Minnesota Department of Health, Saint Paul, Minnesota, United States of America – name: 22 Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, Pennsylvania, United States of America – name: 9 Epidemilogy, Arkansas Department of Health, Little Rock, Arkansas, United States of America – name: 21 Disease Epidemiology and Prevention Division, Indiana Department of Health, Indianapolis, Indiana, United States of America
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ContentType	Journal Article
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Copyright_xml	– notice: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. – notice: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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Snippet	Background SARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S.... SARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S. multi-jurisdictional... BackgroundSARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S.... Background SARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S....
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SubjectTerms	Age Age groups Biology and Life Sciences COVID-19 COVID-19 vaccines Disease control Disease prevention FDA approval Health surveillance Immunity Immunization Infections Jurisdiction Medicine and Health Sciences People and Places Public health Reduction Severe acute respiratory syndrome coronavirus 2 Surveillance Survival analysis Tables (data) Vaccine efficacy Vaccines
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Title	Application of a life table approach to assess duration of BNT162b2 vaccine-derived immunity by age using COVID-19 case surveillance data during the Omicron variant period
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