Monitoring Incidence of COVID-19 Cases, Hospitalizations, and Deaths, by Vaccination Status — 13 U.S. Jurisdictions, April 4–July 17, 2021
COVID-19 vaccine breakthrough infection surveillance helps monitor trends in disease incidence and severe outcomes in fully vaccinated persons, including the impact of the highly transmissible B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19. Reported COVID-19 cases, hospitali...
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| Published in: | MMWR. Morbidity and mortality weekly report Vol. 70; no. 37; pp. 1284 - 1290 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article Newsletter |
| Language: | English |
| Published: |
Atlanta
Centers for Disease Control & Prevention (CDC)
17.09.2021
U.S. Government Printing Office U.S. Center for Disease Control Centers for Disease Control and Prevention |
| Subjects: | |
| ISSN: | 0149-2195, 1545-861X, 1545-861X |
| Online Access: | Get full text |
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| Abstract | COVID-19 vaccine breakthrough infection surveillance helps monitor trends in disease incidence and severe outcomes in fully vaccinated persons, including the impact of the highly transmissible B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19. Reported COVID-19 cases, hospitalizations, and deaths occurring among persons aged ≥18 years during April 4-July 17, 2021, were analyzed by vaccination status across 13 U.S. jurisdictions that routinely linked case surveillance and immunization registry data. Averaged weekly, age-standardized incidence rate ratios (IRRs) for cases among persons who were not fully vaccinated compared with those among fully vaccinated persons decreased from 11.1 (95% confidence interval [CI] = 7.8-15.8) to 4.6 (95% CI = 2.5-8.5) between two periods when prevalence of the Delta variant was lower (<50% of sequenced isolates; April 4-June 19) and higher (≥50%; June 20-July 17), and IRRs for hospitalizations and deaths decreased between the same two periods, from 13.3 (95% CI = 11.3-15.6) to 10.4 (95% CI = 8.1-13.3) and from 16.6 (95% CI = 13.5-20.4) to 11.3 (95% CI = 9.1-13.9). Findings were consistent with a potential decline in vaccine protection against confirmed SARS-CoV-2 infection and continued strong protection against COVID-19-associated hospitalization and death. Getting vaccinated protects against severe illness from COVID-19, including the Delta variant, and monitoring COVID-19 incidence by vaccination status might provide early signals of changes in vaccine-related protection that can be confirmed through well-controlled vaccine effectiveness (VE) studies.COVID-19 vaccine breakthrough infection surveillance helps monitor trends in disease incidence and severe outcomes in fully vaccinated persons, including the impact of the highly transmissible B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19. Reported COVID-19 cases, hospitalizations, and deaths occurring among persons aged ≥18 years during April 4-July 17, 2021, were analyzed by vaccination status across 13 U.S. jurisdictions that routinely linked case surveillance and immunization registry data. Averaged weekly, age-standardized incidence rate ratios (IRRs) for cases among persons who were not fully vaccinated compared with those among fully vaccinated persons decreased from 11.1 (95% confidence interval [CI] = 7.8-15.8) to 4.6 (95% CI = 2.5-8.5) between two periods when prevalence of the Delta variant was lower (<50% of sequenced isolates; April 4-June 19) and higher (≥50%; June 20-July 17), and IRRs for hospitalizations and deaths decreased between the same two periods, from 13.3 (95% CI = 11.3-15.6) to 10.4 (95% CI = 8.1-13.3) and from 16.6 (95% CI = 13.5-20.4) to 11.3 (95% CI = 9.1-13.9). Findings were consistent with a potential decline in vaccine protection against confirmed SARS-CoV-2 infection and continued strong protection against COVID-19-associated hospitalization and death. Getting vaccinated protects against severe illness from COVID-19, including the Delta variant, and monitoring COVID-19 incidence by vaccination status might provide early signals of changes in vaccine-related protection that can be confirmed through well-controlled vaccine effectiveness (VE) studies. |
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| AbstractList | What is already known about this topic? The incidence of SARS-CoV-2 infection, hospitalization, and death is higher in unvaccinated than vaccinated persons, and the incidence rate ratios are related to vaccine effectiveness. What is added by this report? Across 13 U.S. jurisdictions, incidence rate ratios for hospitalization and death changed relatively little after the SARS-CoV-2 B.1.617.2 (Delta) variant reached predominance, suggesting high, continued vaccine effectiveness against severe COVID-19. Case IRRs decreased, suggesting reduced vaccine effectiveness for prevention of SARS-CoV-2 infections. What are the implications for public health practice? Getting vaccinated protects against severe illness from COVID-19, including the Delta variant. Monitoring COVID-19 incidence by vaccination status might provide early signals of potential changes in vaccine effectiveness that can be confirmed through robust controlled studies. COVID-19 vaccine breakthrough infection surveillance helps monitor trends in disease incidence and severe outcomes in fully vaccinated persons, including the impact of the highly transmissible B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19. Reported COVID-19 cases, hospitalizations, and deaths occurring among persons aged ≥18 years during April 4-July 17, 2021, were analyzed by vaccination status across 13 U.S. jurisdictions that routinely linked case surveillance and immunization registry data. Averaged weekly, age-standardized incidence rate ratios (IRRs) for cases among persons who were not fully vaccinated compared with those among fully vaccinated persons decreased from 11.1 (95% confidence interval [CI] = 7.8-15.8) to 4.6 (95% CI = 2.5-8.5) between two periods when prevalence of the Delta variant was lower (<50% of sequenced isolates; April 4-June 19) and higher (≥50%; June 20-July 17), and IRRs for hospitalizations and deaths decreased between the same two periods, from 13.3 (95% CI = 11.3-15.6) to 10.4 (95% CI = 8.1-13.3) and from 16.6 (95% CI = 13.5-20.4) to 11.3 (95% CI = 9.1-13.9). Findings were consistent with a potential decline in vaccine protection against confirmed SARS-CoV-2 infection and continued strong protection against COVID-19-associated hospitalization and death. Getting vaccinated protects against severe illness from COVID-19, including the Delta variant, and monitoring COVID-19 incidence by vaccination status might provide early signals of changes in vaccine-related protection that can be confirmed through well-controlled vaccine effectiveness (VE) studies.COVID-19 vaccine breakthrough infection surveillance helps monitor trends in disease incidence and severe outcomes in fully vaccinated persons, including the impact of the highly transmissible B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19. Reported COVID-19 cases, hospitalizations, and deaths occurring among persons aged ≥18 years during April 4-July 17, 2021, were analyzed by vaccination status across 13 U.S. jurisdictions that routinely linked case surveillance and immunization registry data. Averaged weekly, age-standardized incidence rate ratios (IRRs) for cases among persons who were not fully vaccinated compared with those among fully vaccinated persons decreased from 11.1 (95% confidence interval [CI] = 7.8-15.8) to 4.6 (95% CI = 2.5-8.5) between two periods when prevalence of the Delta variant was lower (<50% of sequenced isolates; April 4-June 19) and higher (≥50%; June 20-July 17), and IRRs for hospitalizations and deaths decreased between the same two periods, from 13.3 (95% CI = 11.3-15.6) to 10.4 (95% CI = 8.1-13.3) and from 16.6 (95% CI = 13.5-20.4) to 11.3 (95% CI = 9.1-13.9). Findings were consistent with a potential decline in vaccine protection against confirmed SARS-CoV-2 infection and continued strong protection against COVID-19-associated hospitalization and death. Getting vaccinated protects against severe illness from COVID-19, including the Delta variant, and monitoring COVID-19 incidence by vaccination status might provide early signals of changes in vaccine-related protection that can be confirmed through well-controlled vaccine effectiveness (VE) studies. |
| Audience | Professional |
| Author | Meyer, Stephanie Scobie, Heather M. Pogosjans, Sargis Blythe, David Davidson, Sherri Kay, Meagan Saupe, Amy Patel, Monita R. Kugeler, Kiersten Balter, Sharon Hanson, Matt Johnson, Amelia G. Cadwell, Betsy Kidrowski, Holly Lyons, Shelby Komatsu, Kenneth Lewis, Melissa Milroy, Lauren Hawkins, Eric White, Kelly Hand, Julie Duchin, Jeff Hicks, Liam Devinney, Katelynn Cheng, Iris Hoskins, Mikhail MacNeil, Adam Delgadillo, Janelle Holtzman, Corinne Ritchey, Matthew D. Alden, Nisha B. Reese, Heather E. McCaffrey, Keegan Bertolino, Daniel Lynfield, Ruth Kim, Curi Brady, Shane Sosin, Daniel Sokol, Theresa Vest, Hailey Stevens, Kelly Severson, Rachel Kaur, Ramandeep Sell, Jessica Silk, Benjamin J. Herlihy, Rachel K. Suthar, Amitabh B. McMullen, Chelsea Grant, Ashley Griffin, Jennifer Haddix, Meredith Fisher, Rebecca Fleischauer, Aaron Hyun, Judie Stanislawski, Emma Wilson, Erica Lyons, B. Casey Duwell, Monique Nolen, Leisha |
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| ContentType | Journal Article Newsletter |
| Copyright | COPYRIGHT 2021 U.S. Government Printing Office Published 2021. This article is a U.S. Government work and is in the public domain in the USA. |
| Copyright_xml | – notice: COPYRIGHT 2021 U.S. Government Printing Office – notice: Published 2021. This article is a U.S. Government work and is in the public domain in the USA. |
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| DOI | 10.15585/mmwr.mm7037e1 |
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| References | Tenforde (key-10.15585/mmwr.mm7037e1-202109160930-R6) 2021; 70 key-10.15585/mmwr.mm7037e1-202109160930-R1 key-10.15585/mmwr.mm7037e1-202109160930-R2 Griffin (key-10.15585/mmwr.mm7037e1-202109160930-R3) 2021; 70 Fowlkes (key-10.15585/mmwr.mm7037e1-202109160930-R4) 2021; 70 Rosenberg (key-10.15585/mmwr.mm7037e1-202109160930-R5) 2021; 70 |
| References_xml | – volume: 70 start-page: 1170 year: 2021 ident: key-10.15585/mmwr.mm7037e1-202109160930-R3 article-title: SARS-CoV-2 infections and hospitalizations among persons aged ≥16 years, by vaccination status—Los Angeles County, California, May 1–July 25, 2021. publication-title: MMWR Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm7034e5 – ident: key-10.15585/mmwr.mm7037e1-202109160930-R2 doi: 10.1101/2021.08.27.21262356 – volume: 70 start-page: 1156 year: 2021 ident: key-10.15585/mmwr.mm7037e1-202109160930-R6 article-title: Sustained effectiveness of Pfizer-BioNTech and Moderna vaccines against COVID-19 associated hospitalizations among adults—United States, March–July 2021. publication-title: MMWR Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm7034e2 – volume: 70 start-page: 1167 year: 2021 ident: key-10.15585/mmwr.mm7037e1-202109160930-R4 article-title: Effectiveness of COVID-19 vaccines in preventing SARS-CoV-2 infection among frontline workers before and during B.1.617.2 (Delta) variant predominance—eight U.S. locations, December 2020–August 2021. publication-title: MMWR Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm7034e4 – ident: key-10.15585/mmwr.mm7037e1-202109160930-R1 – volume: 70 start-page: 1150 year: 2021 ident: key-10.15585/mmwr.mm7037e1-202109160930-R5 article-title: New COVID-19 cases and hospitalizations among adults, by vaccination status—New York, May 3–July 25, 2021. publication-title: MMWR Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm7034e1 |
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| Snippet | COVID-19 vaccine breakthrough infection surveillance helps monitor trends in disease incidence and severe outcomes in fully vaccinated persons, including the... What is already known about this topic? The incidence of SARS-CoV-2 infection, hospitalization, and death is higher in unvaccinated than vaccinated persons,... |
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| Title | Monitoring Incidence of COVID-19 Cases, Hospitalizations, and Deaths, by Vaccination Status — 13 U.S. Jurisdictions, April 4–July 17, 2021 |
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