COVID-19 Incidence and Mortality Among Unvaccinated and Vaccinated Persons Aged ≥12 Years by Receipt of Bivalent Booster Doses and Time Since Vaccination — 24 U.S. Jurisdictions, October 3, 2021–December 24, 2022
On September 1, 2022, CDC recommended an updated (bivalent) COVID-19 vaccine booster to help restore waning protection conferred by previous vaccination and broaden protection against emerging variants for persons aged ≥12 years (subsequently extended to persons aged ≥6 months).* To assess the impac...
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| Vydáno v: | MMWR. Morbidity and mortality weekly report Ročník 72; číslo 6; s. 145 - 152 |
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| Médium: | Journal Article Newsletter |
| Jazyk: | angličtina |
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United States
U.S. Government Printing Office
10.02.2023
U.S. Center for Disease Control Centers for Disease Control and Prevention |
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| ISSN: | 0149-2195, 1545-861X, 1545-861X |
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| Abstract | On September 1, 2022, CDC recommended an updated (bivalent) COVID-19 vaccine booster to help restore waning protection conferred by previous vaccination and broaden protection against emerging variants for persons aged ≥12 years (subsequently extended to persons aged ≥6 months).* To assess the impact of original (monovalent) COVID-19 vaccines and bivalent boosters, case and mortality rate ratios (RRs) were estimated comparing unvaccinated and vaccinated persons aged ≥12 years by overall receipt of and by time since booster vaccination (monovalent or bivalent) during Delta variant and Omicron sublineage (BA.1, BA.2, early BA.4/BA.5, and late BA.4/BA.5) predominance.
During the late BA.4/BA.5 period, unvaccinated persons had higher COVID-19 mortality and infection rates than persons receiving bivalent doses (mortality RR = 14.1 and infection RR = 2.8) and to a lesser extent persons vaccinated with only monovalent doses (mortality RR = 5.4 and infection RR = 2.5). Among older adults, mortality rates among unvaccinated persons were significantly higher than among those who had received a bivalent booster (65-79 years; RR = 23.7 and ≥80 years; 10.3) or a monovalent booster (65-79 years; 8.3 and ≥80 years; 4.2). In a second analysis stratified by time since booster vaccination, there was a progressive decline from the Delta period (RR = 50.7) to the early BA.4/BA.5 period (7.4) in relative COVID-19 mortality rates among unvaccinated persons compared with persons receiving who had received a monovalent booster within 2 weeks-2 months. During the early BA.4/BA.5 period, declines in relative mortality rates were observed at 6-8 (RR = 4.6), 9-11 (4.5), and ≥12 (2.5) months after receiving a monovalent booster. In contrast, bivalent boosters received during the preceding 2 weeks-2 months improved protection against death (RR = 15.2) during the late BA.4/BA.5 period. In both analyses, when compared with unvaccinated persons, persons who had received bivalent boosters were provided additional protection against death over monovalent doses or monovalent boosters. Restored protection was highest in older adults. All persons should stay up to date with COVID-19 vaccination, including receipt of a bivalent booster by eligible persons, to reduce the risk for severe COVID-19. |
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| AbstractList | On September 1, 2022, CDC recommended an updated (bivalent) COVID-19 vaccine booster to help restore waning protection conferred by previous vaccination and broaden protection against emerging variants for persons aged ≥12 years (subsequently extended to persons aged ≥6 months).* To assess the impact of original (monovalent) COVID-19 vaccines and bivalent boosters, case and mortality rate ratios (RRs) were estimated comparing unvaccinated and vaccinated persons aged ≥12 years by overall receipt of and by time since booster vaccination (monovalent or bivalent) during Delta variant and Omicron sublineage (BA.1, BA.2, early BA.4/BA.5, and late BA.4/BA.5) predominance.
During the late BA.4/BA.5 period, unvaccinated persons had higher COVID-19 mortality and infection rates than persons receiving bivalent doses (mortality RR = 14.1 and infection RR = 2.8) and to a lesser extent persons vaccinated with only monovalent doses (mortality RR = 5.4 and infection RR = 2.5). Among older adults, mortality rates among unvaccinated persons were significantly higher than among those who had received a bivalent booster (65-79 years; RR = 23.7 and ≥80 years; 10.3) or a monovalent booster (65-79 years; 8.3 and ≥80 years; 4.2). In a second analysis stratified by time since booster vaccination, there was a progressive decline from the Delta period (RR = 50.7) to the early BA.4/BA.5 period (7.4) in relative COVID-19 mortality rates among unvaccinated persons compared with persons receiving who had received a monovalent booster within 2 weeks-2 months. During the early BA.4/BA.5 period, declines in relative mortality rates were observed at 6-8 (RR = 4.6), 9-11 (4.5), and ≥12 (2.5) months after receiving a monovalent booster. In contrast, bivalent boosters received during the preceding 2 weeks-2 months improved protection against death (RR = 15.2) during the late BA.4/BA.5 period. In both analyses, when compared with unvaccinated persons, persons who had received bivalent boosters were provided additional protection against death over monovalent doses or monovalent boosters. Restored protection was highest in older adults. All persons should stay up to date with COVID-19 vaccination, including receipt of a bivalent booster by eligible persons, to reduce the risk for severe COVID-19. On September 1, 2022, CDC recommended an updated (bivalent) COVID-19 vaccine booster to help restore waning protection conferred by previous vaccination and broaden protection against emerging variants for persons aged ≥12 years (subsequently extended to persons aged ≥6 months).* To assess the impact of original (monovalent) COVID-19 vaccines and bivalent boosters, case and mortality rate ratios (RRs) were estimated comparing unvaccinated and vaccinated persons aged ≥12 years by overall receipt of and by time since booster vaccination (monovalent or bivalent) during Delta variant and Omicron sublineage (BA.1, BA.2, early BA.4/BA.5, and late BA.4/BA.5) predominance.† During the late BA.4/BA.5 period, unvaccinated persons had higher COVID-19 mortality and infection rates than persons receiving bivalent doses (mortality RR = 14.1 and infection RR = 2.8) and to a lesser extent persons vaccinated with only monovalent doses (mortality RR = 5.4 and infection RR = 2.5). Among older adults, mortality rates among unvaccinated persons were significantly higher than among those who had received a bivalent booster (65-79 years; RR = 23.7 and ≥80 years; 10.3) or a monovalent booster (65-79 years; 8.3 and ≥80 years; 4.2). In a second analysis stratified by time since booster vaccination, there was a progressive decline from the Delta period (RR = 50.7) to the early BA.4/BA.5 period (7.4) in relative COVID-19 mortality rates among unvaccinated persons compared with persons receiving who had received a monovalent booster within 2 weeks-2 months. During the early BA.4/BA.5 period, declines in relative mortality rates were observed at 6-8 (RR = 4.6), 9-11 (4.5), and ≥12 (2.5) months after receiving a monovalent booster. In contrast, bivalent boosters received during the preceding 2 weeks-2 months improved protection against death (RR = 15.2) during the late BA.4/BA.5 period. In both analyses, when compared with unvaccinated persons, persons who had received bivalent boosters were provided additional protection against death over monovalent doses or monovalent boosters. Restored protection was highest in older adults. All persons should stay up to date with COVID-19 vaccination, including receipt of a bivalent booster by eligible persons, to reduce the risk for severe COVID-19.On September 1, 2022, CDC recommended an updated (bivalent) COVID-19 vaccine booster to help restore waning protection conferred by previous vaccination and broaden protection against emerging variants for persons aged ≥12 years (subsequently extended to persons aged ≥6 months).* To assess the impact of original (monovalent) COVID-19 vaccines and bivalent boosters, case and mortality rate ratios (RRs) were estimated comparing unvaccinated and vaccinated persons aged ≥12 years by overall receipt of and by time since booster vaccination (monovalent or bivalent) during Delta variant and Omicron sublineage (BA.1, BA.2, early BA.4/BA.5, and late BA.4/BA.5) predominance.† During the late BA.4/BA.5 period, unvaccinated persons had higher COVID-19 mortality and infection rates than persons receiving bivalent doses (mortality RR = 14.1 and infection RR = 2.8) and to a lesser extent persons vaccinated with only monovalent doses (mortality RR = 5.4 and infection RR = 2.5). Among older adults, mortality rates among unvaccinated persons were significantly higher than among those who had received a bivalent booster (65-79 years; RR = 23.7 and ≥80 years; 10.3) or a monovalent booster (65-79 years; 8.3 and ≥80 years; 4.2). In a second analysis stratified by time since booster vaccination, there was a progressive decline from the Delta period (RR = 50.7) to the early BA.4/BA.5 period (7.4) in relative COVID-19 mortality rates among unvaccinated persons compared with persons receiving who had received a monovalent booster within 2 weeks-2 months. During the early BA.4/BA.5 period, declines in relative mortality rates were observed at 6-8 (RR = 4.6), 9-11 (4.5), and ≥12 (2.5) months after receiving a monovalent booster. In contrast, bivalent boosters received during the preceding 2 weeks-2 months improved protection against death (RR = 15.2) during the late BA.4/BA.5 period. In both analyses, when compared with unvaccinated persons, persons who had received bivalent boosters were provided additional protection against death over monovalent doses or monovalent boosters. Restored protection was highest in older adults. All persons should stay up to date with COVID-19 vaccination, including receipt of a bivalent booster by eligible persons, to reduce the risk for severe COVID-19. What is already known about this topic? COVID-19 vaccine effectiveness decreased with waning of vaccine-derived immunity and emerging Omicron sublineages. An updated (bivalent) booster dose enhances protection against infection and medically attended illness, but protection against death has not been evaluated. What is added by this report? Bivalent booster recipients in 24 U.S. jurisdictions had slightly higher protection against infection and significantly higher protection against death than was observed for monovalent booster recipients or unvaccinated persons, especially among older adults. What are the implications for public health practice? Bivalent COVID-19 booster doses protected against infection and death during BA.4/BA.5 circulation. All eligible persons should get 1 bivalent booster dose ≥2 months after their COVID-19 primary series or last monovalent booster dose. |
| Audience | Professional |
| Author | Durant, Tonji Khan, Saadiah I. Scobie, Heather M. Chasse, Melisse Omoike, Enaholo Cunningham, Spencer DeSantis, Allison Husain, Sofia Hodis, Jeffrey D. Kirkendall, Samantha Johnson, Amelia G. Lyons, Shelby Ali, Akilah R. Pilishvili, Tamara Praetorius, Kevin Masarik, John Hicks, Liam Sigalo, Nekabari Auche, Steven Harrington, Pauline Hoskins, Mikhail Linde, Lauren Delgadillo, Janelle Hoefer, Dina Ingram, L. Amanda Turner, Kathryn A. Armstrong, Brett Kanishka, F. N. U. Drenzek, Cherie Jones, Amanda Christofferson, Scott Lauro, Priscilla Reed, Isaiah G. Patel, Komal Jara, Amanda Mansfield, Joshua McCormick, Donald Morris, Keeley J. Shi, Minchan Hamilton, Ross Armstrong, Brandy Tilakaratne, Buddhi P. Markelz, Amanda Stich, Sarah Zaldivar, Allison Adam, Carolyn Kaur, Ramandeep Silk, Benjamin J. Horrocks, Sam Wiedeman, Caleb Bayoumi, Nagla S. Cima, Michael Dorabawila, Vajeera Severson, Rachel L. Dupervil, Brandi Fleischauer, Aaron Pike, Melissa A. Stanislawski, Emma Mendoza, Erica Bingay, Boudu Asbell, Madison Cueto, Kevin |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36757865$$D View this record in MEDLINE/PubMed |
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| Copyright | COPYRIGHT 2023 U.S. Government Printing Office Published 2023. This article is a U.S. Government work and is in the public domain in the USA. |
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| PublicationTitle | MMWR. Morbidity and mortality weekly report |
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| References | Link-Gelles (key-10.15585/mmwr.mm7206a3-202302090653-R5) 2022; 71 Tenforde (key-10.15585/mmwr.mm7206a3-202302090653-R7) 2022; 71 Paz-Bailey (key-10.15585/mmwr.mm7206a3-202302090653-R4) 2021 Fast (key-10.15585/mmwr.mm7206a3-202302090653-R10) 2021; 70 key-10.15585/mmwr.mm7206a3-202302090653-R8 Surie (key-10.15585/mmwr.mm7206a3-202302090653-R6) 2022; 71 Scheffer (key-10.15585/mmwr.mm7206a3-202302090653-R9) 2015; 46 Johnson (key-10.15585/mmwr.mm7206a3-202302090653-R3) 2022; 71 key-10.15585/mmwr.mm7206a3-202302090653-R1 Scobie (key-10.15585/mmwr.mm7206a3-202302090653-R2) 2021; 70 |
| References_xml | – volume: 71 start-page: 1526 year: 2022 ident: key-10.15585/mmwr.mm7206a3-202302090653-R5 article-title: Effectiveness of bivalent mRNA vaccines in preventing symptomatic SARS-CoV-2 infection—Increasing Community Access to Testing Program, United States, September–November 2022. publication-title: MMWR Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm7148e1 – ident: key-10.15585/mmwr.mm7206a3-202302090653-R1 – year: 2021 ident: key-10.15585/mmwr.mm7206a3-202302090653-R4 article-title: Covid-19 rates by time since vaccination during Delta variant predominance. publication-title: NEJM Evid doi: 10.1056/EVIDoa2100057 – volume: 71 start-page: 1616 year: 2022 ident: key-10.15585/mmwr.mm7206a3-202302090653-R7 article-title: Early estimates of bivalent mRNA vaccine effectiveness in preventing COVID-19–associated emergency department or urgent care encounters and hospitalizations among immunocompetent adults—VISION Network, nine states, September–November 2022. publication-title: MMWR Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm715152e1 – volume: 71 start-page: 132 year: 2022 ident: key-10.15585/mmwr.mm7206a3-202302090653-R3 article-title: COVID-19 incidence and death rates among unvaccinated and fully vaccinated adults with and without booster doses during periods of Delta and Omicron variant emergence—25 U.S. jurisdictions, April 4–December 25, 2021. publication-title: MMWR Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm7104e2 – volume: 70 start-page: 1735 year: 2021 ident: key-10.15585/mmwr.mm7206a3-202302090653-R10 article-title: Booster and additional primary dose COVID-19 vaccinations among adults aged ≥65 years—United States, August 13, 2021–November 19, 2021. publication-title: MMWR Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm7050e2 – volume: 46 start-page: 145 year: 2015 ident: key-10.15585/mmwr.mm7206a3-202302090653-R9 article-title: Generic indicators of ecological resilience: inferring the chance of a critical transition. publication-title: Annu Rev Ecol Evol Syst doi: 10.1146/annurev-ecolsys-112414-054242 – volume: 70 start-page: 1284 year: 2021 ident: key-10.15585/mmwr.mm7206a3-202302090653-R2 article-title: Monitoring incidence of COVID-19 cases, hospitalizations, and deaths, by vaccination status—13 US jurisdictions, April 4–July 17, 2021. publication-title: MMWR Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm7037e1 – volume: 71 start-page: 1625 year: 2022 ident: key-10.15585/mmwr.mm7206a3-202302090653-R6 article-title: Early effectiveness estimates of bivalent mRNA vaccines in preventing COVID-19–associated hospitalization among immunocompetent adults aged ≥65 years—IVY Network, 18 states, September 8–November 30, 2022. publication-title: MMWR Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm715152e2 – ident: key-10.15585/mmwr.mm7206a3-202302090653-R8 |
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| Snippet | On September 1, 2022, CDC recommended an updated (bivalent) COVID-19 vaccine booster to help restore waning protection conferred by previous vaccination and... What is already known about this topic? COVID-19 vaccine effectiveness decreased with waning of vaccine-derived immunity and emerging Omicron sublineages. An... |
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| SubjectTerms | Adults Age groups Aged Coronaviruses COVID-19 COVID-19 - epidemiology COVID-19 - prevention & control COVID-19 Vaccines Death Death & dying Dosage Full Report Health aspects Humans Immunity Immunization Incidence Infections Jurisdiction Mortality Older people Protection Public health SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Vaccination Vaccine efficacy Vaccines Viral diseases |
| Title | COVID-19 Incidence and Mortality Among Unvaccinated and Vaccinated Persons Aged ≥12 Years by Receipt of Bivalent Booster Doses and Time Since Vaccination — 24 U.S. Jurisdictions, October 3, 2021–December 24, 2022 |
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