Effectiveness of Pfizer-BioNTech and Moderna Vaccines Against COVID-19 Among Hospitalized Adults Aged ≥65 Years - United States, January-March 2021 - PubMed (original) (raw)

. 2021 May 7;70(18):674-679.

doi: 10.15585/mmwr.mm7018e1.

Samantha M Olson, Wesley H Self, H Keipp Talbot, Christopher J Lindsell, Jay S Steingrub, Nathan I Shapiro, Adit A Ginde, David J Douin, Matthew E Prekker, Samuel M Brown, Ithan D Peltan, Michelle N Gong, Amira Mohamed, Akram Khan, Matthew C Exline, D Clark Files, Kevin W Gibbs, William B Stubblefield, Jonathan D Casey, Todd W Rice, Carlos G Grijalva, David N Hager, Arber Shehu, Nida Qadir, Steven Y Chang, Jennifer G Wilson, Manjusha Gaglani, Kempapura Murthy, Nicole Calhoun, Arnold S Monto, Emily T Martin, Anurag Malani, Richard K Zimmerman, Fernanda P Silveira, Donald B Middleton, Yuwei Zhu, Dayna Wyatt, Meagan Stephenson, Adrienne Baughman, Kelsey N Womack, Kimberly W Hart, Miwako Kobayashi, Jennifer R Verani, Manish M Patel; IVY Network; HAIVEN Investigators

Collaborators, Affiliations

Effectiveness of Pfizer-BioNTech and Moderna Vaccines Against COVID-19 Among Hospitalized Adults Aged ≥65 Years - United States, January-March 2021

Mark W Tenforde et al. MMWR Morb Mortal Wkly Rep. 2021.

Abstract

Adults aged ≥65 years are at increased risk for severe outcomes from COVID-19 and were identified as a priority group to receive the first COVID-19 vaccines approved for use under an Emergency Use Authorization (EUA) in the United States (1-3). In an evaluation at 24 hospitals in 14 states,* the effectiveness of partial or full vaccination† with Pfizer-BioNTech or Moderna vaccines against COVID-19-associated hospitalization was assessed among adults aged ≥65 years. Among 417 hospitalized adults aged ≥65 years (including 187 case-patients and 230 controls), the median age was 73 years, 48% were female, 73% were non-Hispanic White, 17% were non-Hispanic Black, 6% were Hispanic, and 4% lived in a long-term care facility. Adjusted vaccine effectiveness (VE) against COVID-19-associated hospitalization among adults aged ≥65 years was estimated to be 94% (95% confidence interval [CI] = 49%-99%) for full vaccination and 64% (95% CI = 28%-82%) for partial vaccination. These findings are consistent with efficacy determined from clinical trials in the subgroup of adults aged ≥65 years (4,5). This multisite U.S. evaluation under real-world conditions suggests that vaccination provided protection against COVID-19-associated hospitalization among adults aged ≥65 years. Vaccination is a critical tool for reducing severe COVID-19 in groups at high risk.

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Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Christopher J. Lindsell reports grants from National Institutes of Health, U.S. Department of Defense, Marcus Foundation, Endpoint Health, Entegrion, bioMerieux, and Bioscape Digital, outside the submitted work. Jay S. Steingrub reports grants from National Institutes of Health, outside the submitted work. Akram Khan reports grants from United Therapeutics, Actelion Pharmaceuticals, Regeneron, and Reata Pharmaceuticals, outside the submitted work. Samuel M. Brown reports grants from National Institutes of Health, U.S. Department of Defense, Intermountain Research and Medical Foundation, and Janssen, and consulting fees paid to his employer from Faron and Sedana, all outside the submitted work. Ithan D. Peltan reports grants from National Institutes of Health and, outside the submitted work, grants from Asahi Kasei Pharma, Janssen Pharmaceuticals, and Regeneron. Adit A. Ginde reports grants from National Institutes of Health, U.S. Department of Defense and AbbVie, outside the submitted work. Carlos G. Grijalva reports consulting fees from Pfizer, Merck, and Sanofi-Pasteur, grants from Campbell Alliance/Syneos Health, National Institutes of Health, Food and Drug Administration, and Agency for Health Care Research and Quality, outside the submitted work. Michelle N. Gong reports grants from National Institutes of Health, Agency for Healthcare Research and Quality, and consulting fees from Regeneron, Philips Healthcare, all outside the submitted work. Steven Y. Chang reports consulting fees from PureTech Health and speaker fees from La Jolla Pharmaceuticals, both outside the submitted work. Jonathan D. Casey reports grants from National Institutes of Health, outside the submitted work. Todd W. Rice reports grants from National Institutes of Health and Endpoint Health, consulting work for Cumberland Pharmaceuticals, Inc, and Sanofi, Inc., outside the submitted work. Manjusha Gaglani reports grants from CDC-Abt Associates, outside the submitted work. Emily T. Martin reports personal fees from Pfizer and grants from Merck, outside the submitted work. Anurag Malani reports shareholder of Pfizer pharmaceuticals. Arnold S. Monto reports personal fees from Sanofi Pasteur and Seqirus, outside the submitted work. Fernanda P. Silveira reports grants from Shire, Qiagen, Ansun, and Novartis, outside the submitted work. Richard K. Zimmerman reports grants from Sanofi Pasteur, outside the submitted work. Donald B. Middleton reports grants and personal fees from Pfizer and personal fees from Seqirus, Sanofi Pasteur, and GlaxoSmithKline, outside the submitted work. No other potential conflicts of interest were disclosed.

Figures

FIGURE

FIGURE

Adjusted vaccine effectiveness (with 95% confidence intervals) against COVID-19 among hospitalized adults aged ≥65 years, by vaccination status — 24 medical centers in 14 states, January–March 2021 Abbreviations: HAIVEN = Hospitalized Adult Influenza Vaccine Effectiveness Network; IVY = Influenza and Other Viruses in the Acutely Ill. * Vaccine effectiveness estimates were adjusted for U.S. Census region, calendar month, continuous age in years, sex, race and ethnicity (non-Hispanic White, non-Hispanic Black, non-Hispanic other or unknown, or Hispanic of any race), and one or more versus zero self-reported previous hospitalizations in the past year. † Clinical criteria for hospitalized COVID-19–like illness varied by hospital network. IVY Network criteria for COVID-19–like illness included presence of fever, feverishness, cough, sore throat, myalgias, shortness of breath, chest pain, loss of taste, loss of smell, respiratory congestion, increased sputum production, new oxygen saturation <94% on room air, new invasive or noninvasive ventilation, or new pulmonary findings on chest imaging consistent with pneumonia in the IVY Network; criteria included fever without a known non–COVID-19 cause, new or worsening cough, a change in sputum production, or new or worsening shortness of breath in the HAIVEN network. § SARS-CoV-2 vaccination status included the following four categories: 1) unvaccinated, defined as no receipt of any SARS CoV-2 vaccine; 2) first vaccine dose <14 days before illness onset, defined as a single dose of vaccine within 14 days prior to onset of COVID-19–like illness; 3) partially vaccinated, defined as receipt of 1 dose of a 2-dose vaccine series (Pfizer-BioNTech or Moderna) ≥14 days before illness onset or 2 doses with the second dose received <14 days before illness onset); 4) fully vaccinated, defined as receipt of both doses of a 2-dose vaccine series ≥14 days before illness onset. Patients were enrolled from 24 medical centers in 14 states (University of California Los Angeles and Stanford University [California], UCHealth University of Colorado Hospital [Colorado], Johns Hopkins Hospital [Maryland], Beth Israel Deaconess Medical Center and Baystate Medical Center [Massachusetts], University of Michigan, Henry Ford, and St. Joseph [Michigan], Hennepin County Medical Center [Minnesota], Montefiore Healthcare Center [New York], Wake Forest University [North Carolina], Ohio State University [Ohio], Oregon Health & Science University [Oregon], University of Pittsburgh Medical Center, Shadyside, Mercy, Passavant, St. Margaret, and Presbyterian Hospitals [Pennsylvania], Vanderbilt University Medical Center [Tennessee], Baylor Scott & White Medical Center, Temple, Round Rock, Hillcrest/Waco [Texas], and Intermountain Health [Utah]).

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