1887
Research Open Access
Like 0

Abstract

Background

As COVID-19 vaccine effectiveness against SARS-CoV-2 infection was lower for cases of the Omicron vs the Delta variant, understanding the effect of vaccination in reducing risk of hospitalisation and severe disease among COVID-19 cases is crucial.

Aim

To evaluate risk reduction of hospitalisation and severe disease in vaccinated COVID-19 cases during the Omicron BA.1-predominant period in Navarre, Spain.

Methods

A case-to-case comparison included COVID-19 epidemiological surveillance data in adults ≥ 18 years from 3 January–20 March 2022. COVID-19 vaccination status was compared between hospitalised and non-hospitalised cases, and between severe (intensive care unit admission or death) and non-severe cases using logistic regression models.

Results

Among 58,952 COVID-19 cases, 565 (1.0%) were hospitalised and 156 (0.3%) were severe. The risk of hospitalisation was reduced within the first 6 months after full COVID-19 vaccination (complete primary series) (adjusted odds ratio (aOR): 0.06; 95% CI: 0.04–0.09) and after 6 months (aOR: 0.16; 95% CI: 0.12–0.21; p < 0.001), as well as after a booster dose (aOR: 0.06: 95% CI: 0.04–0.07). Similarly, the risk of severe disease was reduced (aOR: 0.13, 0.18, and 0.06, respectively). Compared with cases fully vaccinated 6 months or more before a positive test, those who had received a booster dose had lower risk of hospitalisation (aOR: 0.38; 95% CI: 0.28–0.52) and severe disease (aOR: 0.38; 95% CI: 0.21–0.68).

Conclusions

Full COVID-19 vaccination greatly reduced the risk of hospitalisation and severe outcomes in COVID-19 cases with the Omicron variant, and a booster dose improved this effect in people aged over 65 years.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2023.28.5.2200337
2023-02-02
2024-05-25
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.5.2200337
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/28/5/eurosurv-28-5-4.html?itemId=/content/10.2807/1560-7917.ES.2023.28.5.2200337&mimeType=html&fmt=ahah

References

  1. World Health Organization (WHO). Classification of Omicron (B.1.1.529): SARS CoV-2 variant of concern. Geneva: WHO; 2021. Available from: https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern
  2. European Centre for Disease Prevention and Control (ECDC). Assessment of the further spread and potential impact of the SARS-CoV-2 Omicron variant of concern in the EU/EEA, 19th update - 27 January 2022. Stockholm; ECDC; 2022. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/RRA-19-update-27-jan-2022.pdf
  3. World Health Organization (WHO). Weekly epidemiological update on COVID-19 – 22 March 2022. Geneva: WHO: 2022. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---22-march-2022
  4. World Health Organization (WHO). Interim statement on COVID-19 vaccines in the context of the circulation of the Omicron SARS-CoV-2 variant from the WHO Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC), 08 March 2022. Geneva: WHO; 2022. Available from: https://www.who.int/news/item/08-03-2022-interim-statement-on-covid-19-vaccines-in-the-context-of-the-circulation-of-the-omicron-sars-cov-2-variant-from-the-who-technical-advisory-group-on-covid-19-vaccine-composition-(tag-co-vac)-08-march-2022
  5. Consejo Interterritorial del Sistema Nacional de Salud. Estrategia de vacunación frente a COVID-19 en España. Actualización 11, 8 febrero 2022. [Vaccination strategy against COVID-19 in Spain. Update 11, 8 February 2022]. Madrid: Spanish Ministry of Health, 2022. Spanish. Available from: https://www.sanidad.gob.es/profesionales/saludPublica/prevPromocion/vacunaciones/covid19/Actualizaciones_Estrategia_Vacunacion/docs/COVID-19_Actualizacion6_EstrategiaVacunacion.pdf
  6. Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020;383(27):2603-15.  https://doi.org/10.1056/NEJMoa2034577  PMID: 33301246 
  7. Voysey M, Costa Clemens SA, Madhi SA, Weckx LY, Folegatti PM, Aley PK, et al. Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine: a pooled analysis of four randomised trials. Lancet. 2021;397(10277):881-91.  https://doi.org/10.1016/S0140-6736(21)00432-3  PMID: 33617777 
  8. Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med. 2021;384(5):403-16.  https://doi.org/10.1056/NEJMoa2035389  PMID: 33378609 
  9. Sadoff J, Gray G, Vandebosch A, Cárdenas V, Shukarev G, Grinsztejn B, et al. Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19. N Engl J Med. 2021;384(23):2187-201.  https://doi.org/10.1056/NEJMoa2101544  PMID: 33882225 
  10. Ministerio de Sanidad. GIV COVID-19. Gestión integral de la vacunación COVID-19. Fecha del Informe 30/11/2021 [Spanish Ministry of Health. Integrate management of the COVID-19 vaccination programme. Report 30/11/2021]. Madrid: Spanish government; 2021. Available from: https://www.sanidad.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/Informe_GIV_comunicacion_20211130.pdf
  11. Eggink D, Andeweg SP, Vennema H, van Maarseveen N, Vermaas K, Vlaemynck B, et al. Increased risk of infection with SARS-CoV-2 Omicron BA.1 compared with Delta in vaccinated and previously infected individuals, the Netherlands, 22 November 2021 to 19 January 2022. Euro Surveill. 2022;27(4):2101196.  https://doi.org/10.2807/1560-7917.ES.2022.27.4.2101196  PMID: 35086609 
  12. Accorsi EK, Britton A, Fleming-Dutra KE, Smith ZR, Shang N, Derado G, et al. Association between 3 doses of mRNA COVID-19 vaccine and symptomatic infection caused by the SARS-CoV-2 Omicron and Delta variants. JAMA. 2022;327(7):639-51.  https://doi.org/10.1001/jama.2022.0470  PMID: 35060999 
  13. Veneti L, Bøås H, Bråthen Kristoffersen A, Stålcrantz J, Bragstad K, Hungnes O, et al. Reduced risk of hospitalisation among reported COVID-19 cases infected with the SARS-CoV-2 Omicron BA.1 variant compared with the Delta variant, Norway, December 2021 to January 2022. Euro Surveill. 2022;27(4):2200077.  https://doi.org/10.2807/1560-7917.ES.2022.27.4.2200077  PMID: 35086614 
  14. Andrews N, Stowe J, Kirsebom F, Toffa S, Rickeard T, Gallagher E, et al. Covid-19 vaccine effectiveness against the Omicron (B.1.1.529) variant. N Engl J Med. 2022;386(16):1532-46.  https://doi.org/10.1056/NEJMoa2119451  PMID: 35249272 
  15. Abu-Raddad LJ, Chemaitelly H, Ayoub HH, AlMukdad S, Yassine HM, Al-Khatib HA, et al. Effect of mRNA Vaccine Boosters against SARS-CoV-2 Omicron Infection in Qatar. N Engl J Med. 2022;386(19):1804-16.  https://doi.org/10.1056/NEJMoa2200797  PMID: 35263534 
  16. Nyberg T, Ferguson NM, Nash SG, Webster HH, Flaxman S, Andrews N, et al. Comparative analysis of the risks of hospitalisation and death associated with SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study. Lancet. 2022;399(10332):1303-12.  https://doi.org/10.1016/S0140-6736(22)00462-7  PMID: 35305296 
  17. Lauring AS, Tenforde MW, Chappell JD, Gaglani M, Ginde AA, McNeal T, et al. Clinical severity of, and effectiveness of mRNA vaccines against, covid-19 from omicron, delta, and alpha SARS-CoV-2 variants in the United States: prospective observational study. BMJ. 2022;376:e069761.  https://doi.org/10.1136/bmj-2021-069761  PMID: 35264324 
  18. Ministerio de Sanidad. Estrategia de detección precoz, vigilancia y control de COVID-19. Actualizado a 22 de diciembre de 2021. [Strategy for early detection, surveillance and control of COVID-19. Updated 22 December 2021]. Madrid: Spanish Ministry of Health; 2021. Available from: https://www.sanidad.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/COVID19_Estrategia_vigilancia_y_control_e_indicadores.pdf
  19. Colson P, Delerce J, Beye M, Levasseur A, Boschi C, Houhamdi L, et al. First cases of infection with the 21L/BA.2 Omicron variant in Marseille, France. J Med Virol. 2022;94(7):3421-30.  https://doi.org/10.1002/jmv.27695  PMID: 35243660 
  20. Public Health England (PHE). SARS-CoV-2 variants of concern and variants under investigation in England: Technical briefing 38. London: gov.uk; 2022. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1060337/Technical-Briefing-38-11March2022.pdf
  21. Monge S, Rojas-Benedicto A, Olmedo C, Mazagatos C, José Sierra M, Limia A, et al. Effectiveness of mRNA vaccine boosters against infection with the SARS-CoV-2 omicron (B.1.1.529) variant in Spain: a nationwide cohort study. Lancet Infect Dis. 2022;22(9):1313-20.  https://doi.org/10.1016/S1473-3099(22)00292-4  PMID: 35658998 
  22. Chemaitelly H, Tang P, Hasan MR, AlMukdad S, Yassine HM, Benslimane FM, et al. Waning of BNT162b2 vaccine protection against SARS-CoV-2 infection in Qatar. N Engl J Med. 2021;385(24):e83.  https://doi.org/10.1056/NEJMoa2114114  PMID: 34614327 
  23. Björk J, Bonander C, Moghaddassi M, Rasmussen M, Malmqvist U, Inghammar M, et al. COVID-19 vaccine effectiveness against severe disease from SARS-CoV-2 Omicron BA.1 and BA.2 subvariants - surveillance results from southern Sweden, December 2021 to March 2022. Euro Surveill. 2022;27(18):2200322.  https://doi.org/10.2807/1560-7917.ES.2022.27.18.2200322  PMID: 35514304 
  24. Grgič Vitek M, Klavs I, Učakar V, Vrh M, Mrzel M, Serdt M, et al. mRNA vaccine effectiveness against hospitalisation due to severe acute respiratory infection (SARI) COVID-19 during Omicron variant predominance estimated from real-world surveillance data, Slovenia, February to March 2022. Euro Surveill. 2022;27(20):2200350.  https://doi.org/10.2807/1560-7917.ES.2022.27.20.2200350  PMID: 35593166 
  25. Sentís A, Kislaya I, Nicolay N, Meijerink H, Starrfelt J, Martínez-Baz I, et al. Estimation of COVID-19 vaccine effectiveness against hospitalisation in individuals aged ≥ 65 years using electronic health registries; a pilot study in four EU/EEA countries, October 2021 to March 2022. Euro Surveill. 2022;27(30):2200551.  https://doi.org/10.2807/1560-7917.ES.2022.27.30.2200551  PMID: 35904059 
  26. Bager P, Wohlfahrt J, Bhatt S, Stegger M, Legarth R, Møller CH, et al. Risk of hospitalisation associated with infection with SARS-CoV-2 omicron variant versus delta variant in Denmark: an observational cohort study. Lancet Infect Dis. 2022;22(7):967-76.  https://doi.org/10.1016/S1473-3099(22)00154-2  PMID: 35468331 
  27. Feikin DR, Higdon MM, Abu-Raddad LJ, Andrews N, Araos R, Goldberg Y, et al. Duration of effectiveness of vaccines against SARS-CoV-2 infection and COVID-19 disease: results of a systematic review and meta-regression. Lancet. 2022;399(10328):924-44.  https://doi.org/10.1016/S0140-6736(22)00152-0  PMID: 35202601 
  28. Marrone G, Nicolay N, Bundle N, Karki T, Spiteri G, Suija H, et al. Risk reduction of severe outcomes in vaccinated COVID-19 cases: an analysis of surveillance data from Estonia, Ireland, Luxembourg and Slovakia, January to November 2021. Euro Surveill. 2022;27(7):2200060.  https://doi.org/10.2807/1560-7917.ES.2022.27.7.2200060  PMID: 35177166 
  29. Monge S, Rojas-Benedicto A, Olmedo C, Martín-Merino E, Mazagatos C, Limia A, et al. Effectiveness of a second dose of an mRNA vaccine against SARS-CoV-2 Omicron infection in individuals previously infected by other variants. Clin Infect Dis. 2022;ciac429.  https://doi.org/10.1093/cid/ciac429  PMID: 35687580 
  30. Martínez-Baz I, Trobajo-Sanmartín C, Miqueleiz A, Guevara M, Fernández-Huerta M, Burgui C, et al. Product-specific COVID-19 vaccine effectiveness against secondary infection in close contacts, Navarre, Spain, April to August 2021. Euro Surveill. 2021;26(39):2100894.  https://doi.org/10.2807/1560-7917.ES.2021.26.39.2100894  PMID: 34596016 
/content/10.2807/1560-7917.ES.2023.28.5.2200337
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error