학술논문
Effectiveness of mRNA Vaccination in Preventing COVID-19–Associated Invasive Mechanical Ventilation and Death — United States, March 2021–January 2022
Document Type
article
Author
Tenforde, Mark W; Self, Wesley H; Gaglani, Manjusha; Ginde, Adit A; Douin, David J; Talbot, H Keipp; Casey, Jonathan D; Mohr, Nicholas M; Zepeski, Anne; McNeal, Tresa; Ghamande, Shekhar; Gibbs, Kevin W; Files, D Clark; Hager, David N; Shehu, Arber; Prekker, Matthew E; Frosch, Anne E; Gong, Michelle N; Mohamed, Amira; Johnson, Nicholas J; Srinivasan, Vasisht; Steingrub, Jay S; Peltan, Ithan D; Brown, Samuel M; Martin, Emily T; Monto, Arnold S; Khan, Akram; Hough, Catherine L; Busse, Laurence W; Duggal, Abhijit; Wilson, Jennifer G; Qadir, Nida; Chang, Steven Y; Mallow, Christopher; Rivas, Carolina; Babcock, Hilary M; Kwon, Jennie H; Exline, Matthew C; Botros, Mena; Lauring, Adam S; Shapiro, Nathan I; Halasa, Natasha; Chappell, James D; Grijalva, Carlos G; Rice, Todd W; Jones, Ian D; Stubblefield, William B; Baughman, Adrienne; Womack, Kelsey N; Rhoads, Jillian P; Lindsell, Christopher J; Hart, Kimberly W; Zhu, Yuwei; Adams, Katherine; Surie, Diya; McMorrow, Meredith L; Patel, Manish M; Network, IVY
Source
MMWR Morbidity and Mortality Weekly Report. 71(12)
Subject
Language
Abstract
COVID-19 mRNA vaccines (BNT162b2 [Pfizer-BioNTech] and mRNA-1273 [Moderna]) are effective at preventing COVID-19-associated hospitalization (1-3). However, how well mRNA vaccines protect against the most severe outcomes of these hospitalizations, including invasive mechanical ventilation (IMV) or death is uncertain. Using a case-control design, mRNA vaccine effectiveness (VE) against COVID-19-associated IMV and in-hospital death was evaluated among adults aged ≥18 years hospitalized at 21 U.S. medical centers during March 11, 2021-January 24, 2022. During this period, the most commonly circulating variants of SARS-CoV-2, the virus that causes COVID-19, were B.1.1.7 (Alpha), B.1.617.2 (Delta), and B.1.1.529 (Omicron). Previous vaccination (2 or 3 versus 0 vaccine doses before illness onset) in prospectively enrolled COVID-19 case-patients who received IMV or died within 28 days of hospitalization was compared with that among hospitalized control patients without COVID-19. Among 1,440 COVID-19 case-patients who received IMV or died, 307 (21%) had received 2 or 3 vaccine doses before illness onset. Among 6,104 control-patients, 4,020 (66%) had received 2 or 3 vaccine doses. Among the 1,440 case-patients who received IMV or died, those who were vaccinated were older (median age = 69 years), more likely to be immunocompromised* (40%), and had more chronic medical conditions compared with unvaccinated case-patients (median age = 55 years; immunocompromised = 10%; p