The study examines the severe incidence of COVID-19 in fully vaccinated at-risk populations

In a recent study published in Journal of the American Medical AssociationAnd the A team of researchers studied a group of patients at United States Veterans Health Administration (US) facilities to determine the incidence of severe coronavirus disease 2019 (COVID-19) among individuals with initial and supportive doses of any combination of BNT162b2, mRNA-1273, and Ad26 .COV2.S Vaccines.

background

While studies have shown that complete primary vaccines combined with booster doses were effective in reducing the number and severity of SARS-CoV-2 infection, diminished immunity, and emergence of SARS-CoV- two variants were associated with the risk of infection, particularly in populations at high risk of infection.

The US Centers for Disease Control and Prevention has now recommended reducing the interval between initial and booster vaccinations to three months from five months to maintain effective immunity. Although studies have shown that booster vaccines prevent severe clinical outcomes of COVID-19, the effectiveness of primary vaccines and boosters in protecting immunocompromised and high-risk individuals has not been studied.

about studying

The current study used a group of participants from US Veterans Health Administration facilities who received combinations of BNT162b2, mRNA-1273, and Ad26.COV2.S vaccines for their primary and booster vaccinations. The study was conducted between July 1, 2021 and May 30, 2022, and consisted of 1,610,719 participants.

Primary and booster vaccination combinations were considered as exposure variables. The three outcomes measured were breakthrough asymptomatic COVID-19, hospitalization or death from any symptoms of COVID-19 or pneumonia within 30 days of breakthrough infection, and hospitalization or death from severe COVID-19 pneumonia within 30 days from injury. .

COVID-19 pneumonia was defined based on the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) codes. Severe COVID-19 pneumonia was defined based on ICD-10 codes and the need for mechanical ventilation.

A large number of covariates were taken into account in the analyses, including demographic factors such as age, gender, race, geographic location and marital status, as well as parameters such as BMI and a variety of comorbidities. A comprehensive list of comorbidities including cardiovascular, renal, respiratory, spinal, immune system-related and cancer conditions was included in the study. Behavioral risks such as smoking and alcohol use were also considered.

consequences

The results showed that the risk of hospitalization and death associated with COVID-19 was lower in individuals with primary and booster vaccine coverage. The observation period in the study overlapped with a predominance of the delta variant and multiple omicron subvariables, indicating that the vaccines provided effective protection against emerging variants, although there was evidence of immune escape by some of the subvariables.

While all study participants belonged to high-risk populations based on age (65 or older) or serious comorbidities, the authors noted that severe symptoms and an increased incidence of infection were associated with immunocompromised individuals. Hospitalizations varied significantly between these groups, with 1.9, 6.7, and 39.6 hospital admissions per 10,000 persons of 65 years or more, high-risk and immunocompromised individuals, respectively.

The authors believe that their assessment of COVID-9 severity based specifically on pneumonia as an outcome strengthened the study by eliminating potential misclassifications of symptoms or severity.

The study, however, has several limitations. Aside from not accounting for COVID-19 exposure behaviors, it excluded nursing homes, which have a significant portion of the high-risk population. While the study included female, Hispanic, and African American individuals, the participants were predominantly white men, which makes generalizing the results difficult.

Conclusions

To summarize, the results indicated that all combinations of Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273), and Janssen/Johnson & Johnson (Ad26.COV2.S) vaccines for primary immunization and a single booster dose were effective in lowering the risk of hospitalization associated with COVID- 19 and death among residents living in high-risk communities in the United States

With the exception of immunocompromised individuals, primary vaccinations and single booster vaccines appear to protect high-risk groups with comorbidities even from emerging variants such as Delta, Omicron BA.1, BA.2, and BA.2.12.1. The authors concluded that additional booster doses during the study period would have benefited only immunocompromised patients.

Journal reference:

• Kelly, J. D., Leonard, S., Hoggatt, K. J., Boscardin, W. J., Lum, E. N., Moss-Vazquez, T. A., Andino, R., Wong, J. K., Byers, A., Bravata, D. M., Tien, PC, & Kehani, S.; (2022). Incidence of severe COVID-19 disease after vaccination and booster with BNT162b2, mRNA-1273 and Ad26.COV2.S vaccines. Gamma. banghttps://doi.org/10.1001/jama.2022.17985 https://jamanetwork.com/journals/jama/fullarticle/2796892

from San Jose News Bulletin https://sjnewsbulletin.com/the-study-examines-the-severe-incidence-of-covid-19-in-fully-vaccinated-at-risk-populations/