mRNA Vaccine Effectiveness Against Coronavirus Disease 2019 Hospitalization Among Solid Organ Transplant Recipients

• Authors: Jennie H Kwon, Washington University; Mark W Tenforde, CDC COVID 19 Response Team; Manjusha Gaglani, Texas A&M University; Keipp H Talbot, Vanderbilt University; Adit A Ginde, University of Colorado; Tresa McNeal, Texas A&M University; Shekhar Ghamande, Texas A&M University; David J Douin, University of Colorado; Jonathan D Casey, Vanderbilt University; Nicholas M Mohr, University of Iowa; Anne Zepeski, University of Iowa; Nathan Shapiro, Beth Israel Deaconess Medical Center; Kevin W Gibbs, Wake Forest School of Medicine; Clark D Files, Wake Forest School of Medicine; David N Hager, Johns Hopkins University; Arber Shehu, Johns Hopkins University; Matthew E Prekker, Hennepin County Medical Center; Sean D Caspers, Hennepin County Medical Center; Matthew C Exline, Ohio State University; Mena Botros, Ohio State University; Michelle N Gong, Albert Einstein College of Medicine; Alex Li, Albert Einstein College of Medicine; Amira Mohamed, Albert Einstein College of Medicine; Nicholas J Johnson, University of Washington; Vasisht Srinivasan, University of Washington; Jay S Steingrub, Baystate Medical Center; Ithan D Peltan, Intermountain Medical Center; Sameul M Brown, Intermountain Medical Center; Emily T Martin, University of Michigan; Akram Khan, Oregon Health and Sciences University; Catherine L Hough, Oregon Health and Sciences University; Laurence W Busse, Emory University; Abhijit Duggal, Cleveland Clinic; Jennifer G Wilson, Stanford University; Cynthia Perez, Stanford University; Steven Y Chang, University of California Los Angeles; Christopher Mallow, University of Miami; Randal Rovinski, University of Miami; Hilary M Babcock, Washington University; Adam S Lauring, University of Michigan; Laura Felley, University of Michigan; Natasha Halasa, Vanderbilt University; James D Chappell, Vanderbilt University; Carlos G Grijalva, Vanderbilt University; Todd W Rice, Vanderbilt University; Kelsey N Womack, Vanderbilt University; Christopher J Lindsell, Vanderbilt University; Kimberly W Hart, Vanderbilt University; Adrienne Baughman, Vanderbilt University; Samantha M Olson, CDC COVID 19 Response Team; Stephanie Schrag, CDC COVID 19 Response Team; Miwako Kobayashi, CDC COVID 19 Response Team; Jennifer Verani, Emory University; Manish M Patel, CDC COVID 19 Response Team; Wesley H Self, Vanderbilt University
• Journal Title: JOURNAL OF INFECTIOUS DISEASES
• Publisher: OXFORD UNIV PRESS INC | 2022-04-06
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1093/infdis/jiac118
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Immunology; Infectious Diseases; Microbiology; COVID-19; immunocompromised; SARS-CoV-2; solid organ transplantation; vaccine effectiveness; IMMUNOCOMPROMISED PATIENTS; INFLUENZA VACCINATION; COVID-19 VACCINES; ADULTS; STATES

Abstract

BACKGROUND: The study objective was to evaluate 2 and 3 dose COVID-19 mRNA vaccine effectiveness (VE) in preventing COVID-19 hospitalization among adult solid organ transplant (SOT) recipients. METHODS: 21-site case-control analysis of 10,425 adults hospitalized March-December 2021. Cases were hospitalized with COVID-19; controls were hospitalized for an alternative diagnosis (SARS-CoV-2 negative). Participants were classified as: SOT recipient (n=440), other immunocompromising condition (n=1684), or immunocompetent (n=8301). VE against COVID-19 associated hospitalization was calculated as 1-adjusted odds ratio of prior vaccination among cases compared with controls. RESULTS: Among SOT recipients, VE was 29% (95% CI: -19 to 58%) for 2 doses and 77% (95% CI: 48 to 90%) for 3 doses. Among patients with other immunocompromising conditions, VE was 72% (95% CI: 64 to 79%) for 2 doses and 92% (95% CI: 85 to 95%) for 3 doses. Among immunocompetent patients, VE was 88% (95% CI: 87 to 90%) for 2 doses and 96% (95% CI: 83 to 99%) for 3 doses. CONCLUSION: Effectiveness of COVID-19 mRNA vaccines was lower for SOT recipients than immunocompetent people and those with other immunocompromising conditions. Among SOT recipients, vaccination with 3 doses of an mRNA vaccine led to substantially greater protection than 2 doses.