Protection Conferred by COVID-19 Vaccination, Prior SARS-CoV-2 Infection, or Hybrid Immunity Against Omicron-Associated Severe Outcomes Among Community-Dwelling Adults

Abstract Introduction We assessed protection from coronavirus disease 2019 (COVID-19) vaccines and/or prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection against Omicron-associated severe outcomes during successive sublineage-predominant periods. Methods We used a test-negat...

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Published in:Clinical infectious diseases 2024-05, Vol.78 (5), p.1372-1382
Main Authors: Lee, Nelson, Nguyen, Lena, Austin, Peter C, Brown, Kevin A, Grewal, Ramandip, Buchan, Sarah A, Nasreen, Sharifa, Gubbay, Jonathan, Schwartz, Kevin L, Tadrous, Mina, Wilson, Kumanan, Wilson, Sarah E, Kwong, Jeffrey C
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
COVID-19 - immunology
COVID-19 - prevention & control
COVID-19 Vaccines - administration & dosage
COVID-19 Vaccines - immunology
Female
Hospitalization - statistics & numerical data
Humans
Independent Living
Major
Male
Middle Aged
Ontario - epidemiology
SARS-CoV-2 - immunology
Vaccination
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Summary:Abstract Introduction We assessed protection from coronavirus disease 2019 (COVID-19) vaccines and/or prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection against Omicron-associated severe outcomes during successive sublineage-predominant periods. Methods We used a test-negative design to estimate protection by vaccines and/or prior infection against hospitalization/death among community-dwelling, polymerase chain reaction (PCR)-tested adults aged ≥50 years in Ontario, Canada, between 2 January 2022 and 30 June 2023. Multivariable logistic regression was used to estimate the relative change in the odds of hospitalization/death with each vaccine dose (2–5) and/or prior PCR-confirmed SARS-CoV-2 infection (compared with unvaccinated, uninfected subjects) up to 15 months since the last vaccination or infection. Results We included 18 526 cases with Omicron-associated severe outcomes and 90 778 test-negative controls. Vaccine protection was high during BA.1/BA.2 predominance but was generally
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciad716