Effectiveness of Covid-19 Vaccines in Ambulatory and Inpatient Care Settings
Copyright © 2021 Massachusetts Medical Society..
BACKGROUND: There are limited data on the effectiveness of the vaccines against symptomatic coronavirus disease 2019 (Covid-19) currently authorized in the United States with respect to hospitalization, admission to an intensive care unit (ICU), or ambulatory care in an emergency department or urgent care clinic.
METHODS: We conducted a study involving adults (≥50 years of age) with Covid-19-like illness who underwent molecular testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We assessed 41,552 admissions to 187 hospitals and 21,522 visits to 221 emergency departments or urgent care clinics during the period from January 1 through June 22, 2021, in multiple states. The patients' vaccination status was documented in electronic health records and immunization registries. We used a test-negative design to estimate vaccine effectiveness by comparing the odds of a positive test for SARS-CoV-2 infection among vaccinated patients with those among unvaccinated patients. Vaccine effectiveness was adjusted with weights based on propensity-for-vaccination scores and according to age, geographic region, calendar time (days from January 1, 2021, to the index date for each medical visit), and local virus circulation.
RESULTS: The effectiveness of full messenger RNA (mRNA) vaccination (≥14 days after the second dose) was 89% (95% confidence interval [CI], 87 to 91) against laboratory-confirmed SARS-CoV-2 infection leading to hospitalization, 90% (95% CI, 86 to 93) against infection leading to an ICU admission, and 91% (95% CI, 89 to 93) against infection leading to an emergency department or urgent care clinic visit. The effectiveness of full vaccination with respect to a Covid-19-associated hospitalization or emergency department or urgent care clinic visit was similar with the BNT162b2 and mRNA-1273 vaccines and ranged from 81% to 95% among adults 85 years of age or older, persons with chronic medical conditions, and Black or Hispanic adults. The effectiveness of the Ad26.COV2.S vaccine was 68% (95% CI, 50 to 79) against laboratory-confirmed SARS-CoV-2 infection leading to hospitalization and 73% (95% CI, 59 to 82) against infection leading to an emergency department or urgent care clinic visit.
CONCLUSIONS: Covid-19 vaccines in the United States were highly effective against SARS-CoV-2 infection requiring hospitalization, ICU admission, or an emergency department or urgent care clinic visit. This vaccine effectiveness extended to populations that are disproportionately affected by SARS-CoV-2 infection. (Funded by the Centers for Disease Control and Prevention.).
Errataetall: |
CommentIn: N Engl J Med. 2021 Oct 7;385(15):1431-1433. - PMID 34496195 |
---|---|
Medienart: |
E-Artikel |
Erscheinungsjahr: |
2021 |
---|---|
Erschienen: |
2021 |
Enthalten in: |
Zur Gesamtaufnahme - volume:385 |
---|---|
Enthalten in: |
The New England journal of medicine - 385(2021), 15 vom: 07. Okt., Seite 1355-1371 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Thompson, Mark G [VerfasserIn] |
---|
Links: |
---|
Anmerkungen: |
Date Completed 19.10.2021 Date Revised 23.11.2023 published: Print-Electronic CommentIn: N Engl J Med. 2021 Oct 7;385(15):1431-1433. - PMID 34496195 Citation Status MEDLINE |
---|
doi: |
10.1056/NEJMoa2110362 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM330384821 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM330384821 | ||
003 | DE-627 | ||
005 | 20231225211155.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2021 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1056/NEJMoa2110362 |2 doi | |
028 | 5 | 2 | |a pubmed24n1101.xml |
035 | |a (DE-627)NLM330384821 | ||
035 | |a (NLM)34496194 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Thompson, Mark G |e verfasserin |4 aut | |
245 | 1 | 0 | |a Effectiveness of Covid-19 Vaccines in Ambulatory and Inpatient Care Settings |
264 | 1 | |c 2021 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 19.10.2021 | ||
500 | |a Date Revised 23.11.2023 | ||
500 | |a published: Print-Electronic | ||
500 | |a CommentIn: N Engl J Med. 2021 Oct 7;385(15):1431-1433. - PMID 34496195 | ||
500 | |a Citation Status MEDLINE | ||
520 | |a Copyright © 2021 Massachusetts Medical Society. | ||
520 | |a BACKGROUND: There are limited data on the effectiveness of the vaccines against symptomatic coronavirus disease 2019 (Covid-19) currently authorized in the United States with respect to hospitalization, admission to an intensive care unit (ICU), or ambulatory care in an emergency department or urgent care clinic | ||
520 | |a METHODS: We conducted a study involving adults (≥50 years of age) with Covid-19-like illness who underwent molecular testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We assessed 41,552 admissions to 187 hospitals and 21,522 visits to 221 emergency departments or urgent care clinics during the period from January 1 through June 22, 2021, in multiple states. The patients' vaccination status was documented in electronic health records and immunization registries. We used a test-negative design to estimate vaccine effectiveness by comparing the odds of a positive test for SARS-CoV-2 infection among vaccinated patients with those among unvaccinated patients. Vaccine effectiveness was adjusted with weights based on propensity-for-vaccination scores and according to age, geographic region, calendar time (days from January 1, 2021, to the index date for each medical visit), and local virus circulation | ||
520 | |a RESULTS: The effectiveness of full messenger RNA (mRNA) vaccination (≥14 days after the second dose) was 89% (95% confidence interval [CI], 87 to 91) against laboratory-confirmed SARS-CoV-2 infection leading to hospitalization, 90% (95% CI, 86 to 93) against infection leading to an ICU admission, and 91% (95% CI, 89 to 93) against infection leading to an emergency department or urgent care clinic visit. The effectiveness of full vaccination with respect to a Covid-19-associated hospitalization or emergency department or urgent care clinic visit was similar with the BNT162b2 and mRNA-1273 vaccines and ranged from 81% to 95% among adults 85 years of age or older, persons with chronic medical conditions, and Black or Hispanic adults. The effectiveness of the Ad26.COV2.S vaccine was 68% (95% CI, 50 to 79) against laboratory-confirmed SARS-CoV-2 infection leading to hospitalization and 73% (95% CI, 59 to 82) against infection leading to an emergency department or urgent care clinic visit | ||
520 | |a CONCLUSIONS: Covid-19 vaccines in the United States were highly effective against SARS-CoV-2 infection requiring hospitalization, ICU admission, or an emergency department or urgent care clinic visit. This vaccine effectiveness extended to populations that are disproportionately affected by SARS-CoV-2 infection. (Funded by the Centers for Disease Control and Prevention.) | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Multicenter Study | |
650 | 4 | |a Research Support, Non-U.S. Gov't | |
650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
650 | 7 | |a Ad26COVS1 |2 NLM | |
650 | 7 | |a JT2NS6183B |2 NLM | |
650 | 7 | |a COVID-19 Vaccines |2 NLM | |
650 | 7 | |a 2019-nCoV Vaccine mRNA-1273 |2 NLM | |
650 | 7 | |a EPK39PL4R4 |2 NLM | |
650 | 7 | |a BNT162 Vaccine |2 NLM | |
650 | 7 | |a N38TVC63NU |2 NLM | |
700 | 1 | |a Stenehjem, Edward |e verfasserin |4 aut | |
700 | 1 | |a Grannis, Shaun |e verfasserin |4 aut | |
700 | 1 | |a Ball, Sarah W |e verfasserin |4 aut | |
700 | 1 | |a Naleway, Allison L |e verfasserin |4 aut | |
700 | 1 | |a Ong, Toan C |e verfasserin |4 aut | |
700 | 1 | |a DeSilva, Malini B |e verfasserin |4 aut | |
700 | 1 | |a Natarajan, Karthik |e verfasserin |4 aut | |
700 | 1 | |a Bozio, Catherine H |e verfasserin |4 aut | |
700 | 1 | |a Lewis, Ned |e verfasserin |4 aut | |
700 | 1 | |a Dascomb, Kristin |e verfasserin |4 aut | |
700 | 1 | |a Dixon, Brian E |e verfasserin |4 aut | |
700 | 1 | |a Birch, Rebecca J |e verfasserin |4 aut | |
700 | 1 | |a Irving, Stephanie A |e verfasserin |4 aut | |
700 | 1 | |a Rao, Suchitra |e verfasserin |4 aut | |
700 | 1 | |a Kharbanda, Elyse |e verfasserin |4 aut | |
700 | 1 | |a Han, Jungmi |e verfasserin |4 aut | |
700 | 1 | |a Reynolds, Sue |e verfasserin |4 aut | |
700 | 1 | |a Goddard, Kristin |e verfasserin |4 aut | |
700 | 1 | |a Grisel, Nancy |e verfasserin |4 aut | |
700 | 1 | |a Fadel, William F |e verfasserin |4 aut | |
700 | 1 | |a Levy, Matthew E |e verfasserin |4 aut | |
700 | 1 | |a Ferdinands, Jill |e verfasserin |4 aut | |
700 | 1 | |a Fireman, Bruce |e verfasserin |4 aut | |
700 | 1 | |a Arndorfer, Julie |e verfasserin |4 aut | |
700 | 1 | |a Valvi, Nimish R |e verfasserin |4 aut | |
700 | 1 | |a Rowley, Elizabeth A |e verfasserin |4 aut | |
700 | 1 | |a Patel, Palak |e verfasserin |4 aut | |
700 | 1 | |a Zerbo, Ousseny |e verfasserin |4 aut | |
700 | 1 | |a Griggs, Eric P |e verfasserin |4 aut | |
700 | 1 | |a Porter, Rachael M |e verfasserin |4 aut | |
700 | 1 | |a Demarco, Maria |e verfasserin |4 aut | |
700 | 1 | |a Blanton, Lenee |e verfasserin |4 aut | |
700 | 1 | |a Steffens, Andrea |e verfasserin |4 aut | |
700 | 1 | |a Zhuang, Yan |e verfasserin |4 aut | |
700 | 1 | |a Olson, Natalie |e verfasserin |4 aut | |
700 | 1 | |a Barron, Michelle |e verfasserin |4 aut | |
700 | 1 | |a Shifflett, Patricia |e verfasserin |4 aut | |
700 | 1 | |a Schrag, Stephanie J |e verfasserin |4 aut | |
700 | 1 | |a Verani, Jennifer R |e verfasserin |4 aut | |
700 | 1 | |a Fry, Alicia |e verfasserin |4 aut | |
700 | 1 | |a Gaglani, Manjusha |e verfasserin |4 aut | |
700 | 1 | |a Azziz-Baumgartner, Eduardo |e verfasserin |4 aut | |
700 | 1 | |a Klein, Nicola P |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t The New England journal of medicine |d 1945 |g 385(2021), 15 vom: 07. Okt., Seite 1355-1371 |w (DE-627)NLM000008184 |x 1533-4406 |7 nnns |
773 | 1 | 8 | |g volume:385 |g year:2021 |g number:15 |g day:07 |g month:10 |g pages:1355-1371 |
856 | 4 | 0 | |u http://dx.doi.org/10.1056/NEJMoa2110362 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 385 |j 2021 |e 15 |b 07 |c 10 |h 1355-1371 |