Pulse Brain · Growing Health Evidence Index
Tier 3 — Observational / field trialPeer-reviewed

Clinical severity of, and effectiveness of mRNA vaccines against, covid-19 from omicron, delta, and alpha SARS-CoV-2 variants in the United States: prospective observational study

Adam S. Lauring, Mark W. Tenforde, James D. Chappell, Manjusha Gaglani, Adit A. Ginde, Tresa McNeal, Shekhar Ghamande, David J. Douin, H. Keipp Talbot, Jonathan D. Casey, Nicholas M. Mohr, Anne Zepeski, Nathan I. Shapiro, Kevin W. Gibbs, D. Clark Files, David N. Hager, Arber Shehu, Matthew E. Prekker, Heidi L. Erickson, Matthew C. Exline, Michelle N. Gong, Amira Mohamed, Nicholas J. Johnson, Vasisht Srinivasan, Jay S. Steingrub, Ithan D. Peltan, Samuel M. Brown, Emily T. Martin, Arnold S. Monto, Akram Khan, Catherine L. Hough, Laurence W. Busse, Caitlin C. ten Lohuis, Abhijit Duggal, Jennifer G. Wilson, Alexandra June Gordon, Nida Qadir, Steven Y. Chang, Christopher Mallow, Carolina Rivas, Hilary M. Babcock, Jennie H. Kwon, Natasha Halasa, Carlos G. Grijalva, Todd W. Rice, William B. Stubblefield, Adrienne Baughman, Kelsey N. Womack, Jillian P. Rhoads, Christopher J. Lindsell, Kimberly W. Hart, Yuwei Zhu, Katherine Adams, Stephanie J. Schrag, Samantha M. Olson, Miwako Kobayashi, Jennifer R. Verani, Manish M. Patel, Wesley H. Self

BMJ · 2022

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Summary

This prospective observational case-control study of 11,690 US adults assessed mRNA vaccine effectiveness and clinical severity of COVID-19 across three SARS-CoV-2 variants. Two doses of mRNA vaccine provided 85% protection against alpha and delta variants, but only 65% against omicron; three doses restored protection to 86% against omicron. Disease severity varied by variant, with delta associated with higher mortality (12.2%) than omicron (7.1%), and vaccinated patients consistently experiencing lower severity than unvaccinated patients across all variants.

UK applicability

The findings are broadly applicable to the United Kingdom, where the same mRNA vaccines were deployed during the same variant waves. UK vaccination policy and clinical management decisions for COVID-19 would have benefited from these data on dose requirements for omicron protection and variant-specific severity profiles.

Key measures

Vaccine effectiveness (percentage with 95% confidence intervals); in-hospital mortality rates by variant; WHO clinical progression scale severity scores; proportional odds ratios for disease severity comparisons

Outcomes reported

The study measured mRNA vaccine effectiveness in preventing COVID-19 hospital admissions for alpha, delta, and omicron variants, and compared clinical disease severity among hospitalised patients across variants using the WHO clinical progression scale.

Theme
Nutrition & health
Subject
Antimicrobial resistance
Study type
Research
Study design
Case-control study
Source type
Peer-reviewed study
Status
Published
Geography
United States
System type
Human clinical
DOI
10.1136/bmj-2021-069761
Catalogue ID
SNmohdwbhh-gdnnm9

Topic tags

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