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Cited by 204SARS-CoV-2 and COVID-19 ResearchVaccine Coverage and HesitancyCOVID-19 epidemiological studies

The DOI matches its Crossref record; 8 of the 8 references it cites were found in a registry or an index.

Sustained Effectiveness of Pfizer-BioNTech and Moderna Vaccines Against COVID-19 Associated Hospitalizations Among Adults — United States, March–July 2021

Open access
Tenforde, Mark W., Self, Wesley H., Naioti, Eric A., Ginde, Adit A., Douin, David J., Olson, Samantha M., Talbot, H. Keipp, Casey, Jonathan D., Mohr, Nicholas M., Zepeski, Anne, Gaglani, Manjusha, McNeal, Tresa, Ghamande, Shekhar, Shapiro, Nathan I., Gibbs, Kevin W., Files, D. Clark, Hager, David N., Shehu, Arber, Prekker, Matthew E., Erickson, Heidi L., Gong, Michelle N., Mohamed, Amira, Henning, Daniel J., Steingrub, Jay S., Peltan, Ithan D., Brown, Samuel M., Martin, Emily T., Monto, Arnold S., Khan, Akram, Hough, Catherine L., Busse, Laurence W., ten Lohuis, Caitlin C., Duggal, Abhijit, Wilson, Jennifer G., Gordon, Alexandra June, Qadir, Nida, Chang, Steven Y., Mallow, Christopher, Rivas, Carolina, Babcock, Hilary M., Kwon, Jennie H., Exline, Matthew C., Halasa, Natasha, Chappell, James D., Lauring, Adam S., Grijalva, Carlos G., Rice, Todd W., Jones, Ian D., Stubblefield, William B., Baughman, Adrienne, Womack, Kelsey N., Lindsell, Christopher J., Hart, Kimberly W., Zhu, Yuwei, Stephenson, Meagan, Schrag, Stephanie J., Kobayashi, Miwako, Verani, Jennifer R., Patel, Manish M., IVY Network Investigators, IVY Network, Calhoun, Nicole, Murthy, Kempapura, Herrick, Judy, McKillop, Amanda, Hoffman, Eric, Zayed, Martha, Smith, Michael, Settele, Natalie, Ettlinger, Jason, Priest, Elisa, Thomas, Jennifer, Arroliga, Alejandro, Beeram, Madhava, Kindle, Ryan, Kozikowski, Lori-Ann, De Souza, Lesley, Ouellette, Scott, Thornton-Thompson, Sherell, Tyler, Patrick, Mehkri, Omar, Ashok, Kiran, Gole, Susan, King, Alexander, Poynter, Bryan, Stanley, Nicholas, Hendrickson, Audrey, Maruggi, Ellen, Scharber, Tyler, Jorgensen, Jeffrey, Bowers, Robert, King, Jennifer, Aston, Valerie, Armbruster, Brent, Rothman, Richard E., Nair, Rahul, Chen, Jen-Ting (Tina), Karow, Sarah, Robart, Emily, Maldonado, Paulo Nunes, Khan, Maryiam, So, Preston, Levitt, Joe, Perez, Cynthia, Visweswaran, Anita, Roque, Jonasel, Rivera, Adreanne, Frankel, Trevor, Howell, Michelle, Friedel, Jennifer, Goff, Jennifer, Huynh, David, Tozier, Michael, Driver, Conner, Carricato, Michael, Foster, Alexandra, Nassar, Paul, Stout, Lori, Sibenaller, Zita, Walter, Alicia, Mares, Jasmine, Olson, Logan, Clinansmith, Bradley, Rivas, Carolina, Gershengorn, Hayley, McSpadden, EJ, Truscon, Rachel, Kaniclides, Anne, Thomas, Lara, Bielak, Ramsay, Valvano, Weronika Damek, Fong, Rebecca, Fitzsimmons, William J., Blair, Christopher, Valesano, Andrew L., Gilbert, Julie, Crider, Christine D., Steinbock, Kyle A., Paulson, Thomas C., Anderson, Layla A., Kampe, Christy, Johnson, Jakea, McHenry, Rendie, Blair, Marcia, Conway, Douglas, LaRose, Mary, Landreth, Leigha, Hicks, Madeline, Parks, Lisa, Bongu, Jahnavi, McDonald, David, Cass, Candice, Seiler, Sondra, Park, David, Hink, Tiffany, Wallace, Meghan, Burnham, Carey-Ann, Arter, Olivia G.·2021·MMWR. Morbidity and Mortality Weekly Report
DOI 10.15585/mmwr.mm7034e2PMC PMC8389395
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Abstract

Real-world evaluations have demonstrated high effectiveness of vaccines against COVID-19-associated hospitalizations (1-4) measured shortly after vaccination; longer follow-up is needed to assess durability of protection. In an evaluation at 21 hospitals in 18 states, the duration of mRNA vaccine (Pfizer-BioNTech or Moderna) effectiveness (VE) against COVID-19-associated hospitalizations was assessed among adults aged ≥18 years. Among 3,089 hospitalized adults (including 1,194 COVID-19 case-patients and 1,895 non-COVID-19 control-patients), the median age was 59 years, 48.7% were female, and 21.1% had an immunocompromising condition. Overall, 141 (11.8%) case-patients and 988 (52.1%) controls were fully vaccinated (defined as receipt of the second dose of Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines ≥14 days before illness onset), with a median interval of 65 days (range = 14-166 days) after receipt of second dose. VE against COVID-19-associated hospitalization during the full surveillance period was 86% (95% confidence interval [CI] = 82%-88%) overall and 90% (95% CI = 87%-92%) among adults without immunocompromising conditions. VE against COVID-19- associated hospitalization was 86% (95% CI = 82%-90%) 2-12 weeks and 84% (95% CI = 77%-90%) 13-24 weeks from receipt of the second vaccine dose, with no significant change between these periods (p = 0.854). Whole genome sequencing of 454 case-patient specimens found that 242 (53.3%) belonged to the B.1.1.7 (Alpha) lineage and 74 (16.3%) to the B.1.617.2 (Delta) lineage. Effectiveness of mRNA vaccines against COVID-19-associated hospitalization was sustained over a 24-week period, including among groups at higher risk for severe COVID-19; ongoing monitoring is needed as new SARS-CoV-2 variants emerge. To reduce their risk for hospitalization, all eligible persons should be offered COVID-19 vaccination.

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FIGURE 1 Whole genome sequencing lineage determination among adults hospitalized with COVID-19 — 21 academic medical centers in 18 states,*,† March–July 2021 * Specimens with SARS-CoV-2 detected by reverse transcription–polymerase chain reaction and with a cycle threshold <32 for at least one of two nucleocapsid gene targets tested underwent whole genome sequencing. SARS-CoV-2 lineages were assigned with >80% coverage using Pangolin genomes. Results are presented for B.1.1.7 (Alpha) variants, B.1.617.2 (Delta) variants, and other (neither B.1.1.7 or B.1.617.2) variant with lineage determined by whole genome sequencing. Of 74 Delta variants sequenced, four belonged to the AY.3 Delta sublineage. The histogram provides the number of viruses sequenced by week of hospital admission. † Hospitals by region included Northeast: Baystate Medical Center (Springfield, Massachusetts), Beth Israel Deaconess Medical Center (Boston, Massachusetts), Montefiore Medical Center (Bronx, New York); South: Vanderbilt University Medical Center (Nashville, Tennessee), University of Miami Medical Center (Miami, Florida), Emory University Medical Center (Atlanta, Georgia), Johns Hopkins Hospital (Baltimore, Maryland), Wake Forest University Baptist Medical Center (Winston-Salem, North Carolina), Baylor Scott and White Health (Temple, Texas); Midwest: University of Iowa Hospitals (Iowa City, Iowa), University of Michigan Hospital (Ann Arbor, Michigan), Hennepin County Medical Center (Minneapolis, Minnesota), Barnes-Jewish Hospital (St. Louis, Missouri), Cleveland Clinic (Cleveland, Ohio), Ohio State University Wexner Medical Center (Columbus, Ohio); West: Stanford University Medical Center (Stanford, California), UCLA Medical Center (Los Angeles, California), UCHealth University of Colorado Hospital (Aurora, Colorado), Oregon Health & Science University Hospital (Portland, Oregon), Intermountain Medical Center (Murray, Utah), University of Washington (Seattle, Washington).
FIGURE 1 Whole genome sequencing lineage determination among adults hospitalized with COVID-19 — 21 academic medical centers in 18 states,*,† March–July 2021 * Specimens with SARS-CoV-2 detected by reverse transcription–polymerase chain reaction and with a cycle threshold <32 for at least one of two nucleocapsid gene targets tested underwent whole genome sequencing. SARS-CoV-2 lineages were assigned with >80% coverage using Pangolin genomes. Results are presented for B.1.1.7 (Alpha) variants, B.1.617.2 (Delta) variants, and other (neither B.1.1.7 or B.1.617.2) variant with lineage determined by whole genome sequencing. Of 74 Delta variants sequenced, four belonged to the AY.3 Delta sublineage. The histogram provides the number of viruses sequenced by week of hospital admission. † Hospitals by region included Northeast: Baystate Medical Center (Springfield, Massachusetts), Beth Israel Deaconess Medical Center (Boston, Massachusetts), Montefiore Medical Center (Bronx, New York); South: Vanderbilt University Medical Center (Nashville, Tennessee), University of Miami Medical Center (Miami, Florida), Emory University Medical Center (Atlanta, Georgia), Johns Hopkins Hospital (Baltimore, Maryland), Wake Forest University Baptist Medical Center (Winston-Salem, North Carolina), Baylor Scott and White Health (Temple, Texas); Midwest: University of Iowa Hospitals (Iowa City, Iowa), University of Michigan Hospital (Ann Arbor, Michigan), Hennepin County Medical Center (Minneapolis, Minnesota), Barnes-Jewish Hospital (St. Louis, Missouri), Cleveland Clinic (Cleveland, Ohio), Ohio State University Wexner Medical Center (Columbus, Ohio); West: Stanford University Medical Center (Stanford, California), UCLA Medical Center (Los Angeles, California), UCHealth University of Colorado Hospital (Aurora, Colorado), Oregon Health & Science University Hospital (Portland, Oregon), Intermountain Medical Center (Murray, Utah), University of Washington (Seattle, Washington).CC0 · PubMed Central
FIGURE 2 Sustained vaccine effectiveness* against COVID-19 among hospitalized adults, by patient status†,§ and interval since vaccination — 21 medical centers in 18 states,¶ March–July 2021 Abbreviation: VE = vaccine effectiveness. * VE was estimated using logistic regression comparing the odds of being fully vaccinated with an authorized mRNA COVID-19 vaccine with being unvaccinated in case patients and controls using the equation VE = 100 × (1 – odds ratio). Models were adjusted for date of hospital admission (biweekly intervals), U.S. Department of Health and Human Services region of hospital, age group (18–49, 50–64, or ≥65 years), sex, and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic of any race, non-Hispanic Other, or unknown). Analyses restricted to adults aged ≥65 years adjusted for age in years as a continuous variable. Binary time since second dose of mRNA vaccine was added to the model with results for 2–12 weeks and 13–24 weeks shown. 95% confidence intervals shown by error bars. † Immunocompromising conditions included having one or more of the following: active solid organ cancer (active cancer defined as treatment for the cancer or newly diagnosed cancer in the past 6 months), active hematologic cancer (such as leukemia, lymphoma, or myeloma), HIV infection without AIDS, AIDS, congenital immunodeficiency syndrome, previous splenectomy, previous solid organ transplant, immunosuppressive medication, systemic lupus erythematosus, rheumatoid arthritis, psoriasis, scleroderma, or inflammatory bowel disease, including Crohn’s disease or ulcerative colitis. § Multiple morbidities were defined as having chronic conditions within three or more of the following condition categories: cardiovascular disease, neurologic disease, pulmonary disease, gastrointestinal disease, endocrine disease, renal disease, hematologic disease, malignancy, immunosuppression not captured in other categories, autoimmune condition, or other condition (sarcoidosis, amyloidosis, or unintentional weight loss ≥10 pounds in the last 90 days). ¶ Hospitals by region included Northeast: Baystate Medical Center (Springfield, Massachusetts), Beth Israel Deaconess Medical Center (Boston, Massachusetts), Montefiore Medical Center (Bronx, New York); South: Vanderbilt University Medical Center (Nashville, Tennessee), University of Miami Medical Center (Miami, Florida), Emory University Medical Center (Atlanta, Georgia), Johns Hopkins Hospital (Baltimore, Maryland), Wake Forest University Baptist Medical Center (Winston-Salem, North Carolina), Baylor Scott and White Health (Temple, Texas); Midwest: University of Iowa Hospitals (Iowa City, Iowa), University of Michigan Hospital (Ann Arbor, Michigan), Hennepin County Medical Center (Minneapolis, Minnesota), Barnes-Jewish Hospital (St. Louis, Missouri), Cleveland Clinic (Cleveland, Ohio), Ohio State University Wexner Medical Center (Columbus, Ohio); West: Stanford University Medical Center (Stanford, California), UCLA Medical Center (Los Angeles, California), UCHealth University of Colorado Hospital (Aurora, Colorado), Oregon Health & Science University Hospital (Portland, Oregon), Intermountain Medical Center (Murray, Utah), University of Washington (Seattle, Washington).
FIGURE 2 Sustained vaccine effectiveness* against COVID-19 among hospitalized adults, by patient status†,§ and interval since vaccination — 21 medical centers in 18 states,¶ March–July 2021 Abbreviation: VE = vaccine effectiveness. * VE was estimated using logistic regression comparing the odds of being fully vaccinated with an authorized mRNA COVID-19 vaccine with being unvaccinated in case patients and controls using the equation VE = 100 × (1 – odds ratio). Models were adjusted for date of hospital admission (biweekly intervals), U.S. Department of Health and Human Services region of hospital, age group (18–49, 50–64, or ≥65 years), sex, and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic of any race, non-Hispanic Other, or unknown). Analyses restricted to adults aged ≥65 years adjusted for age in years as a continuous variable. Binary time since second dose of mRNA vaccine was added to the model with results for 2–12 weeks and 13–24 weeks shown. 95% confidence intervals shown by error bars. † Immunocompromising conditions included having one or more of the following: active solid organ cancer (active cancer defined as treatment for the cancer or newly diagnosed cancer in the past 6 months), active hematologic cancer (such as leukemia, lymphoma, or myeloma), HIV infection without AIDS, AIDS, congenital immunodeficiency syndrome, previous splenectomy, previous solid organ transplant, immunosuppressive medication, systemic lupus erythematosus, rheumatoid arthritis, psoriasis, scleroderma, or inflammatory bowel disease, including Crohn’s disease or ulcerative colitis. § Multiple morbidities were defined as having chronic conditions within three or more of the following condition categories: cardiovascular disease, neurologic disease, pulmonary disease, gastrointestinal disease, endocrine disease, renal disease, hematologic disease, malignancy, immunosuppression not captured in other categories, autoimmune condition, or other condition (sarcoidosis, amyloidosis, or unintentional weight loss ≥10 pounds in the last 90 days). ¶ Hospitals by region included Northeast: Baystate Medical Center (Springfield, Massachusetts), Beth Israel Deaconess Medical Center (Boston, Massachusetts), Montefiore Medical Center (Bronx, New York); South: Vanderbilt University Medical Center (Nashville, Tennessee), University of Miami Medical Center (Miami, Florida), Emory University Medical Center (Atlanta, Georgia), Johns Hopkins Hospital (Baltimore, Maryland), Wake Forest University Baptist Medical Center (Winston-Salem, North Carolina), Baylor Scott and White Health (Temple, Texas); Midwest: University of Iowa Hospitals (Iowa City, Iowa), University of Michigan Hospital (Ann Arbor, Michigan), Hennepin County Medical Center (Minneapolis, Minnesota), Barnes-Jewish Hospital (St. Louis, Missouri), Cleveland Clinic (Cleveland, Ohio), Ohio State University Wexner Medical Center (Columbus, Ohio); West: Stanford University Medical Center (Stanford, California), UCLA Medical Center (Los Angeles, California), UCHealth University of Colorado Hospital (Aurora, Colorado), Oregon Health & Science University Hospital (Portland, Oregon), Intermountain Medical Center (Murray, Utah), University of Washington (Seattle, Washington).CC0 · PubMed Central

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Authors
Tenforde, M. W., Self, W. H., Naioti, E. A., Ginde, A. A., Douin, D. J., Olson, S. M., Talbot, H. K., Casey, J. D., Mohr, N. M., Zepeski, A., Gaglani, M., McNeal, T., Ghamande, S., Shapiro, N. I., Gibbs, K. W., Files, D. C., Hager, D. N., Shehu, A., Prekker, M. E., Erickson, H. L., Gong, M. N., Mohamed, A., Henning, D. J., Steingrub, J. S., Peltan, I. D., Brown, S. M., Martin, E. T., Monto, A. S., Khan, A., Hough, C. L., Busse, L. W., ten Lohuis, C. C., Duggal, A., Wilson, J. G., Gordon, A. J., Qadir, N., Chang, S. Y., Mallow, C., Rivas, C., Babcock, H. M., Kwon, J. H., Exline, M. C., Halasa, N., Chappell, J. D., Lauring, A. S., Grijalva, C. G., Rice, T. W., Jones, I. D., Stubblefield, W. B., Baughman, A., Womack, K. N., Lindsell, C. J., Hart, K. W., Zhu, Y., Stephenson, M., Schrag, S. J., Kobayashi, M., Verani, J. R., Patel, M. M., IVY Network Investigators, IVY Network, Calhoun, N., Murthy, K., Herrick, J., McKillop, A., Hoffman, E., Zayed, M., Smith, M., Settele, N., Ettlinger, J., Priest, E., Thomas, J., Arroliga, A., Beeram, M., Kindle, R., Kozikowski, L.-A., De Souza, L., Ouellette, S., Thornton-Thompson, S., Tyler, P., Mehkri, O., Ashok, K., Gole, S., King, A., Poynter, B., Stanley, N., Hendrickson, A., Maruggi, E., Scharber, T., Jorgensen, J., Bowers, R., King, J., Aston, V., Armbruster, B., Rothman, R. E., Nair, R., Chen, J.-T. (., Karow, S., Robart, E., Maldonado, P. N., Khan, M., So, P., Levitt, J., Perez, C., Visweswaran, A., Roque, J., Rivera, A., Frankel, T., Howell, M., Friedel, J., Goff, J., Huynh, D., Tozier, M., Driver, C., Carricato, M., Foster, A., Nassar, P., Stout, L., Sibenaller, Z., Walter, A., Mares, J., Olson, L., Clinansmith, B., Rivas, C., Gershengorn, H., McSpadden, E., Truscon, R., Kaniclides, A., Thomas, L., Bielak, R., Valvano, W. D., Fong, R., Fitzsimmons, W. J., Blair, C., Valesano, A. L., Gilbert, J., Crider, C. D., Steinbock, K. A., Paulson, T. C., Anderson, L. A., Kampe, C., Johnson, J., McHenry, R., Blair, M., Conway, D., LaRose, M., Landreth, L., Hicks, M., Parks, L., Bongu, J., McDonald, D., Cass, C., Seiler, S., Park, D., Hink, T., Wallace, M., Burnham, C.-A., & Arter, O. G.
Affiliations
  • Montefiore Medical Center (US)
  • Beth Israel Deaconess Medical Center (US)
  • Baylor Scott & White Health (US)
  • Baystate Medical Center (US)
  • Cleveland Clinic (US)
  • Emory University (US)
  • Hennepin County Medical Center (US)
  • Intermountain Medical Center (US)
  • Johns Hopkins University (US)
  • The Ohio State University (US)
  • Stanford University (US)
  • University of California, Los Angeles (US)
  • University of Colorado Hospital (US)
  • University of Iowa (US)
  • University of Miami (US)
  • University of Michigan (US)
  • University of Washington (US)
  • Vanderbilt University Medical Center (US)
  • Wake Forest University (US)
  • Washington University in St. Louis (US)
Corresponding author
Tenforde, Mark W.
ORCID
Venue
MMWR. Morbidity and Mortality Weekly Report
Publisher
Centers for Disease Control MMWR Office
Published
2021-08-27
Volume
70
Issue
34
Pages
1156-1162
ISSN
  • 0149-2195 (ISSN-L)
  • 1545-861X
DOI
10.15585/mmwr.mm7034e2
PMC
PMC8389395
OpenAlex
W3195990721
Cited by
204
References
8
Citations by year
2026: 1 · 2025: 10 · 2024: 22 · 2023: 43 · 2022: 86 · 2021: 42
FWCI
15.28
Type
journal article
Language
en
Open access
Locations
  • MMWR Morbidity and Mortality Weekly Report (publishedVersion)
  • PubMed Central (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • U.S. Department of Defense
  • Pfizer
  • Sanofi
  • Vanderbilt University
  • University of Miami
  • Brigham Young University
  • Ohio State University
  • Emory University
  • Medpace
  • United Therapeutics Corporation
  • Wake Forest University
  • Cleveland Clinic
  • University of Washington
  • Johns Hopkins University
  • Hennepin County Medical Center
  • Cumberland Pharmaceuticals
  • Regeneron Pharmaceuticals
  • Vanderbilt University Medical Center
  • Incyte
  • Marcus Foundation
  • University of Oxford
  • Seqirus
  • National Institutes of Health
  • Agency for Healthcare Research and Quality
  • University of California, Los Angeles
  • National Heart, Lung, and Blood Institute (T32HL087738)
  • National Institute of General Medical Sciences (T32GM135169)
  • Janssen Pharmaceuticals
Topics
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
Keywords
mRNA vaccines, BNT162b2, Moderna vaccine, COVID-19 pandemic, vaccine effectiveness, hospitalization, immunocompromising conditions, SARS-CoV-2 variants, hospitalized adults, real-world effectiveness, whole genome sequencing
MeSH terms
COVID-19, COVID-19 Vaccines, mRNA Vaccines, Adolescent, Adult, Aged, Female, Hospitalization, Humans, Male, Middle Aged, Time Factors, United States, Vaccination, Vaccines, Synthetic, Young Adult

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