Cited by 170SARS-CoV-2 and COVID-19 ResearchCOVID-19 Clinical Research StudiesVaccine Coverage and Hesitancy

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Effectiveness of mRNA Vaccination in Preventing COVID-19–Associated Invasive Mechanical Ventilation and Death — United States, March 2021–January 2022

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Tenforde, Mark W., Self, Wesley H., Gaglani, Manjusha, Ginde, Adit A., Douin, David J., Talbot, H. Keipp, Casey, Jonathan D., Mohr, Nicholas M., Zepeski, Anne, McNeal, Tresa, Ghamande, Shekhar, Gibbs, Kevin W., Files, D. Clark, Hager, David N., Shehu, Arber, Prekker, Matthew E., Frosch, Anne E., Gong, Michelle N., Mohamed, Amira, Johnson, Nicholas J., Srinivasan, Vasisht, Steingrub, Jay S., Peltan, Ithan D., Brown, Samuel M., Martin, Emily T., Monto, Arnold S., Khan, Akram, Hough, Catherine L., Busse, Laurence W., Duggal, Abhijit, Wilson, Jennifer G., Qadir, Nida, Chang, Steven Y., Mallow, Christopher, Rivas, Carolina, Babcock, Hilary M., Kwon, Jennie H., Exline, Matthew C., Botros, Mena, Lauring, Adam S., Shapiro, Nathan I., Halasa, Natasha, Chappell, James D., Grijalva, Carlos G., Rice, Todd W., Jones, Ian D., Stubblefield, William B., Baughman, Adrienne, Womack, Kelsey N., Rhoads, Jillian P., Lindsell, Christopher J., Hart, Kimberly W., Zhu, Yuwei, Adams, Katherine, Surie, Diya, McMorrow, Meredith L., Patel, Manish M., IVY Network·2022·MMWR. Morbidity and Mortality Weekly Report

DOI 10.15585/mmwr.mm7112e1PMC PMC8956334

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Abstract

COVID-19 mRNA vaccines (BNT162b2 [Pfizer-BioNTech] and mRNA-1273 [Moderna]) are effective at preventing COVID-19-associated hospitalization (1-3). However, how well mRNA vaccines protect against the most severe outcomes of these hospitalizations, including invasive mechanical ventilation (IMV) or death is uncertain. Using a case-control design, mRNA vaccine effectiveness (VE) against COVID-19-associated IMV and in-hospital death was evaluated among adults aged ≥18 years hospitalized at 21 U.S. medical centers during March 11, 2021-January 24, 2022. During this period, the most commonly circulating variants of SARS-CoV-2, the virus that causes COVID-19, were B.1.1.7 (Alpha), B.1.617.2 (Delta), and B.1.1.529 (Omicron). Previous vaccination (2 or 3 versus 0 vaccine doses before illness onset) in prospectively enrolled COVID-19 case-patients who received IMV or died within 28 days of hospitalization was compared with that among hospitalized control patients without COVID-19. Among 1,440 COVID-19 case-patients who received IMV or died, 307 (21%) had received 2 or 3 vaccine doses before illness onset. Among 6,104 control-patients, 4,020 (66%) had received 2 or 3 vaccine doses. Among the 1,440 case-patients who received IMV or died, those who were vaccinated were older (median age = 69 years), more likely to be immunocompromised* (40%), and had more chronic medical conditions compared with unvaccinated case-patients (median age = 55 years; immunocompromised = 10%; p<0.001 for both). VE against IMV or in-hospital death was 90% (95% CI = 88%-91%) overall, including 88% (95% CI = 86%-90%) for 2 doses and 94% (95% CI = 91%-96%) for 3 doses, and 94% (95% CI = 88%-97%) for 3 doses during the Omicron-predominant period. COVID-19 mRNA vaccines are highly effective in preventing COVID-19-associated death and respiratory failure treated with IMV. CDC recommends that all persons eligible for vaccination get vaccinated and stay up to date with COVID-19 vaccination (4).

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Authors: Tenforde, M. W., Self, W. H., Gaglani, M., Ginde, A. A., Douin, D. J., Talbot, H. K., Casey, J. D., Mohr, N. M., Zepeski, A., McNeal, T., Ghamande, S., Gibbs, K. W., Files, D. C., Hager, D. N., Shehu, A., Prekker, M. E., Frosch, A. E., Gong, M. N., Mohamed, A., Johnson, N. J., Srinivasan, V., Steingrub, J. S., Peltan, I. D., Brown, S. M., Martin, E. T., Monto, A. S., Khan, A., Hough, C. L., Busse, L. W., Duggal, A., Wilson, J. G., Qadir, N., Chang, S. Y., Mallow, C., Rivas, C., Babcock, H. M., Kwon, J. H., Exline, M. C., Botros, M., Lauring, A. S., Shapiro, N. I., Halasa, N., Chappell, J. D., Grijalva, C. G., Rice, T. W., Jones, I. D., Stubblefield, W. B., Baughman, A., Womack, K. N., Rhoads, J. P., Lindsell, C. J., Hart, K. W., Zhu, Y., Adams, K., Surie, D., McMorrow, M. L., Patel, M. M., & IVY Network
Affiliations: University of Iowa (US)
University of Colorado Anschutz (US)
Corresponding author: Tenforde, Mark W.
ORCID: Tenforde, Mark W.
Self, Wesley H.
Gaglani, Manjusha
Ginde, Adit A.
Douin, David J.
Talbot, H. Keipp
Casey, Jonathan D.
Mohr, Nicholas M.
Zepeski, Anne
McNeal, Tresa
Ghamande, Shekhar
Gibbs, Kevin W.
Files, D. Clark
Hager, David N.
Shehu, Arber
Prekker, Matthew E.
Frosch, Anne E.
Gong, Michelle N.
Mohamed, Amira
Johnson, Nicholas J.
Srinivasan, Vasisht
Steingrub, Jay S.
Peltan, Ithan D.
Brown, Samuel M.
Martin, Emily T.
Monto, Arnold S.
Khan, Akram
Hough, Catherine L.
Busse, Laurence W.
Duggal, Abhijit
Wilson, Jennifer G.
Qadir, Nida
Chang, Steven Y.
Mallow, Christopher
Rivas, Carolina
Babcock, Hilary M.
Kwon, Jennie H.
Exline, Matthew C.
Botros, Mena
Lauring, Adam S.
Shapiro, Nathan I.
Halasa, Natasha
Chappell, James D.
Grijalva, Carlos G.
Rice, Todd W.
Stubblefield, William B.
Womack, Kelsey N.
Rhoads, Jillian P.
Lindsell, Christopher J.
Hart, Kimberly W.
Zhu, Yuwei
Adams, Katherine
Surie, Diya
McMorrow, Meredith L.
Patel, Manish M.
Venue: MMWR. Morbidity and Mortality Weekly Report
Publisher: Centers for Disease Control MMWR Office
Published: 2022-03-25
Volume: 71
Issue: 12
Pages: 459-465
ISSN: 0149-2195 (ISSN-L)
1545-861X
DOI: 10.15585/mmwr.mm7112e1
PMC: PMC8956334
OpenAlex: W4220929994
Cited by: 170
References: 7
Citations by year: 2026: 5 · 2025: 19 · 2024: 36 · 2023: 61 · 2022: 49
FWCI: 20.17
Type: journal article
Language: en
Open access: diamond
doi.org
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
Eli Lilly and Company
Pfizer
Sanofi
Vanderbilt University
University of Miami
Ohio State University
Medpace
United Therapeutics Corporation
Wake Forest University
University of Washington
Intermountain Research and Medical Foundation
Cumberland Pharmaceuticals
Regeneron Pharmaceuticals
Vanderbilt University Medical Center
Marcus Foundation
National Institutes of Health
Agency for Healthcare Research and Quality
University of California, Los Angeles
National Heart, Lung, and Blood Institute (K23HL153584)
National Institute of General Medical Sciences (K23GM129661, T32GM135169)
National Institute of Allergy and Infectious Diseases (K08AI141761)
National Center for Advancing Translational Sciences
Janssen Pharmaceuticals
Topics: Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Social Sciences › Health › Vaccine Coverage and Hesitancy
Keywords: COVID-19 mRNA vaccine, vaccine effectiveness, invasive mechanical ventilation, in-hospital mortality, BNT162b2, mRNA-1273, hospitalized COVID-19 patients, SARS-CoV-2 variants, Omicron variant, Delta variant, Alpha variant, immunocompromised patients, prior vaccination, SARS-CoV-2 infection prevention, severe COVID-19 outcomes
MeSH terms: COVID-19, Vaccine Efficacy, BNT162 Vaccine, 2019-nCoV Vaccine mRNA-1273, Humans, Respiration, Artificial, United States, Hospital Mortality

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Effectiveness of mRNA Vaccination in Preventing COVID-19–Associated Invasive Mechanical Ventilation and Death — United States, March 2021–January 2022

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