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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
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
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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