Effectiveness of Monovalent mRNA Vaccines Against COVID-19–Associated Hospitalization Among Immunocompetent Adults During BA.1/BA.2 and BA.4/BA.5 Predominant Periods of SARS-CoV-2 Omicron Variant in the United States — IVY Network, 18 States, December 26, 2021–August 31, 2022
Open accessAbstract
The SARS-CoV-2 Omicron variant (B.1.1.529or BA.1) became predominant in the United States by late December 2021 (1).BA.1 has since been replaced by emerging lineages BA.2 (including BA.2.12.1) in March 2022, followed by BA.4 and BA.5, which have accounted for a majority of SARS-CoV-2 infections since late June 2022 (1).Data on the effectiveness of monovalent mRNA COVID-19 vaccines against BA.4/BA.5associatedhospitalizations are limited, and their interpretation is complicated by waning of vaccine-induced immunity (2-5).Further, infections with earlier Omicron lineages, including BA.1 and BA.2, reduce vaccine effectiveness (VE) estimates because certain persons in the referent unvaccinated group have protection from infection-induced immunity.The IVY Network † assessed effectiveness of 2, 3, and 4 doses of monovalent mRNA vaccines compared with no vaccination against COVID-19associated hospitalization among immunocompetent adults aged ≥18 years during December 26, 2021-August 31, 2022.During the BA.1/BA.2period, VE 14-150 days after a second dose was 63% and decreased to 34% after 150 days.Similarly, * These authors contributed equally to this report.
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Eight studies assessed VE of primary series or first booster dose vaccination separately for at least two different Omicron subvariants (six assessed VE of both primary series and booster dose vaccination and two assessed VE of a booster dose only).
“Eight studies assessed VE of primary series or first booster dose vaccination separately for at least two different Omicron subvariants (six assessed VE of both primary series and booster dose vaccination and two assessed VE of a booster dose only, Tables 1 and 2) [21,24-26,28-33].”
From Assessing COVID-19 vaccine effectiveness against Omicron subvariants: Report from a meeting of the World Health Organization (2023) · cites this paper as [30]
The Methods and Results report separate VE estimates for two-dose primary vaccination and three-dose booster vaccination during the BA.1/BA.2 and BA.4/BA.5 periods. However, the Discussion says the lineages within each period were pooled, so the study did not estimate VE separately for individual Omicron subvariants. The count of eight studies is the citing authors’ synthesis, not a finding attributed to this paper alone. (LLM, conf=0.83)
Experimental — accuracy not yet measuredFor several studies that evaluated median time since last dose, time since last dose was longer for BA.4/5 compared to BA.1.
“For several studies that evaluated the median time since last dose, indeed the time since last dose was longer for BA.4/5 compared to BA.1 [25,26,30].”
From Assessing COVID-19 vaccine effectiveness against Omicron subvariants: Report from a meeting of the World Health Organization (2023) · cites this paper as [30]
Among three studies that compared VE against BA.1/2 with BA.4/5, one showed a similar VE within the first four months following a booster dose, but lower VE against BA.4/5 beyond 4 months; one study showed similar VE at all periods; the third showed lower VE against BA.4/5 than BA.1/2 at all periods, though confidence intervals overlapped.
“Among three studies that compared VE against BA.1/2 with BA.4/5, one showed a similar VE within the first four months following a booster dose, but lower VE against BA.4/5 beyond 4 months; one study showed similar VE at all periods; the third showed lower VE against BA.4/5 than BA.1/2 at all periods, though confidence intervals overlapped [21,28,30].”
From Assessing COVID-19 vaccine effectiveness against Omicron subvariants: Report from a meeting of the World Health Organization (2023) · cites this paper as [30]
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- Authors
- Surie, D., Bonnell, L., Adams, K., 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., Frosch, A. P., Erickson, H. L., Gong, M. N., Mohamed, A., Johnson, N. J., Srinivasan, V., Steingrub, J. S., Peltan, I. D., Brown, S. M., Martin, E. T., Khan, A., Bender, W. S., Duggal, A., Wilson, J. G., Qadir, N., Chang, S. Y., Mallow, C., Rivas, C., Kwon, J. H., Exline, M. C., Lauring, A. S., Shapiro, N. I., Halasa, N., Chappell, J. D., Grijalva, C. G., Rice, T. W., Stubblefield, W. B., Baughman, A., Womack, K. N., Hart, K. W., Swan, S. A., Zhu, Y., DeCuir, J., Tenforde, M. W., Patel, M. M., McMorrow, M. L., Self, W. H., IVY Network, IVY Network, Calhoun, N., Herrick, J., Hoffman, E., McKillop, A., Murthy, K., Smith, M., Zayed, M., De Souza, L., Kozikowski, L.-A., Ouellette, S., Ashok, K., Gole, S., King, A., Mehkri, O., Poynter, B., ten Lohuis, C., Stanley, N., Caspers, S., Hendrickson, A., Kaus, O., Taghizadeh, L., Tordsen, W., Aston, V., Bowers, R., Jorgensen, J., King, J., Ali, H., Rothman, R. E., Chen, J.-T., Nair, R., Allada, G., Briceno, G., Giovanni, S., Hubel, K. A., Martinez, J., Oh, M., Pak, J., Pena, J., Gordon, A. J., Levitt, J., Perez, C., Roque, J., Visweswaran, A., Karow, S., Khan, M., Klingler, A., Pannu, S., Smith, D., Schwartz, E., Snyder, C., So, M., So, P., Swoope, G., Weigand, M., Carricato, M., Chambers, I., Driver, C., Goff, J., Huynh, D., Jensen, K., Chandrasekaran, S., Frankel, T., Garner, O., Fairfield, C., Landers, S., Nassar, P., Williams, C., Gershengorn, H., Bielak, R., Blair, C., Fitzsimmons, W. J., Fong, R., Gilbert, J., McSpadden, E., Thomas, L., Truscon, R., Valvano, W. D., Anderson, L. A., Crider, C. D., Paulson, T. C., Steinbock, K. A., Blair, M., Ezzell, L. J., Hargrave, S. J., Kampe, C., Johnson, J., Luther, J. L., McHenry, R. E., Peterson, B. P. M., Pulido, C. G., Short, L. L., Whitsett, M. E., Hicks, M., Landreth, L., LaRose, M., Parks, L., Babcock, H., Hink, T., Jolani, K., McDonald, D., O’Neal, C., Parikh, B., Parrish, K., & Samuels, C.
- Affiliations
- University of Iowa (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)
- Montefiore Medical Center (US)
- Oregon Health & Science University (US)
- Stanford University (US)
- The Ohio State University (US)
- University of Colorado Hospital (US)
- University of California, Los Angeles (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
- Surie, Diya
- ORCID
- Surie, Diya
- Adams, Katherine
- 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
- Erickson, Heidi L.
- Gong, Michelle N.
- Mohamed, Amira
- Johnson, Nicholas J.
- Srinivasan, Vasisht
- Steingrub, Jay S.
- Peltan, Ithan D.
- Brown, Samuel M.
- Martin, Emily T.
- Khan, Akram
- Duggal, Abhijit
- Wilson, Jennifer G.
- Qadir, Nida
- Chang, Steven Y.
- Mallow, Christopher
- Rivas, Carolina
- Kwon, Jennie H.
- Exline, Matthew C.
- Lauring, Adam S.
- Shapiro, Nathan I.
- Halasa, Natasha
- Chappell, James D.
- Grijalva, Carlos G.
- Rice, Todd W.
- Stubblefield, William B.
- Womack, Kelsey N.
- Hart, Kimberly W.
- Zhu, Yuwei
- Tenforde, Mark W.
- Patel, Manish M.
- McMorrow, Meredith L.
- Self, Wesley H.
- Murthy, Kempapura
- Smith, Michael
- Kozikowski, Lori-Ann
- Ouellette, Scott
- Mehkri, Omar
- Taghizadeh, Leyla
- Rothman, Richard E.
- Hubel, Kinsley A.
- Oh, Minn
- Schwartz, Elizabeth
- Huynh, David
- Chandrasekaran, Sukantha
- Garner, Omai
- Fairfield, Catherine
- Landers, Shannon
- Gershengorn, Hayley
- Fitzsimmons, William J.
- Thomas, Lara
- Truscon, Rachel
- Valvano, Weronika Damek
- Short, Laura L.
- Babcock, Hilary
- Parikh, Bijal
- Parrish, Katie
- Venue
- MMWR. Morbidity and Mortality Weekly Report
- Published
- 2022-10-21
- Volume
- 71
- Issue
- 42
- Pages
- 1327-1334
- ISSN
- 0149-2195 (ISSN-L)
- 1545-861X
- PMC
- PMC9590291
- OpenAlex
- W4306942168
- Cited by
- 59
- References
- 5
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 7 · 2023: 39 · 2022: 5
- FWCI
- 6.72
- 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)
- Funders
- U.S. Department of Defense
- American Thoracic Society
- Eli Lilly and Company
- Pfizer
- GlaxoSmithKline
- Sanofi
- Medpace
- United Therapeutics Corporation
- University of Washington
- Regeneron Pharmaceuticals
- Society of Hospital Medicine
- Kiniksa Pharmaceuticals
- National Institutes of Health
- Agency for Healthcare Research and Quality
- Military Health System
- National Heart, Lung, and Blood Institute (K23HL153584)
- National Institute of General Medical Sciences (K23GM129661, T32GM135169)
- National Institute of Allergy and Infectious Diseases
- Janssen Pharmaceuticals
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Keywords
- vaccine effectiveness, COVID-19 hospitalization, Omicron variant, BA.4/BA.5, vaccine waning, immunocompetent adult, breakthrough infection, SARS-CoV-2
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Vaccines, mRNA Vaccines, Adolescent, Adult, Hospitalization, Humans, RNA, Messenger, United States, Vaccines, Combined
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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