Comparative effectiveness of bivalent BA.4–5 or BA.1 mRNA booster vaccines among immunocompromised individuals across three Nordic countries: A nationwide cohort study

Mie Agermose Gram; Emilia Myrup Thiesson; Nicklas Pihlström; Jori Perälä; Eero Poukka; Tuija Leino; Rickard Ljung; Niklas Worm Andersson; Anders Hviid

doi:10.1016/j.jinf.2024.106261

Comparative effectiveness of bivalent BA.4–5 or BA.1 mRNA booster vaccines among immunocompromised individuals across three Nordic countries: A nationwide cohort study

Mie Agermose Gram^*, Emilia Myrup Thiesson, Nicklas Pihlström, Jori Perälä, Eero Poukka, Tuija Leino, Rickard Ljung, Niklas Worm Andersson, Anders Hviid

^*Corresponding author af dette arbejde

Farmaceutisk Informatik

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

2 Citationer (Scopus)

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Abstract

Objectives: To estimate the effectiveness and waning of the bivalent BA.4–5 or BA.1 mRNA booster vaccine against Covid-19-related hospitalization and death in immunocompromised individuals. Methods: Nationwide analyses across Nordic countries from 1 September 2022 to 31 October 2023 using a matched cohort design. Individuals boosted with a BA.4–5 or BA.1 vaccine were matched 1:1 with unboosted individuals. The outcomes of interest were country-combined vaccine effectiveness (VE) estimates against Covid-19-related hospitalization and death at day 270 of follow-up. Waning was assessed in 45-day intervals. Results: A total of 352,762 BA.4–5 and 191,070 BA.1 booster vaccine doses were included. At day 270, the comparative VE against Covid-19-related hospitalization was 34.2% (95% CI, 7.1% to 61.3%) for the bivalent BA.4–5 vaccine and 42.6% (95% CI, 31.3% to 53.9%) for the BA.1 vaccine compared with matched unboosted. The comparative VE against Covid-19-related death was 53.9% (95% CI, 38.6% to 69.3%) for the bivalent BA.4–5 vaccine and 57.9% (95% CI, 48.5% to 67.4%) for the BA.1 vaccine. Conclusions: In immunocompromised individuals, vaccination with bivalent BA.4–5 or BA.1 booster lowered the risk of Covid-19-related hospitalization and death over a follow-up period of 9 months. The effectiveness was highest during the first months since vaccination with subsequent gradual waning.

Originalsprog	Engelsk
Artikelnummer	106261
Tidsskrift	Journal of Infection
Vol/bind	89
Udgave nummer	4
Antal sider	10
ISSN	0163-4453
DOI	https://doi.org/10.1016/j.jinf.2024.106261
Status	Udgivet - 2024

Bibliografisk note

Funding Information:
AH reports receiving unrelated grants from Independent Research Fund Denmark, the Lundbeck Foundation and the Novo Nordisk Foundation. AH reports acting as a scientific board member for VAC4EU.

Funding Information:
EP reports receiving a unrelated grant from Finnish Medical Foundation.

Funding Information:
This research was supported by the European Medicines Agency. The funders had no role in considering the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. This document expresses the opinion of the authors of the paper and may not be understood or quoted as being made on behalf of, or reflecting the position of, the European Medicines Agency or one of its committees or working parties.

Publisher Copyright:
© 2024 The Authors

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Citationsformater

Gram, M. A., Thiesson, E. M., Pihlström, N., Perälä, J., Poukka, E., Leino, T., Ljung, R., Andersson, N. W., & Hviid, A. (2024). Comparative effectiveness of bivalent BA.4–5 or BA.1 mRNA booster vaccines among immunocompromised individuals across three Nordic countries: A nationwide cohort study. Journal of Infection, 89(4), Artikel 106261. https://doi.org/10.1016/j.jinf.2024.106261

Comparative effectiveness of bivalent BA.4–5 or BA.1 mRNA booster vaccines among immunocompromised individuals across three Nordic countries: A nationwide cohort study. / Gram, Mie Agermose; Thiesson, Emilia Myrup; Pihlström, Nicklas et al.
I: Journal of Infection, Bind 89, Nr. 4, 106261, 2024.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Gram, MA, Thiesson, EM, Pihlström, N, Perälä, J, Poukka, E, Leino, T, Ljung, R, Andersson, NW & Hviid, A 2024, 'Comparative effectiveness of bivalent BA.4–5 or BA.1 mRNA booster vaccines among immunocompromised individuals across three Nordic countries: A nationwide cohort study', Journal of Infection, bind 89, nr. 4, 106261. https://doi.org/10.1016/j.jinf.2024.106261

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title = "Comparative effectiveness of bivalent BA.4–5 or BA.1 mRNA booster vaccines among immunocompromised individuals across three Nordic countries: A nationwide cohort study",

abstract = "Objectives: To estimate the effectiveness and waning of the bivalent BA.4–5 or BA.1 mRNA booster vaccine against Covid-19-related hospitalization and death in immunocompromised individuals. Methods: Nationwide analyses across Nordic countries from 1 September 2022 to 31 October 2023 using a matched cohort design. Individuals boosted with a BA.4–5 or BA.1 vaccine were matched 1:1 with unboosted individuals. The outcomes of interest were country-combined vaccine effectiveness (VE) estimates against Covid-19-related hospitalization and death at day 270 of follow-up. Waning was assessed in 45-day intervals. Results: A total of 352,762 BA.4–5 and 191,070 BA.1 booster vaccine doses were included. At day 270, the comparative VE against Covid-19-related hospitalization was 34.2% (95% CI, 7.1% to 61.3%) for the bivalent BA.4–5 vaccine and 42.6% (95% CI, 31.3% to 53.9%) for the BA.1 vaccine compared with matched unboosted. The comparative VE against Covid-19-related death was 53.9% (95% CI, 38.6% to 69.3%) for the bivalent BA.4–5 vaccine and 57.9% (95% CI, 48.5% to 67.4%) for the BA.1 vaccine. Conclusions: In immunocompromised individuals, vaccination with bivalent BA.4–5 or BA.1 booster lowered the risk of Covid-19-related hospitalization and death over a follow-up period of 9 months. The effectiveness was highest during the first months since vaccination with subsequent gradual waning.",

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author = "Gram, {Mie Agermose} and Thiesson, {Emilia Myrup} and Nicklas Pihlstr{\"o}m and Jori Per{\"a}l{\"a} and Eero Poukka and Tuija Leino and Rickard Ljung and Andersson, {Niklas Worm} and Anders Hviid",

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year = "2024",

doi = "10.1016/j.jinf.2024.106261",

language = "English",

volume = "89",

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T1 - Comparative effectiveness of bivalent BA.4–5 or BA.1 mRNA booster vaccines among immunocompromised individuals across three Nordic countries

T2 - A nationwide cohort study

AU - Gram, Mie Agermose

AU - Thiesson, Emilia Myrup

AU - Pihlström, Nicklas

AU - Perälä, Jori

AU - Poukka, Eero

AU - Leino, Tuija

AU - Ljung, Rickard

AU - Andersson, Niklas Worm

AU - Hviid, Anders

PY - 2024

Y1 - 2024

N2 - Objectives: To estimate the effectiveness and waning of the bivalent BA.4–5 or BA.1 mRNA booster vaccine against Covid-19-related hospitalization and death in immunocompromised individuals. Methods: Nationwide analyses across Nordic countries from 1 September 2022 to 31 October 2023 using a matched cohort design. Individuals boosted with a BA.4–5 or BA.1 vaccine were matched 1:1 with unboosted individuals. The outcomes of interest were country-combined vaccine effectiveness (VE) estimates against Covid-19-related hospitalization and death at day 270 of follow-up. Waning was assessed in 45-day intervals. Results: A total of 352,762 BA.4–5 and 191,070 BA.1 booster vaccine doses were included. At day 270, the comparative VE against Covid-19-related hospitalization was 34.2% (95% CI, 7.1% to 61.3%) for the bivalent BA.4–5 vaccine and 42.6% (95% CI, 31.3% to 53.9%) for the BA.1 vaccine compared with matched unboosted. The comparative VE against Covid-19-related death was 53.9% (95% CI, 38.6% to 69.3%) for the bivalent BA.4–5 vaccine and 57.9% (95% CI, 48.5% to 67.4%) for the BA.1 vaccine. Conclusions: In immunocompromised individuals, vaccination with bivalent BA.4–5 or BA.1 booster lowered the risk of Covid-19-related hospitalization and death over a follow-up period of 9 months. The effectiveness was highest during the first months since vaccination with subsequent gradual waning.

AB - Objectives: To estimate the effectiveness and waning of the bivalent BA.4–5 or BA.1 mRNA booster vaccine against Covid-19-related hospitalization and death in immunocompromised individuals. Methods: Nationwide analyses across Nordic countries from 1 September 2022 to 31 October 2023 using a matched cohort design. Individuals boosted with a BA.4–5 or BA.1 vaccine were matched 1:1 with unboosted individuals. The outcomes of interest were country-combined vaccine effectiveness (VE) estimates against Covid-19-related hospitalization and death at day 270 of follow-up. Waning was assessed in 45-day intervals. Results: A total of 352,762 BA.4–5 and 191,070 BA.1 booster vaccine doses were included. At day 270, the comparative VE against Covid-19-related hospitalization was 34.2% (95% CI, 7.1% to 61.3%) for the bivalent BA.4–5 vaccine and 42.6% (95% CI, 31.3% to 53.9%) for the BA.1 vaccine compared with matched unboosted. The comparative VE against Covid-19-related death was 53.9% (95% CI, 38.6% to 69.3%) for the bivalent BA.4–5 vaccine and 57.9% (95% CI, 48.5% to 67.4%) for the BA.1 vaccine. Conclusions: In immunocompromised individuals, vaccination with bivalent BA.4–5 or BA.1 booster lowered the risk of Covid-19-related hospitalization and death over a follow-up period of 9 months. The effectiveness was highest during the first months since vaccination with subsequent gradual waning.

KW - Covid-19

KW - Immunocompromised

KW - Vaccine effectiveness

U2 - 10.1016/j.jinf.2024.106261

DO - 10.1016/j.jinf.2024.106261

M3 - Journal article

C2 - 39218308

AN - SCOPUS:85202840880

SN - 0163-4453

VL - 89

JO - Journal of Infection

JF - Journal of Infection

IS - 4

M1 - 106261

ER -