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  2. Feb 10, 2023 · Synthesising evidence on the long-term vaccine effectiveness of COVID-19 vaccines (BNT162b2 [Pfizer–BioNTech], mRNA-1273 [Moderna], ChAdOx1 nCoV-19 [AZD1222; Oxford–AstraZeneca], and Ad26.COV2.S [Janssen]) against infections, hospitalisations, and mortality is crucial to making evidence-based pandemic policy decisions.

    • Overview
    • Discussion
    • References

    On April 28, 2021, this report was posted online as an MMWR Early Release.

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    Monitoring the effectiveness of SARS-CoV-2 vaccination under routine public health use and specifically against severe outcomes in patients at higher risk, including older adults, is a high priority. In this multistate analysis of adults aged ≥65 years, receipt of an authorized COVID-19 vaccine was associated with significant protection against COVID-19 hospitalization. Effectiveness was 94% among adults who were fully vaccinated and 64% among adults who were partially vaccinated (i.e., onset of COVID-like illness ≥14 days after the first vaccine dose in a 2-dose series but <14 days after the second dose). These findings are consistent with efficacy determined from clinical trials in the subgroup of adults aged ≥65 years (4,5). Early reports from Israel have also documented the real-world effectiveness of SARS-CoV-2 vaccination, including among older adults (7,9). However, those postmarketing reports only represented the Pfizer-BioNTech vaccine. In the current report, Pfizer-BioNTech and Moderna vaccine products were equally represented, and approximately one half of the patients were aged ≥75 years, providing evidence of real-world effectiveness of both vaccines against an important measure of severe COVID-19 in older adults. Moreover, in assessing the impact of receiving only a single dose, no significant vaccine effectiveness <14 days after the first dose of a SARS-CoV-2 vaccine was detected. This suggests that bias is unlikely in the primary estimates of vaccine effectiveness from partial and full vaccination. This also highlights the continued risk for severe illness shortly after vaccination, before a protective immune response has been achieved and reinforces the need for vaccinated adults to continue physical distancing and prevention behaviors, such as use of face masks and recommended hand hygiene at least 14 days after the second dose of a 2-dose vaccine. The findings suggest that SARS-CoV-2 vaccines can reduce the risk for COVID-19–associated hospitalization and, as a consequence of preventing severe COVID-19, vaccination might have an impact on post-COVID conditions (e.g., “long COVID”) and deaths (2,10).

    The findings in this report are subject to at least six limitations. First, the CIs for VE estimates were wide because of the small sample size, and the number of participants was too small to assess VE by vaccine product, age group, or underlying conditions. Second, as an interim analysis that included self-reported data, vaccination status might have been misclassified, or participants might have had imperfect recollection of vaccination or illness onset dates. Third, selection bias and residual confounding cannot be excluded. Fourth, although the analysis included hospitalized adults from 14 states, the participants were not geographically representative of the U.S. population. Fifth, the case-control design infers protection based on associations between disease outcome and previous vaccination but cannot establish causation. Finally, duration of VE and VE for nonhospitalized COVID-19 was not assessed.

    1.Garg S, Kim L, Whitaker M, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019—COVID-NET, 14 states, March 1–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:458–64. https://doi.org/10.15585/mmwr.mm6915e3external icon PMID:32298251external icon

    2.Wortham JM, Lee JT, Althomsons S, et al. Characteristics of persons who died with COVID-19—United States, February 12–May 18, 2020. MMWR Morb Mortal Wkly Rep 2020;69:923–9. https://doi.org/10.15585/mmwr.mm6928e1external icon PMID:32673298external icon

    3.Dooling K, Marin M, Wallace M, et al. The Advisory Committee on Immunization Practices’ updated interim recommendation for allocation of COVID-19 vaccine—United States, December 2020. MMWR Morb Mortal Wkly Rep 2021;69:1657–60. https://doi.org/10.15585/mmwr.mm695152e2external icon PMID:33382671external icon

    4.Baden LR, El Sahly HM, Essink B, et al.; COVE Study Group. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med 2021;384:403–16. https://doi.org/10.1056/NEJMoa2035389external icon PMID:33378609external icon

    5.Polack FP, Thomas SJ, Kitchin N, et al.; C4591001 Clinical Trial Group. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med 2020;383:2603–15. https://doi.org/10.1056/NEJMoa2034577external icon PMID:33301246external icon

    6.Patel MM, Jackson ML, Ferdinands J. Postlicensure evaluation of COVID-19 vaccines. JAMA 2020;324:1939–40. https://doi.org/10.1001/jama.2020.19328external icon PMID:33064144external icon

    • Mark W. Tenforde, Samantha M. Olson, Wesley H. Self, H. Keipp Talbot, Christopher J. Lindsell, Jay S...
    • 2021
  3. Jan 12, 2022 · For the two-dose regimens of messenger RNA (mRNA) vaccines BNT162b2 (30 μg per dose) and mRNA-1273 (100 μg per dose), vaccine effectiveness against Covid-19 was 94.5% (95% confidence interval ...

  4. Mar 3, 2022 · The efficacy of the BNT162b2 (Pfizer-BioNTech) vaccine against laboratory-confirmed COVID-19 exceeded 90% in clinical trials that included children and adolescents aged 511, 1215, and 1617 years ( 13 ).

  5. Oct 21, 2021 · These findings are consistent with efficacy data from the Pfizer-BioNTech clinical trial among persons aged 12–15 years, which found an observed vaccine efficacy of 100% (95% CI = 75.3%100%) ( 2 ). However, that trial was not powered to assess efficacy against hospitalized COVID-19.

    • Samantha M Olson, Margaret M Newhams, Natasha B Halasa, Ashley M Price, Julie A Boom, Leila C Sahni,...
    • 2021
  6. Apr 1, 2021 · Analysis of 927 confirmed symptomatic cases of COVID-19 demonstrates BNT162b2 is highly effective with 91.3% vaccine efficacy observed against COVID-19, measured seven days through up to six months after the second dose.

  7. Aug 23, 2022 · Among children ages 6 through 23 months, the vaccine was 75.8% (2-sided 95% CI: 9.7%, 94.7%) effective at preventing COVID-19, based on 4 cases in the vaccine group (n=296) and 8 cases in the placebo group (n=147), after a median of 1.9 months (range: 0.0, 4.9) follow-up after the third dose.

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  2. 65 And Older & Got A 2023-24 COVID-19 Shot? You May Be Eligible For An Additional Dose. Use The Vaccine Finder To Find COVID-19 Vax Locations Near You & Help Stay Protected.

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