Browsing by Author "DeCuir, Jennifer"

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    Estimated 2023-2024 COVID-19 Vaccine Effectiveness in Adults
    (American Medical Association, 2025-06-02) Link-Gelles, Ruth; Rowley, Elizabeth A. K.; Irving, Stephanie A.; Klein, Nicola P.; Grannis, Shaun J.; Ong, Toan C.; Ball, Sarah W.; DeSilva, Malini B.; Dascomb, Kristin; Naleway, Allison L.; Koppolu, Padma; Zerbo, Ousseny; Fireman, Bruce; Hansen, John; Timbol, Julius; Block, Lawrence; Dixon, Brian E.; Duszynski, Thomas J.; Allen, Katie S.; Mayer, David; Chavez, Catia; Barron, Michelle; Reese, Sarah E.; Chickery, Sean; Davis, Jonathan M.; Avrich Ciesla, Allison; Mak, Josephine; Najdowski, Morgan; Akinsete, Omobosola O.; McEvoy, Charlene E.; Essien, Inih J.; Sheffield, Tamara; Bride, Daniel; Arndorfer, Julie; Van Otterloo, Joshua; Natarajan, Karthik; Tenforde, Mark W.; DeCuir, Jennifer; Payne, Amanda B.; Medicine, School of Medicine
    Importance: SARS-CoV-2 continues to evolve, population immunity changes, and COVID-19 vaccine formulas have been updated, necessitating ongoing COVID-19 vaccine effectiveness (VE) monitoring. Objectives: To evaluate the VE of 2023-2024 COVID-19 vaccines against COVID-19-associated emergency department (ED) and urgent care (UC) encounters, hospitalizations, and critical illness, including during XBB- and JN.1-predominant periods. Design, setting, and participants: This test-negative design VE case-control study was conducted using data from September 21, 2023, to August 22, 2024, from EDs, UC centers, and hospitals in 6 US health care systems. Eligible adults 18 years or older with COVID-19-like illness and molecular or antigen testing for SARS-CoV-2 were studied. Case patients were those with a positive molecular or antigen test result; control patients were those with a negative molecular test result. Exposure: Receipt of 2023-2024 (monovalent XBB.1.5) COVID-19 vaccination with products approved or authorized for use in the US. Main outcomes and measures: Main outcomes were COVID-19-associated ED and UC encounters, hospitalizations, and critical illness (admission to the intensive care unit or in-hospital death). VE was estimated comparing the odds of receipt of the 2023-2024 COVID-19 vaccine with no receipt among case and control patients. Results: Among 345 639 eligible ED and UC encounters in immunocompetent adults 18 years or older with COVID-19-like illness and available test results (median [IQR] age, 53 [34-71] years; 209 087 [60%] female), 37 096 (11%) had a positive SARS-CoV-2 test result. VE against COVID-19-associated ED and UC encounters was 24% (95% CI, 21%-26%) during 7 to 299 days after vaccination. Among 111 931 eligible hospitalizations in immunocompetent adults 18 years or older with COVID-19-like illness and available test results (median [IQR] age, 71 [58-81] years), 10 380 (9%) had a positive SARS-CoV-2 test result. During 7 to 299 days after vaccination, VE was 29% (95% CI, 25%-33%) against COVID-19-associated hospitalization and 48% (95% CI, 40%-55%) against COVID-19-associated critical illness. VE was highest 7 to 59 days after vaccination (VE against ED and UC encounters 49%; 95% CI, 46%-52%; hospitalization, 51%; 95% CI, 46%-56%; critical illness, 68%; 95% CI, 56%-76%) and then waned (VE 180-299 days after vaccination against ED and UC encounters, -7% [95% CI, -13% to -2%]; hospitalization, -4% [95% CI, -14% to 5%]; and critical illness, 16% [95% CI, -6 to 34%]). Conclusions and relevance: In this case-control study of VE, 2023-2024 COVID-19 vaccines were estimated to provide additional effectiveness against medically attended COVID-19, with the highest and most sustained estimates against critical illness. These results highlight the importance of receiving recommended COVID-19 vaccination for adults 18 years or older.