Estimating COVID-19 Vaccination and Booster Effectiveness Using Electronic Health Records From an Academic Medical Center in Michigan
Introduction: Observational studies of COVID-19 vaccines’ effectiveness can provide crucial information regarding the strength and durability of protection against SARS-CoV-2 infection and whether the protective response varies across different patient subpopulations and in the context of different...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-09-01
|
| Series: | AJPM Focus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S277306542200013X |
| _version_ | 1811324290510880768 |
|---|---|
| author | Emily K. Roberts, PhD Tian Gu, PhD Abram L. Wagner, PhD Bhramar Mukherjee, PhD Lars G. Fritsche, PhD |
| author_facet | Emily K. Roberts, PhD Tian Gu, PhD Abram L. Wagner, PhD Bhramar Mukherjee, PhD Lars G. Fritsche, PhD |
| author_sort | Emily K. Roberts, PhD |
| collection | DOAJ |
| description | Introduction: Observational studies of COVID-19 vaccines’ effectiveness can provide crucial information regarding the strength and durability of protection against SARS-CoV-2 infection and whether the protective response varies across different patient subpopulations and in the context of different SARS-CoV-2 variants. Methods: We used a test-negative study design to assess vaccine effectiveness against SARS-CoV-2 infection and severe COVID-19 resulting in hospitalization, intensive care unit admission, or death using electronic health records data of 170,741 adults who had been tested for COVID-19 at the University of Michigan Medical Center between January 1 and December 31, 2021. We estimated vaccine effectiveness by comparing the odds of vaccination between cases and controls during each 2021 calendar quarter and stratified all outcomes by vaccine type, patient demographic and clinical characteristics, and booster status. Results: Unvaccinated individuals had more than double the rate of infections (12.1% vs 4.7%) and >3 times the rate of severe COVID-19 outcomes (1.4% vs 0.4%) than vaccinated individuals. COVID-19 vaccines were 62.1% (95% CI=60.3, 63.8) effective against a new infection, with protection waning in the last 2 quarters of 2021. The vaccine effectiveness against severe disease overall was 73.7% (95% CI=69.6, 77.3) and remained high throughout 2021. Data from the last quarter of 2021 indicated that adding a booster dose augmented effectiveness against infection up to 87.3% (95% CI=85.0, 89.2) and against severe outcomes up to 94.0% (95% CI=89.5, 96.6). Pfizer-BioNTech and Moderna vaccines showed comparable performance when controlling for vaccination timing. Vaccine effectiveness was greater in more socioeconomically affluent areas and among healthcare workers; otherwise, we did not detect any significant modification of vaccine effectiveness by covariates, including gender, race, and SES. Conclusions: COVID-19 vaccines were highly protective against infection and severe COVID-19 resulting in hospitalization, intensive care unit admission, or death. Administration of a booster dose significantly increased vaccine effectiveness against both outcomes. Ongoing surveillance is required to assess the durability of these findings. |
| first_indexed | 2024-04-13T14:11:44Z |
| format | Article |
| id | doaj.art-15dc11a2d6b94f06bfd8f509f09b498d |
| institution | Directory Open Access Journal |
| issn | 2773-0654 |
| language | English |
| last_indexed | 2024-04-13T14:11:44Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | AJPM Focus |
| spelling | doaj.art-15dc11a2d6b94f06bfd8f509f09b498d2022-12-22T02:43:45ZengElsevierAJPM Focus2773-06542022-09-0111100015Estimating COVID-19 Vaccination and Booster Effectiveness Using Electronic Health Records From an Academic Medical Center in MichiganEmily K. Roberts, PhD0Tian Gu, PhD1Abram L. Wagner, PhD2Bhramar Mukherjee, PhD3Lars G. Fritsche, PhD4Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan; Center for Precision Health Data Science, School of Public Health, University of Michigan, Ann Arbor, MichiganDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MassachusettsDepartment of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MichiganDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan; Center for Precision Health Data Science, School of Public Health, University of Michigan, Ann Arbor, Michigan; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan; Michigan Institute for Data Science, University of Michigan, Ann Arbor, Michigan; Address correspondence to: Bhramar Mukherjee, PhD, Department of Biostatistics, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor MI 48109.Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan; Center for Precision Health Data Science, School of Public Health, University of Michigan, Ann Arbor, Michigan; Address correspondence to: Lars G. Fritsche, PhD, Department of Biostatistics, School of Publich Health, University of Michigan, 1415 Washington Heights, Ann Arbor MI 48109.Introduction: Observational studies of COVID-19 vaccines’ effectiveness can provide crucial information regarding the strength and durability of protection against SARS-CoV-2 infection and whether the protective response varies across different patient subpopulations and in the context of different SARS-CoV-2 variants. Methods: We used a test-negative study design to assess vaccine effectiveness against SARS-CoV-2 infection and severe COVID-19 resulting in hospitalization, intensive care unit admission, or death using electronic health records data of 170,741 adults who had been tested for COVID-19 at the University of Michigan Medical Center between January 1 and December 31, 2021. We estimated vaccine effectiveness by comparing the odds of vaccination between cases and controls during each 2021 calendar quarter and stratified all outcomes by vaccine type, patient demographic and clinical characteristics, and booster status. Results: Unvaccinated individuals had more than double the rate of infections (12.1% vs 4.7%) and >3 times the rate of severe COVID-19 outcomes (1.4% vs 0.4%) than vaccinated individuals. COVID-19 vaccines were 62.1% (95% CI=60.3, 63.8) effective against a new infection, with protection waning in the last 2 quarters of 2021. The vaccine effectiveness against severe disease overall was 73.7% (95% CI=69.6, 77.3) and remained high throughout 2021. Data from the last quarter of 2021 indicated that adding a booster dose augmented effectiveness against infection up to 87.3% (95% CI=85.0, 89.2) and against severe outcomes up to 94.0% (95% CI=89.5, 96.6). Pfizer-BioNTech and Moderna vaccines showed comparable performance when controlling for vaccination timing. Vaccine effectiveness was greater in more socioeconomically affluent areas and among healthcare workers; otherwise, we did not detect any significant modification of vaccine effectiveness by covariates, including gender, race, and SES. Conclusions: COVID-19 vaccines were highly protective against infection and severe COVID-19 resulting in hospitalization, intensive care unit admission, or death. Administration of a booster dose significantly increased vaccine effectiveness against both outcomes. Ongoing surveillance is required to assess the durability of these findings.http://www.sciencedirect.com/science/article/pii/S277306542200013XCOVID-19vaccineselectronic health records |
| spellingShingle | Emily K. Roberts, PhD Tian Gu, PhD Abram L. Wagner, PhD Bhramar Mukherjee, PhD Lars G. Fritsche, PhD Estimating COVID-19 Vaccination and Booster Effectiveness Using Electronic Health Records From an Academic Medical Center in Michigan AJPM Focus COVID-19 vaccines electronic health records |
| title | Estimating COVID-19 Vaccination and Booster Effectiveness Using Electronic Health Records From an Academic Medical Center in Michigan |
| title_full | Estimating COVID-19 Vaccination and Booster Effectiveness Using Electronic Health Records From an Academic Medical Center in Michigan |
| title_fullStr | Estimating COVID-19 Vaccination and Booster Effectiveness Using Electronic Health Records From an Academic Medical Center in Michigan |
| title_full_unstemmed | Estimating COVID-19 Vaccination and Booster Effectiveness Using Electronic Health Records From an Academic Medical Center in Michigan |
| title_short | Estimating COVID-19 Vaccination and Booster Effectiveness Using Electronic Health Records From an Academic Medical Center in Michigan |
| title_sort | estimating covid 19 vaccination and booster effectiveness using electronic health records from an academic medical center in michigan |
| topic | COVID-19 vaccines electronic health records |
| url | http://www.sciencedirect.com/science/article/pii/S277306542200013X |
| work_keys_str_mv | AT emilykrobertsphd estimatingcovid19vaccinationandboostereffectivenessusingelectronichealthrecordsfromanacademicmedicalcenterinmichigan AT tianguphd estimatingcovid19vaccinationandboostereffectivenessusingelectronichealthrecordsfromanacademicmedicalcenterinmichigan AT abramlwagnerphd estimatingcovid19vaccinationandboostereffectivenessusingelectronichealthrecordsfromanacademicmedicalcenterinmichigan AT bhramarmukherjeephd estimatingcovid19vaccinationandboostereffectivenessusingelectronichealthrecordsfromanacademicmedicalcenterinmichigan AT larsgfritschephd estimatingcovid19vaccinationandboostereffectivenessusingelectronichealthrecordsfromanacademicmedicalcenterinmichigan |