The Risk of Hospitalization and Mortality After Breakthrough SARS-CoV-2 Infection by Vaccine Type: Observational Study of Medical Claims Data
BackgroundSeveral risk factors have been identified for severe COVID-19 disease by the scientific community. In this paper, we focus on understanding the risks for severe COVID-19 infections after vaccination (ie, in breakthrough SARS-CoV-2 infections). Studying these risks b...
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| Format: | Article |
| Language: | English |
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JMIR Publications
2022-11-01
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| Series: | JMIR Public Health and Surveillance |
| Online Access: | https://publichealth.jmir.org/2022/11/e38898 |
| _version_ | 1797734679043899392 |
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| author | Meghana Kshirsagar Md Nasir Sumit Mukherjee Nicholas Becker Rahul Dodhia William B Weeks Juan Lavista Ferres Barbra Richardson |
| author_facet | Meghana Kshirsagar Md Nasir Sumit Mukherjee Nicholas Becker Rahul Dodhia William B Weeks Juan Lavista Ferres Barbra Richardson |
| author_sort | Meghana Kshirsagar |
| collection | DOAJ |
| description |
BackgroundSeveral risk factors have been identified for severe COVID-19 disease by the scientific community. In this paper, we focus on understanding the risks for severe COVID-19 infections after vaccination (ie, in breakthrough SARS-CoV-2 infections). Studying these risks by vaccine type, age, sex, comorbidities, and any prior SARS-CoV-2 infection is important to policy makers planning further vaccination efforts.
ObjectiveWe performed a comparative study of the risks of hospitalization (n=1140) and mortality (n=159) in a SARS-CoV-2 positive cohort of 19,815 patients who were all fully vaccinated with the Pfizer, Moderna, or Janssen vaccines.
MethodsWe performed Cox regression analysis to calculate the risk factors for developing a severe breakthrough SARS-CoV-2 infection in the study cohort by controlling for vaccine type, age, sex, comorbidities, and a prior SARS-CoV-2 infection.
ResultsWe found lower hazard ratios for those receiving the Moderna vaccine (P<.001) and Pfizer vaccine (P<.001), with the lowest hazard rates being for Moderna, as compared to those who received the Janssen vaccine, independent of age, sex, comorbidities, vaccine type, and prior SARS-CoV-2 infection. Further, individuals who had a SARS-CoV-2 infection prior to vaccination had some increased protection over and above the protection already provided by the vaccines, from hospitalization (P=.001) and death (P=.04), independent of age, sex, comorbidities, and vaccine type. We found that the top statistically significant risk factors for severe breakthrough SARS-CoV-2 infections were age of >50, male gender, moderate and severe renal failure, severe liver disease, leukemia, chronic lung disease, coagulopathy, and alcohol abuse.
ConclusionsAmong individuals who were fully vaccinated, the risk of severe breakthrough SARS-CoV-2 infection was lower for recipients of the Moderna or Pfizer vaccines and higher for recipients of the Janssen vaccine. These results from our analysis at a population level will be helpful to public health policy makers. Our result on the influence of a previous SARS-CoV-2 infection necessitates further research into the impact of multiple exposures on the risk of developing severe COVID-19. |
| first_indexed | 2024-03-12T12:47:51Z |
| format | Article |
| id | doaj.art-cd5375f07c6f419288a315c243e201bb |
| institution | Directory Open Access Journal |
| issn | 2369-2960 |
| language | English |
| last_indexed | 2024-03-12T12:47:51Z |
| publishDate | 2022-11-01 |
| publisher | JMIR Publications |
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| series | JMIR Public Health and Surveillance |
| spelling | doaj.art-cd5375f07c6f419288a315c243e201bb2023-08-28T23:15:04ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602022-11-01811e3889810.2196/38898The Risk of Hospitalization and Mortality After Breakthrough SARS-CoV-2 Infection by Vaccine Type: Observational Study of Medical Claims DataMeghana Kshirsagarhttps://orcid.org/0000-0002-4673-614XMd Nasirhttps://orcid.org/0000-0002-3955-0996Sumit Mukherjeehttps://orcid.org/0000-0001-6532-3343Nicholas Beckerhttps://orcid.org/0000-0002-5552-8051Rahul Dodhiahttps://orcid.org/0000-0003-3812-3906William B Weekshttps://orcid.org/0000-0002-9918-1360Juan Lavista Ferreshttps://orcid.org/0000-0002-9654-3178Barbra Richardsonhttps://orcid.org/0000-0001-9564-1828 BackgroundSeveral risk factors have been identified for severe COVID-19 disease by the scientific community. In this paper, we focus on understanding the risks for severe COVID-19 infections after vaccination (ie, in breakthrough SARS-CoV-2 infections). Studying these risks by vaccine type, age, sex, comorbidities, and any prior SARS-CoV-2 infection is important to policy makers planning further vaccination efforts. ObjectiveWe performed a comparative study of the risks of hospitalization (n=1140) and mortality (n=159) in a SARS-CoV-2 positive cohort of 19,815 patients who were all fully vaccinated with the Pfizer, Moderna, or Janssen vaccines. MethodsWe performed Cox regression analysis to calculate the risk factors for developing a severe breakthrough SARS-CoV-2 infection in the study cohort by controlling for vaccine type, age, sex, comorbidities, and a prior SARS-CoV-2 infection. ResultsWe found lower hazard ratios for those receiving the Moderna vaccine (P<.001) and Pfizer vaccine (P<.001), with the lowest hazard rates being for Moderna, as compared to those who received the Janssen vaccine, independent of age, sex, comorbidities, vaccine type, and prior SARS-CoV-2 infection. Further, individuals who had a SARS-CoV-2 infection prior to vaccination had some increased protection over and above the protection already provided by the vaccines, from hospitalization (P=.001) and death (P=.04), independent of age, sex, comorbidities, and vaccine type. We found that the top statistically significant risk factors for severe breakthrough SARS-CoV-2 infections were age of >50, male gender, moderate and severe renal failure, severe liver disease, leukemia, chronic lung disease, coagulopathy, and alcohol abuse. ConclusionsAmong individuals who were fully vaccinated, the risk of severe breakthrough SARS-CoV-2 infection was lower for recipients of the Moderna or Pfizer vaccines and higher for recipients of the Janssen vaccine. These results from our analysis at a population level will be helpful to public health policy makers. Our result on the influence of a previous SARS-CoV-2 infection necessitates further research into the impact of multiple exposures on the risk of developing severe COVID-19.https://publichealth.jmir.org/2022/11/e38898 |
| spellingShingle | Meghana Kshirsagar Md Nasir Sumit Mukherjee Nicholas Becker Rahul Dodhia William B Weeks Juan Lavista Ferres Barbra Richardson The Risk of Hospitalization and Mortality After Breakthrough SARS-CoV-2 Infection by Vaccine Type: Observational Study of Medical Claims Data JMIR Public Health and Surveillance |
| title | The Risk of Hospitalization and Mortality After Breakthrough SARS-CoV-2 Infection by Vaccine Type: Observational Study of Medical Claims Data |
| title_full | The Risk of Hospitalization and Mortality After Breakthrough SARS-CoV-2 Infection by Vaccine Type: Observational Study of Medical Claims Data |
| title_fullStr | The Risk of Hospitalization and Mortality After Breakthrough SARS-CoV-2 Infection by Vaccine Type: Observational Study of Medical Claims Data |
| title_full_unstemmed | The Risk of Hospitalization and Mortality After Breakthrough SARS-CoV-2 Infection by Vaccine Type: Observational Study of Medical Claims Data |
| title_short | The Risk of Hospitalization and Mortality After Breakthrough SARS-CoV-2 Infection by Vaccine Type: Observational Study of Medical Claims Data |
| title_sort | risk of hospitalization and mortality after breakthrough sars cov 2 infection by vaccine type observational study of medical claims data |
| url | https://publichealth.jmir.org/2022/11/e38898 |
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