Analysis of COVID-19 incidence and severity among adults vaccinated with 2-dose mRNA COVID-19 or inactivated SARS-coV-2 vaccines with and without boosters in Singapore
Importance: Assessing booster effectiveness of COVID-19 mRNA vaccine and inactivated SARS-CoV-2 vaccine over longer time intervals and in response to any further SARS-CoV-2 variants is crucial in determining optimal COVID-19 vaccination strategies. Objective: To determine levels of protection agains...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
| Published: |
2023
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| Online Access: | https://hdl.handle.net/10356/164216 |
| _version_ | 1826121009482170368 |
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| author | Ng, Oon Tek Marimuthu, Kalisvar Lim, Nigel Lim, Ze Qin Thevasagayam, Natascha May Koh, Vanessa Chiew, Calvin J. Ma, Stefan Koh, Mingshi Low, Pin Yan Tan, Say Beng Ho, Joses Maurer-Stroh, Sebastian Lee, Vernon J. M. Leo, Yee Sin Tan, Kelvin Bryan Cook, Alex R. Tan, Chorh Chuan |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Ng, Oon Tek Marimuthu, Kalisvar Lim, Nigel Lim, Ze Qin Thevasagayam, Natascha May Koh, Vanessa Chiew, Calvin J. Ma, Stefan Koh, Mingshi Low, Pin Yan Tan, Say Beng Ho, Joses Maurer-Stroh, Sebastian Lee, Vernon J. M. Leo, Yee Sin Tan, Kelvin Bryan Cook, Alex R. Tan, Chorh Chuan |
| author_sort | Ng, Oon Tek |
| collection | NTU |
| description | Importance: Assessing booster effectiveness of COVID-19 mRNA vaccine and inactivated SARS-CoV-2 vaccine over longer time intervals and in response to any further SARS-CoV-2 variants is crucial in determining optimal COVID-19 vaccination strategies. Objective: To determine levels of protection against severe COVID-19 and confirmed SARS-CoV-2 infection by types and combinations of vaccine boosters in Singapore during the Omicron wave. Design, Setting, and Participants: This cohort study included Singapore residents aged 30 years or more vaccinated with either at least 2 doses of mRNA COVID-19 vaccines (ie, Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273) or inactivated SARS-CoV-2 vaccines (Sinovac CoronaVac or Sinopharm BBIBP-CorV) as of March 10, 2022. Individuals with a known SARS-CoV-2 infection prior to December 27, 2021, an infection on or before the date of their second vaccine dose, or with reinfection cases were excluded. Exposures: Two or 3 doses of Pfizer-BioNTech BNT162b2, Moderna mRNA-1273, Sinovac CoronaVac, or Sinopharm BBIBP-CorV. Main Outcomes and Measures: Notified infections from December 27, 2021, to March 10, 2022, adjusted for age, sex, race, housing status, and calendar days. Estimated booster effectiveness, defined as the relative incidence-rate reduction of severe disease (supplemental oxygen, intensive care, or death) or confirmed infection following 3-dose vaccination compared with 5 months after second mRNA dose, was determined using binomial regression. Results: Among 2441581 eligible individuals (1279047 [52.4%] women, 846110 (34.7%) aged 60 years and older), there were 319943 (13.1%) confirmed SARS-CoV-2 infections, of which 1513 (0.4%) were severe COVID-19 cases. mRNA booster effectiveness against confirmed infection 15 to 60 days after boosting was estimated to range from 31.7% to 41.3% for the 4 boosting combinations (homologous BNT162b2, homologous mRNA-1273, 2-dose BNT162b2/mRNA-1273 booster, and 2-dose mRNA-1273/BNT162b2 booster). Five months and more after boosting, estimated booster effectiveness against confirmed infection waned, ranging from -2.8% to 14.6%. Against severe COVID-19, estimated mRNA booster effectiveness was 87.4% (95% CI, 83.3%-90.5%) 15 to 60 days after boosting and 87.2% (95% CI, 84.2%-89.7%) 5 to 6 months after boosting, with no significant difference comparing vaccine combinations. Booster effectiveness against severe COVID-19 15 days to 330 days after 3-dose inactivated COVID-19 vaccination, regardless of combination, was estimated to be 69.6% (95% CI, 48.7%-81.9%). Conclusions and Relevance: Booster mRNA vaccine protection against severe COVID-19 was estimated to be durable over 6 months. Three-dose inactivated SARS-CoV-2 vaccination provided greater protection than 2-dose but weaker protection compared with 3-dose mRNA. |
| first_indexed | 2024-10-01T05:25:45Z |
| format | Journal Article |
| id | ntu-10356/164216 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T05:25:45Z |
| publishDate | 2023 |
| record_format | dspace |
| spelling | ntu-10356/1642162023-03-05T16:52:51Z Analysis of COVID-19 incidence and severity among adults vaccinated with 2-dose mRNA COVID-19 or inactivated SARS-coV-2 vaccines with and without boosters in Singapore Ng, Oon Tek Marimuthu, Kalisvar Lim, Nigel Lim, Ze Qin Thevasagayam, Natascha May Koh, Vanessa Chiew, Calvin J. Ma, Stefan Koh, Mingshi Low, Pin Yan Tan, Say Beng Ho, Joses Maurer-Stroh, Sebastian Lee, Vernon J. M. Leo, Yee Sin Tan, Kelvin Bryan Cook, Alex R. Tan, Chorh Chuan Lee Kong Chian School of Medicine (LKCMedicine) National Centre for Infectious Diseases, Singapore Tan Tock Seng Hospital Yong Loo Lin School of Medicine, NUS National University Health System, Singapore Saw Swee Hock School of Public Health Science::Medicine Coronavac Messenger RNA Importance: Assessing booster effectiveness of COVID-19 mRNA vaccine and inactivated SARS-CoV-2 vaccine over longer time intervals and in response to any further SARS-CoV-2 variants is crucial in determining optimal COVID-19 vaccination strategies. Objective: To determine levels of protection against severe COVID-19 and confirmed SARS-CoV-2 infection by types and combinations of vaccine boosters in Singapore during the Omicron wave. Design, Setting, and Participants: This cohort study included Singapore residents aged 30 years or more vaccinated with either at least 2 doses of mRNA COVID-19 vaccines (ie, Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273) or inactivated SARS-CoV-2 vaccines (Sinovac CoronaVac or Sinopharm BBIBP-CorV) as of March 10, 2022. Individuals with a known SARS-CoV-2 infection prior to December 27, 2021, an infection on or before the date of their second vaccine dose, or with reinfection cases were excluded. Exposures: Two or 3 doses of Pfizer-BioNTech BNT162b2, Moderna mRNA-1273, Sinovac CoronaVac, or Sinopharm BBIBP-CorV. Main Outcomes and Measures: Notified infections from December 27, 2021, to March 10, 2022, adjusted for age, sex, race, housing status, and calendar days. Estimated booster effectiveness, defined as the relative incidence-rate reduction of severe disease (supplemental oxygen, intensive care, or death) or confirmed infection following 3-dose vaccination compared with 5 months after second mRNA dose, was determined using binomial regression. Results: Among 2441581 eligible individuals (1279047 [52.4%] women, 846110 (34.7%) aged 60 years and older), there were 319943 (13.1%) confirmed SARS-CoV-2 infections, of which 1513 (0.4%) were severe COVID-19 cases. mRNA booster effectiveness against confirmed infection 15 to 60 days after boosting was estimated to range from 31.7% to 41.3% for the 4 boosting combinations (homologous BNT162b2, homologous mRNA-1273, 2-dose BNT162b2/mRNA-1273 booster, and 2-dose mRNA-1273/BNT162b2 booster). Five months and more after boosting, estimated booster effectiveness against confirmed infection waned, ranging from -2.8% to 14.6%. Against severe COVID-19, estimated mRNA booster effectiveness was 87.4% (95% CI, 83.3%-90.5%) 15 to 60 days after boosting and 87.2% (95% CI, 84.2%-89.7%) 5 to 6 months after boosting, with no significant difference comparing vaccine combinations. Booster effectiveness against severe COVID-19 15 days to 330 days after 3-dose inactivated COVID-19 vaccination, regardless of combination, was estimated to be 69.6% (95% CI, 48.7%-81.9%). Conclusions and Relevance: Booster mRNA vaccine protection against severe COVID-19 was estimated to be durable over 6 months. Three-dose inactivated SARS-CoV-2 vaccination provided greater protection than 2-dose but weaker protection compared with 3-dose mRNA. Ministry of Health (MOH) National Medical Research Council (NMRC) Published version This work was supported by funds administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), namely, the NMRC COVID-19 Research Fund (grant Nos. MOH-000469 and MOH-000717), the NMRC Centre Grant: Collaborative Solutions Targeting Antimicrobial Resistance Threats in Health Systems (CoSTAR-HS) (CGAug16C005 and CG21APR2005), NMRC Clinician Scientist Award (MOH-000276), and NMRC Clinician Scientist Individual Research Grant (MOH-CIRG18Nov-0034). 2023-01-10T01:55:52Z 2023-01-10T01:55:52Z 2022 Journal Article Ng, O. T., Marimuthu, K., Lim, N., Lim, Z. Q., Thevasagayam, N. M., Koh, V., Chiew, C. J., Ma, S., Koh, M., Low, P. Y., Tan, S. B., Ho, J., Maurer-Stroh, S., Lee, V. J. M., Leo, Y. S., Tan, K. B., Cook, A. R. & Tan, C. C. (2022). Analysis of COVID-19 incidence and severity among adults vaccinated with 2-dose mRNA COVID-19 or inactivated SARS-coV-2 vaccines with and without boosters in Singapore. JAMA Network Open, 5(8), e2228900-. https://dx.doi.org/10.1001/jamanetworkopen.2022.28900 2574-3805 https://hdl.handle.net/10356/164216 10.1001/jamanetworkopen.2022.28900 36018588 2-s2.0-85137135190 8 5 e2228900 en MOH-000469 MOH-000717 CGAug16C005 CG21APR2005 MOH-000276 MOH-CIRG18Nov-0034 JAMA Network Open © 2022 Ng OT et al. JAMA Network Open. This is an open access article distributed under the terms of the CC-BY License. application/pdf |
| spellingShingle | Science::Medicine Coronavac Messenger RNA Ng, Oon Tek Marimuthu, Kalisvar Lim, Nigel Lim, Ze Qin Thevasagayam, Natascha May Koh, Vanessa Chiew, Calvin J. Ma, Stefan Koh, Mingshi Low, Pin Yan Tan, Say Beng Ho, Joses Maurer-Stroh, Sebastian Lee, Vernon J. M. Leo, Yee Sin Tan, Kelvin Bryan Cook, Alex R. Tan, Chorh Chuan Analysis of COVID-19 incidence and severity among adults vaccinated with 2-dose mRNA COVID-19 or inactivated SARS-coV-2 vaccines with and without boosters in Singapore |
| title | Analysis of COVID-19 incidence and severity among adults vaccinated with 2-dose mRNA COVID-19 or inactivated SARS-coV-2 vaccines with and without boosters in Singapore |
| title_full | Analysis of COVID-19 incidence and severity among adults vaccinated with 2-dose mRNA COVID-19 or inactivated SARS-coV-2 vaccines with and without boosters in Singapore |
| title_fullStr | Analysis of COVID-19 incidence and severity among adults vaccinated with 2-dose mRNA COVID-19 or inactivated SARS-coV-2 vaccines with and without boosters in Singapore |
| title_full_unstemmed | Analysis of COVID-19 incidence and severity among adults vaccinated with 2-dose mRNA COVID-19 or inactivated SARS-coV-2 vaccines with and without boosters in Singapore |
| title_short | Analysis of COVID-19 incidence and severity among adults vaccinated with 2-dose mRNA COVID-19 or inactivated SARS-coV-2 vaccines with and without boosters in Singapore |
| title_sort | analysis of covid 19 incidence and severity among adults vaccinated with 2 dose mrna covid 19 or inactivated sars cov 2 vaccines with and without boosters in singapore |
| topic | Science::Medicine Coronavac Messenger RNA |
| url | https://hdl.handle.net/10356/164216 |
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