Effectiveness of Homologous and Heterologous COVID-19 Booster Doses Following 1 Ad.26.COV2.S (Janssen [Johnson & Johnson]) Vaccine Dose Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults - VISION Network, 10 States, December 2021-March 2022
CDC recommends that all persons aged ≥18 years receive a single COVID-19 vaccine booster dose ≥2 months after receipt of an Ad.26.COV2.S (Janssen [Johnson & Johnson]) adenovirus vector-based primary series vaccine; a heterologous COVID-19 mRNA vaccine is preferred over a homologous (matching) Ja...
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| Veröffentlicht in: | MMWR. Morbidity and mortality weekly report 2022-04, Vol.71 (13), p.495-502 |
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| creator | Natarajan, Karthik Prasad, Namrata Dascomb, Kristin Irving, Stephanie A Yang, Duck-Hye Gaglani, Manjusha Klein, Nicola P DeSilva, Malini B Ong, Toan C Grannis, Shaun J Stenehjem, Edward Link-Gelles, Ruth Rowley, Elizabeth A Naleway, Allison L Han, Jungmi Raiyani, Chandni Benitez, Gabriela Vazquez Rao, Suchitra Lewis, Ned Fadel, William F Grisel, Nancy Griggs, Eric P Dunne, Margaret M Stockwell, Melissa S Mamawala, Mufaddal McEvoy, Charlene Barron, Michelle A Goddard, Kristin Valvi, Nimish R Arndorfer, Julie Patel, Palak Mitchell, Patrick K Smith, Michael Kharbanda, Anupam B Fireman, Bruce Embi, Peter J Dickerson, Monica Davis, Jonathan M Zerbo, Ousseny Dalton, Alexandra F Wondimu, Mehiret H Azziz-Baumgartner, Eduardo Bozio, Catherine H Reynolds, Sue Ferdinands, Jill Williams, Jeremiah Schrag, Stephanie J Verani, Jennifer R Ball, Sarah Thompson, Mark G Dixon, Brian E |
| description | CDC recommends that all persons aged ≥18 years receive a single COVID-19 vaccine booster dose ≥2 months after receipt of an Ad.26.COV2.S (Janssen [Johnson & Johnson]) adenovirus vector-based primary series vaccine; a heterologous COVID-19 mRNA vaccine is preferred over a homologous (matching) Janssen vaccine for booster vaccination. This recommendation was made in light of the risks for rare but serious adverse events following receipt of a Janssen vaccine, including thrombosis with thrombocytopenia syndrome and Guillain-Barré syndrome
(1), and clinical trial data indicating similar or higher neutralizing antibody response following heterologous boosting compared with homologous boosting (2). Data on real-world vaccine effectiveness (VE) of different booster strategies following a primary Janssen vaccine dose are limited, particularly during the period of Omicron variant predominance. The VISION Network
determined real-world VE of 1 Janssen vaccine dose and 2 alternative booster dose strategies: 1) a homologous booster (i.e., 2 Janssen doses) and 2) a heterologous mRNA booster (i.e., 1 Janssen dose/1 mRNA dose). In addition, VE of these booster strategies was compared with VE of a homologous booster following mRNA primary series vaccination (i.e., 3 mRNA doses). The study examined 80,287 emergency department/urgent care (ED/UC) visits
and 25,244 hospitalizations across 10 states during December 16, 2021-March 7, 2022, when Omicron was the predominant circulating variant.** VE against laboratory-confirmed COVID-19-associated ED/UC encounters was 24% after 1 Janssen dose, 54% after 2 Janssen doses, 79% after 1 Janssen/1 mRNA dose, and 83% after 3 mRNA doses. VE for the same vaccination strategies against laboratory-confirmed COVID-19-associated hospitalizations were 31%, 67%, 78%, and 90%, respectively. All booster strategies provided higher protection than a single Janssen dose against ED/UC visits and hospitalizations during Omicron variant predominance. Vaccination with 1 Janssen/1 mRNA dose provided higher protection than did 2 Janssen doses against COVID-19-associated ED/UC visits and was comparable to protection provided by 3 mRNA doses during the first 120 days after a booster dose. However, 3 mRNA doses provided higher protection against COVID-19-associated hospitalizations than did other booster strategies during the same time interval since booster dose. All adults who have received mRNA vaccines for their COVID-19 primary series vaccination should |
| doi_str_mv | 10.15585/MMWR.MM7113E2 |
| format | Article |
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(1), and clinical trial data indicating similar or higher neutralizing antibody response following heterologous boosting compared with homologous boosting (2). Data on real-world vaccine effectiveness (VE) of different booster strategies following a primary Janssen vaccine dose are limited, particularly during the period of Omicron variant predominance. The VISION Network
determined real-world VE of 1 Janssen vaccine dose and 2 alternative booster dose strategies: 1) a homologous booster (i.e., 2 Janssen doses) and 2) a heterologous mRNA booster (i.e., 1 Janssen dose/1 mRNA dose). In addition, VE of these booster strategies was compared with VE of a homologous booster following mRNA primary series vaccination (i.e., 3 mRNA doses). The study examined 80,287 emergency department/urgent care (ED/UC) visits
and 25,244 hospitalizations across 10 states during December 16, 2021-March 7, 2022, when Omicron was the predominant circulating variant.** VE against laboratory-confirmed COVID-19-associated ED/UC encounters was 24% after 1 Janssen dose, 54% after 2 Janssen doses, 79% after 1 Janssen/1 mRNA dose, and 83% after 3 mRNA doses. VE for the same vaccination strategies against laboratory-confirmed COVID-19-associated hospitalizations were 31%, 67%, 78%, and 90%, respectively. All booster strategies provided higher protection than a single Janssen dose against ED/UC visits and hospitalizations during Omicron variant predominance. Vaccination with 1 Janssen/1 mRNA dose provided higher protection than did 2 Janssen doses against COVID-19-associated ED/UC visits and was comparable to protection provided by 3 mRNA doses during the first 120 days after a booster dose. However, 3 mRNA doses provided higher protection against COVID-19-associated hospitalizations than did other booster strategies during the same time interval since booster dose. All adults who have received mRNA vaccines for their COVID-19 primary series vaccination should receive an mRNA booster dose when eligible. Adults who received a primary Janssen vaccine dose should preferentially receive a heterologous mRNA vaccine booster dose ≥2 months later, or a homologous Janssen vaccine booster dose if mRNA vaccine is contraindicated or unavailable. Further investigation of the durability of protection afforded by different booster strategies is warranted.</description><identifier>ISSN: 0149-2195</identifier><identifier>EISSN: 1545-861X</identifier><identifier>DOI: 10.15585/MMWR.MM7113E2</identifier><identifier>PMID: 35358170</identifier><language>eng</language><publisher>United States: U.S. Government Printing Office</publisher><subject>Adolescent ; Adult ; Adults ; Ambulatory Care ; Coronaviruses ; COVID-19 ; COVID-19 - prevention & control ; COVID-19 Vaccines ; Drug dosages ; Effectiveness ; Emergency medical care ; Emergency medical services ; Emergency medicine ; Emergency service ; Emergency Service, Hospital ; Full Report ; Guillain-Barre syndrome ; Hospitalization ; Hospitals ; Humans ; Immunization ; Immunization, Secondary ; Infections ; Influenza Vaccines ; Medical laboratories ; Messenger RNA ; mRNA ; mRNA Vaccines ; Pharmaceutical industry ; Public health ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Vaccination ; Vaccine efficacy ; Vaccines ; Vaccines, Synthetic</subject><ispartof>MMWR. Morbidity and mortality weekly report, 2022-04, Vol.71 (13), p.495-502</ispartof><rights>COPYRIGHT 2022 U.S. Government Printing Office</rights><rights>Published 2022. This article is a U.S. Government work and is in the public domain in the USA.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c553t-395d26b4657630691f75ac92d396b8712012cb657287b5aa676727d404875f1b3</citedby><cites>FETCH-LOGICAL-c553t-395d26b4657630691f75ac92d396b8712012cb657287b5aa676727d404875f1b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8979598/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8979598/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35358170$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Natarajan, Karthik</creatorcontrib><creatorcontrib>Prasad, Namrata</creatorcontrib><creatorcontrib>Dascomb, Kristin</creatorcontrib><creatorcontrib>Irving, Stephanie A</creatorcontrib><creatorcontrib>Yang, Duck-Hye</creatorcontrib><creatorcontrib>Gaglani, Manjusha</creatorcontrib><creatorcontrib>Klein, Nicola P</creatorcontrib><creatorcontrib>DeSilva, Malini B</creatorcontrib><creatorcontrib>Ong, Toan C</creatorcontrib><creatorcontrib>Grannis, Shaun J</creatorcontrib><creatorcontrib>Stenehjem, Edward</creatorcontrib><creatorcontrib>Link-Gelles, Ruth</creatorcontrib><creatorcontrib>Rowley, Elizabeth A</creatorcontrib><creatorcontrib>Naleway, Allison L</creatorcontrib><creatorcontrib>Han, Jungmi</creatorcontrib><creatorcontrib>Raiyani, Chandni</creatorcontrib><creatorcontrib>Benitez, Gabriela Vazquez</creatorcontrib><creatorcontrib>Rao, Suchitra</creatorcontrib><creatorcontrib>Lewis, Ned</creatorcontrib><creatorcontrib>Fadel, William F</creatorcontrib><creatorcontrib>Grisel, Nancy</creatorcontrib><creatorcontrib>Griggs, Eric P</creatorcontrib><creatorcontrib>Dunne, Margaret M</creatorcontrib><creatorcontrib>Stockwell, Melissa S</creatorcontrib><creatorcontrib>Mamawala, Mufaddal</creatorcontrib><creatorcontrib>McEvoy, Charlene</creatorcontrib><creatorcontrib>Barron, Michelle A</creatorcontrib><creatorcontrib>Goddard, Kristin</creatorcontrib><creatorcontrib>Valvi, Nimish R</creatorcontrib><creatorcontrib>Arndorfer, Julie</creatorcontrib><creatorcontrib>Patel, Palak</creatorcontrib><creatorcontrib>Mitchell, Patrick K</creatorcontrib><creatorcontrib>Smith, Michael</creatorcontrib><creatorcontrib>Kharbanda, Anupam B</creatorcontrib><creatorcontrib>Fireman, Bruce</creatorcontrib><creatorcontrib>Embi, Peter J</creatorcontrib><creatorcontrib>Dickerson, Monica</creatorcontrib><creatorcontrib>Davis, Jonathan M</creatorcontrib><creatorcontrib>Zerbo, Ousseny</creatorcontrib><creatorcontrib>Dalton, Alexandra F</creatorcontrib><creatorcontrib>Wondimu, Mehiret H</creatorcontrib><creatorcontrib>Azziz-Baumgartner, Eduardo</creatorcontrib><creatorcontrib>Bozio, Catherine H</creatorcontrib><creatorcontrib>Reynolds, Sue</creatorcontrib><creatorcontrib>Ferdinands, Jill</creatorcontrib><creatorcontrib>Williams, Jeremiah</creatorcontrib><creatorcontrib>Schrag, Stephanie J</creatorcontrib><creatorcontrib>Verani, Jennifer R</creatorcontrib><creatorcontrib>Ball, Sarah</creatorcontrib><creatorcontrib>Thompson, Mark G</creatorcontrib><creatorcontrib>Dixon, Brian E</creatorcontrib><title>Effectiveness of Homologous and Heterologous COVID-19 Booster Doses Following 1 Ad.26.COV2.S (Janssen [Johnson & Johnson]) Vaccine Dose Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults - VISION Network, 10 States, December 2021-March 2022</title><title>MMWR. Morbidity and mortality weekly report</title><addtitle>MMWR Morb Mortal Wkly Rep</addtitle><description>CDC recommends that all persons aged ≥18 years receive a single COVID-19 vaccine booster dose ≥2 months after receipt of an Ad.26.COV2.S (Janssen [Johnson & Johnson]) adenovirus vector-based primary series vaccine; a heterologous COVID-19 mRNA vaccine is preferred over a homologous (matching) Janssen vaccine for booster vaccination. This recommendation was made in light of the risks for rare but serious adverse events following receipt of a Janssen vaccine, including thrombosis with thrombocytopenia syndrome and Guillain-Barré syndrome
(1), and clinical trial data indicating similar or higher neutralizing antibody response following heterologous boosting compared with homologous boosting (2). Data on real-world vaccine effectiveness (VE) of different booster strategies following a primary Janssen vaccine dose are limited, particularly during the period of Omicron variant predominance. The VISION Network
determined real-world VE of 1 Janssen vaccine dose and 2 alternative booster dose strategies: 1) a homologous booster (i.e., 2 Janssen doses) and 2) a heterologous mRNA booster (i.e., 1 Janssen dose/1 mRNA dose). In addition, VE of these booster strategies was compared with VE of a homologous booster following mRNA primary series vaccination (i.e., 3 mRNA doses). The study examined 80,287 emergency department/urgent care (ED/UC) visits
and 25,244 hospitalizations across 10 states during December 16, 2021-March 7, 2022, when Omicron was the predominant circulating variant.** VE against laboratory-confirmed COVID-19-associated ED/UC encounters was 24% after 1 Janssen dose, 54% after 2 Janssen doses, 79% after 1 Janssen/1 mRNA dose, and 83% after 3 mRNA doses. VE for the same vaccination strategies against laboratory-confirmed COVID-19-associated hospitalizations were 31%, 67%, 78%, and 90%, respectively. All booster strategies provided higher protection than a single Janssen dose against ED/UC visits and hospitalizations during Omicron variant predominance. Vaccination with 1 Janssen/1 mRNA dose provided higher protection than did 2 Janssen doses against COVID-19-associated ED/UC visits and was comparable to protection provided by 3 mRNA doses during the first 120 days after a booster dose. However, 3 mRNA doses provided higher protection against COVID-19-associated hospitalizations than did other booster strategies during the same time interval since booster dose. All adults who have received mRNA vaccines for their COVID-19 primary series vaccination should receive an mRNA booster dose when eligible. Adults who received a primary Janssen vaccine dose should preferentially receive a heterologous mRNA vaccine booster dose ≥2 months later, or a homologous Janssen vaccine booster dose if mRNA vaccine is contraindicated or unavailable. Further investigation of the durability of protection afforded by different booster strategies is warranted.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>Ambulatory Care</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - prevention & control</subject><subject>COVID-19 Vaccines</subject><subject>Drug dosages</subject><subject>Effectiveness</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Emergency medicine</subject><subject>Emergency service</subject><subject>Emergency Service, Hospital</subject><subject>Full Report</subject><subject>Guillain-Barre syndrome</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunization</subject><subject>Immunization, Secondary</subject><subject>Infections</subject><subject>Influenza Vaccines</subject><subject>Medical laboratories</subject><subject>Messenger RNA</subject><subject>mRNA</subject><subject>mRNA Vaccines</subject><subject>Pharmaceutical industry</subject><subject>Public health</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Vaccination</subject><subject>Vaccine efficacy</subject><subject>Vaccines</subject><subject>Vaccines, 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of Homologous and Heterologous COVID-19 Booster Doses Following 1 Ad.26.COV2.S (Janssen [Johnson & Johnson]) Vaccine Dose Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults - VISION Network, 10 States, December 2021-March 2022</title><author>Natarajan, Karthik ; Prasad, Namrata ; Dascomb, Kristin ; Irving, Stephanie A ; Yang, Duck-Hye ; Gaglani, Manjusha ; Klein, Nicola P ; DeSilva, Malini B ; Ong, Toan C ; Grannis, Shaun J ; Stenehjem, Edward ; Link-Gelles, Ruth ; Rowley, Elizabeth A ; Naleway, Allison L ; Han, Jungmi ; Raiyani, Chandni ; Benitez, Gabriela Vazquez ; Rao, Suchitra ; Lewis, Ned ; Fadel, William F ; Grisel, Nancy ; Griggs, Eric P ; Dunne, Margaret M ; Stockwell, Melissa S ; Mamawala, Mufaddal ; McEvoy, Charlene ; Barron, Michelle A ; Goddard, Kristin ; Valvi, Nimish R ; Arndorfer, Julie ; Patel, Palak ; Mitchell, Patrick K ; Smith, Michael ; Kharbanda, Anupam B ; Fireman, Bruce ; Embi, Peter J ; Dickerson, Monica ; Davis, Jonathan M ; Zerbo, Ousseny ; Dalton, Alexandra F ; Wondimu, Mehiret H ; Azziz-Baumgartner, Eduardo ; Bozio, Catherine H ; Reynolds, Sue ; Ferdinands, Jill ; Williams, Jeremiah ; Schrag, Stephanie J ; Verani, Jennifer R ; Ball, Sarah ; Thompson, Mark G ; Dixon, Brian E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c553t-395d26b4657630691f75ac92d396b8712012cb657287b5aa676727d404875f1b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adults</topic><topic>Ambulatory Care</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - prevention & control</topic><topic>COVID-19 Vaccines</topic><topic>Drug dosages</topic><topic>Effectiveness</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Emergency medicine</topic><topic>Emergency service</topic><topic>Emergency Service, Hospital</topic><topic>Full Report</topic><topic>Guillain-Barre syndrome</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Immunization</topic><topic>Immunization, Secondary</topic><topic>Infections</topic><topic>Influenza Vaccines</topic><topic>Medical laboratories</topic><topic>Messenger RNA</topic><topic>mRNA</topic><topic>mRNA Vaccines</topic><topic>Pharmaceutical industry</topic><topic>Public health</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Vaccination</topic><topic>Vaccine efficacy</topic><topic>Vaccines</topic><topic>Vaccines, Synthetic</topic><toplevel>online_resources</toplevel><creatorcontrib>Natarajan, Karthik</creatorcontrib><creatorcontrib>Prasad, Namrata</creatorcontrib><creatorcontrib>Dascomb, Kristin</creatorcontrib><creatorcontrib>Irving, Stephanie A</creatorcontrib><creatorcontrib>Yang, Duck-Hye</creatorcontrib><creatorcontrib>Gaglani, 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Charlene</creatorcontrib><creatorcontrib>Barron, Michelle A</creatorcontrib><creatorcontrib>Goddard, Kristin</creatorcontrib><creatorcontrib>Valvi, Nimish R</creatorcontrib><creatorcontrib>Arndorfer, Julie</creatorcontrib><creatorcontrib>Patel, Palak</creatorcontrib><creatorcontrib>Mitchell, Patrick K</creatorcontrib><creatorcontrib>Smith, Michael</creatorcontrib><creatorcontrib>Kharbanda, Anupam B</creatorcontrib><creatorcontrib>Fireman, Bruce</creatorcontrib><creatorcontrib>Embi, Peter J</creatorcontrib><creatorcontrib>Dickerson, Monica</creatorcontrib><creatorcontrib>Davis, Jonathan M</creatorcontrib><creatorcontrib>Zerbo, Ousseny</creatorcontrib><creatorcontrib>Dalton, Alexandra F</creatorcontrib><creatorcontrib>Wondimu, Mehiret H</creatorcontrib><creatorcontrib>Azziz-Baumgartner, Eduardo</creatorcontrib><creatorcontrib>Bozio, Catherine H</creatorcontrib><creatorcontrib>Reynolds, Sue</creatorcontrib><creatorcontrib>Ferdinands, Jill</creatorcontrib><creatorcontrib>Williams, Jeremiah</creatorcontrib><creatorcontrib>Schrag, Stephanie J</creatorcontrib><creatorcontrib>Verani, Jennifer R</creatorcontrib><creatorcontrib>Ball, Sarah</creatorcontrib><creatorcontrib>Thompson, Mark G</creatorcontrib><creatorcontrib>Dixon, Brian E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni 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Morbidity and mortality weekly report</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Natarajan, Karthik</au><au>Prasad, Namrata</au><au>Dascomb, Kristin</au><au>Irving, Stephanie A</au><au>Yang, Duck-Hye</au><au>Gaglani, Manjusha</au><au>Klein, Nicola P</au><au>DeSilva, Malini B</au><au>Ong, Toan C</au><au>Grannis, Shaun J</au><au>Stenehjem, Edward</au><au>Link-Gelles, Ruth</au><au>Rowley, Elizabeth A</au><au>Naleway, Allison L</au><au>Han, Jungmi</au><au>Raiyani, Chandni</au><au>Benitez, Gabriela Vazquez</au><au>Rao, Suchitra</au><au>Lewis, Ned</au><au>Fadel, William F</au><au>Grisel, Nancy</au><au>Griggs, Eric P</au><au>Dunne, Margaret M</au><au>Stockwell, Melissa S</au><au>Mamawala, Mufaddal</au><au>McEvoy, Charlene</au><au>Barron, Michelle A</au><au>Goddard, Kristin</au><au>Valvi, Nimish R</au><au>Arndorfer, Julie</au><au>Patel, Palak</au><au>Mitchell, Patrick K</au><au>Smith, Michael</au><au>Kharbanda, Anupam B</au><au>Fireman, Bruce</au><au>Embi, Peter J</au><au>Dickerson, Monica</au><au>Davis, Jonathan M</au><au>Zerbo, Ousseny</au><au>Dalton, Alexandra F</au><au>Wondimu, Mehiret H</au><au>Azziz-Baumgartner, Eduardo</au><au>Bozio, Catherine H</au><au>Reynolds, Sue</au><au>Ferdinands, Jill</au><au>Williams, Jeremiah</au><au>Schrag, Stephanie J</au><au>Verani, Jennifer R</au><au>Ball, Sarah</au><au>Thompson, Mark G</au><au>Dixon, Brian E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of Homologous and Heterologous COVID-19 Booster Doses Following 1 Ad.26.COV2.S (Janssen [Johnson & Johnson]) Vaccine Dose Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults - VISION Network, 10 States, December 2021-March 2022</atitle><jtitle>MMWR. Morbidity and mortality weekly report</jtitle><addtitle>MMWR Morb Mortal Wkly Rep</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>71</volume><issue>13</issue><spage>495</spage><epage>502</epage><pages>495-502</pages><issn>0149-2195</issn><eissn>1545-861X</eissn><abstract>CDC recommends that all persons aged ≥18 years receive a single COVID-19 vaccine booster dose ≥2 months after receipt of an Ad.26.COV2.S (Janssen [Johnson & Johnson]) adenovirus vector-based primary series vaccine; a heterologous COVID-19 mRNA vaccine is preferred over a homologous (matching) Janssen vaccine for booster vaccination. This recommendation was made in light of the risks for rare but serious adverse events following receipt of a Janssen vaccine, including thrombosis with thrombocytopenia syndrome and Guillain-Barré syndrome
(1), and clinical trial data indicating similar or higher neutralizing antibody response following heterologous boosting compared with homologous boosting (2). Data on real-world vaccine effectiveness (VE) of different booster strategies following a primary Janssen vaccine dose are limited, particularly during the period of Omicron variant predominance. The VISION Network
determined real-world VE of 1 Janssen vaccine dose and 2 alternative booster dose strategies: 1) a homologous booster (i.e., 2 Janssen doses) and 2) a heterologous mRNA booster (i.e., 1 Janssen dose/1 mRNA dose). In addition, VE of these booster strategies was compared with VE of a homologous booster following mRNA primary series vaccination (i.e., 3 mRNA doses). The study examined 80,287 emergency department/urgent care (ED/UC) visits
and 25,244 hospitalizations across 10 states during December 16, 2021-March 7, 2022, when Omicron was the predominant circulating variant.** VE against laboratory-confirmed COVID-19-associated ED/UC encounters was 24% after 1 Janssen dose, 54% after 2 Janssen doses, 79% after 1 Janssen/1 mRNA dose, and 83% after 3 mRNA doses. VE for the same vaccination strategies against laboratory-confirmed COVID-19-associated hospitalizations were 31%, 67%, 78%, and 90%, respectively. All booster strategies provided higher protection than a single Janssen dose against ED/UC visits and hospitalizations during Omicron variant predominance. Vaccination with 1 Janssen/1 mRNA dose provided higher protection than did 2 Janssen doses against COVID-19-associated ED/UC visits and was comparable to protection provided by 3 mRNA doses during the first 120 days after a booster dose. However, 3 mRNA doses provided higher protection against COVID-19-associated hospitalizations than did other booster strategies during the same time interval since booster dose. All adults who have received mRNA vaccines for their COVID-19 primary series vaccination should receive an mRNA booster dose when eligible. Adults who received a primary Janssen vaccine dose should preferentially receive a heterologous mRNA vaccine booster dose ≥2 months later, or a homologous Janssen vaccine booster dose if mRNA vaccine is contraindicated or unavailable. Further investigation of the durability of protection afforded by different booster strategies is warranted.</abstract><cop>United States</cop><pub>U.S. Government Printing Office</pub><pmid>35358170</pmid><doi>10.15585/MMWR.MM7113E2</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0149-2195 |
| ispartof | MMWR. Morbidity and mortality weekly report, 2022-04, Vol.71 (13), p.495-502 |
| issn | 0149-2195 1545-861X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8979598 |
| source | MEDLINE; PubMed Central Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adolescent Adult Adults Ambulatory Care Coronaviruses COVID-19 COVID-19 - prevention & control COVID-19 Vaccines Drug dosages Effectiveness Emergency medical care Emergency medical services Emergency medicine Emergency service Emergency Service, Hospital Full Report Guillain-Barre syndrome Hospitalization Hospitals Humans Immunization Immunization, Secondary Infections Influenza Vaccines Medical laboratories Messenger RNA mRNA mRNA Vaccines Pharmaceutical industry Public health SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Vaccination Vaccine efficacy Vaccines Vaccines, Synthetic |
| title | Effectiveness of Homologous and Heterologous COVID-19 Booster Doses Following 1 Ad.26.COV2.S (Janssen [Johnson & Johnson]) Vaccine Dose Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults - VISION Network, 10 States, December 2021-March 2022 |
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