Effectiveness of the Ad26.COV2.S (Johnson & Johnson) Coronavirus Disease 2019 (COVID-19) Vaccine for Preventing COVID-19 Hospitalizations and Progression to High Disease Severity in the United States.

Nathaniel M LewisWesley H SelfManjusha GaglaniAdit A GindeDavid J DouinH Keipp TalbotJonathan D CaseyNicholas M MohrAnne ZepeskiShekhar A GhamandeTresa A McNealNathan I ShapiroKevin W GibbsD Clark FilesDavid N HagerArber ShehuMatthew E PrekkerHeidi L EricksonMichelle N GongAmira MohamedNicholas J JohnsonVasisht SrinivasanJay S SteingrubIthan D PeltanSamuel M BrownEmily T MartinArnold S MontoAkram KhanLaurence W BusseCaitlin C Ten LohuisAbhijit DuggalJennifer G WilsonAlexandra June GordonNida QadirSteven Y ChangChristopher MallowCarolina RivasHilary M BabcockJennie H KwonMatthew C ExlineAdam S LauringNatasha HalasaJames D ChappellCarlos G GrijalvaTodd W RiceJillian P RhoadsIan D JonesWilliam B StubblefieldAdrienne BaughmanKelsey N WomackChristopher J LindsellKimberly W HartYuwei ZhuKatherine AdamsManish M PatelMark W Tenfordenull null

Published in: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2022)

Background . Adults in the United States (US) began receiving the adenovirus vector coronavirus disease 2019 (COVID-19) vaccine, Ad26.COV2.S (Johnson & Johnson [Janssen]), in February 2021. We evaluated Ad26.COV2.S vaccine effectiveness (VE) against COVID-19 hospitalization and high disease severity during the first 10 months of its use. Methods . In a multicenter case-control analysis of US adults (≥18 years) hospitalized 11 March to 15 December 2021, we estimated VE against susceptibility to COVID-19 hospitalization (VEs), comparing odds of prior vaccination with a single dose Ad26.COV2.S vaccine between hospitalized cases with COVID-19 and controls without COVID-19. Among hospitalized patients with COVID-19, we estimated VE against disease progression (VEp) to death or invasive mechanical ventilation (IMV), comparing odds of prior vaccination between patients with and without progression. Results . After excluding patients receiving mRNA vaccines, among 3979 COVID-19 case-patients (5% vaccinated with Ad26.COV2.S) and 2229 controls (13% vaccinated with Ad26.COV2.S), VEs of Ad26.COV2.S against COVID-19 hospitalization was 70% (95% confidence interval [CI]: 63-75%) overall, including 55% (29-72%) among immunocompromised patients, and 72% (64-77%) among immunocompetent patients, for whom VEs was similar at 14-90 days (73% [59-82%]), 91-180 days (71% [60-80%]), and 181-274 days (70% [54-81%]) postvaccination. Among hospitalized COVID-19 case-patients, VEp was 46% (18-65%) among immunocompetent patients. Conclusions . The Ad26.COV2.S COVID-19 vaccine reduced the risk of COVID-19 hospitalization by 72% among immunocompetent adults without waning through 6 months postvaccination. After hospitalization for COVID-19, vaccinated immunocompetent patients were less likely to require IMV or die compared to unvaccinated immunocompetent patients.

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