Homologous and Heterologous Prime-Boost Vaccination: Impact on Clinical Severity of SARS-CoV-2 Omicron Infection among Hospitalized COVID-19 Patients in Belgium.
Marjan MeurisseLucy CatteauJoris A F van LoenhoutToon BraeyeLaurane De MotBen SerrienKoen BlotEmilie CauëtHerman Van OyenLize Cuypersnull Belgian Collaborative Group On Covid-Hospital Surveillancenull Covid-Genomics Belgium ConsortiumAnnie RobertNina Van GoethemPublished in: Vaccines (2023)
We investigated effectiveness of (1) mRNA booster vaccination versus primary vaccination only and (2) heterologous (viral vector-mRNA) versus homologous (mRNA-mRNA) prime-boost vaccination against severe outcomes of BA.1, BA.2, BA.4 or BA.5 Omicron infection (confirmed by whole genome sequencing) among hospitalized COVID-19 patients using observational data from national COVID-19 registries. In addition, it was investigated whether the difference between the heterologous and homologous prime-boost vaccination was homogenous across Omicron sub-lineages. Regression standardization (parametric g-formula) was used to estimate counterfactual risks for severe COVID-19 (combination of severity indicators), intensive care unit (ICU) admission, and in-hospital mortality under exposure to different vaccination schedules. The estimated risk for severe COVID-19 and in-hospital mortality was significantly lower with an mRNA booster vaccination as compared to only a primary vaccination schedule (RR = 0.59 [0.33; 0.85] and RR = 0.47 [0.15; 0.79], respectively). No significance difference was observed in the estimated risk for severe COVID-19, ICU admission and in-hospital mortality with a heterologous compared to a homologous prime-boost vaccination schedule, and this difference was not significantly modified by the Omicron sub-lineage. Our results support evidence that mRNA booster vaccination reduced the risk of severe COVID-19 disease during the Omicron-predominant period.
Keyphrases
- sars cov
- coronavirus disease
- intensive care unit
- respiratory syndrome coronavirus
- early onset
- emergency department
- dna repair
- dna damage
- systematic review
- randomized controlled trial
- climate change
- risk assessment
- skeletal muscle
- metabolic syndrome
- drug induced
- data analysis
- weight loss
- big data
- extracorporeal membrane oxygenation
- human health
- quality improvement