Effectiveness of mRNA COVID-19 vaccine booster doses against Omicron severe outcomes

Ramandip Grewal, Lena Nguyen, Sarah A. Buchan, Sarah E. Wilson, Sharifa Nasreen, Peter C. Austin, Kevin A. Brown, Deshayne B. Fell, Jonathan B. Gubbay, Kevin L. Schwartz, Mina Tadrous, Kumanan Wilson and Jeffrey C. Kwong ()
Additional contact information
Ramandip Grewal: Public Health Ontario
Lena Nguyen: ICES
Sarah A. Buchan: Public Health Ontario
Sarah E. Wilson: Public Health Ontario
Sharifa Nasreen: ICES
Peter C. Austin: ICES
Kevin A. Brown: Public Health Ontario
Deshayne B. Fell: ICES
Jonathan B. Gubbay: Public Health Ontario
Kevin L. Schwartz: Public Health Ontario
Mina Tadrous: ICES
Kumanan Wilson: University of Ottawa
Jeffrey C. Kwong: Public Health Ontario

Nature Communications, 2023, vol. 14, issue 1, 1-10

Abstract: Abstract We estimated the effectiveness of booster doses of monovalent mRNA COVID-19 vaccines against Omicron-associated severe outcomes among adults in Ontario, Canada. We used a test-negative design to estimate vaccine effectiveness (VE) against hospitalization or death among SARS-CoV-2-tested adults aged ≥50 years from January 2 to October 1, 2022, stratified by age and time since vaccination. We also compared VE during BA.1/BA.2 and BA.4/BA.5 sublineage predominance. We included 11,160 cases and 62,880 tests for test-negative controls. Depending on the age group, compared to unvaccinated adults, VE was 91–98% 7–59 days after a third dose, waned to 76–87% after ≥240 days, was restored to 92–97% 7–59 days after a fourth dose, and waned to 86–89% after ≥120 days. VE was lower and declined faster during BA.4/BA.5 versus BA.1/BA.2 predominance, particularly after ≥120 days. Here we show that booster doses of monovalent mRNA COVID-19 vaccines restored strong protection against severe outcomes for at least 3 months after vaccination. Across the entire study period, protection declined slightly over time, but waned more during BA.4/BA.5 predominance.

Date: 2023
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DOI: 10.1038/s41467-023-36566-1

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