The updated 2023-2024 COVID-19 vaccine provides increased protection against COVID-19-related hospitalization among immunocompromised adults, according to study results published in Morbidity and Mortality Weekly Report (MMWR).
On September 12, 2023, the United States Centers for Disease Control and Prevention’s (CDC) Advisor Committee on Immunization Practices recommended the updated 2023-2024 COVID-19 vaccine (monovalent XBB.1.5) for all individuals aged 6 months and older.
To assess vaccine effectiveness (VE) of the updated COVID-19 vaccine among immunocompromised adults, researchers conducted a study using data sourced from the Virtual SARS-CoV-2, Influenza, and Other respiratory viruses Network (VISION). The study included immunocompromised adult patients (N=14,586) who were hospitalized with COVID-19-like symptoms between September 2023 and February 2024. All patients underwent SARS-CoV-2 molecular testing and those who tested positive and negative comprised the case (n=1392) and control (n=13194) groups, respectively. Patients who received the updated vaccine and those who did not were compared via multivariable logistic regression, with adjustments for age, sex, race/ethnicity, calendar time, and geographic region.
Among patients included in the case and control groups, the median ages were 72 (IQR, 63-80) and 70 (IQR, 60-78) years, 48% and 51% were women, 73% and 68% were White, and 16% and 18% had at least 5 chronic medical conditions, respectively. In the total population, the most common immunocompromising conditions were solid organ malignancy (42%), other intrinsic immune condition or immunodeficiency (35%), rheumatologic or inflammatory disorder (25%), and hematologic malignancy (15%).
CDC will continue to monitor VE of updated COVID-19 vaccines in populations at high risk, including those with immunocompromising conditions.
Overall, 195 (14%) patients who tested positive for infection and 2401 (18%) of those who tested negative for infection had received at least 1 dose of the updated COVID-19 vaccine. The researchers noted that less than one-fifth (18%) of the study population received an updated vaccine dose. Across both groups, there were similar rates of intensive care unit admission (20% and 24%, respectively) and in-hospital mortality (8% and 10%, respectively).
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The rate of SARS-CoV-2 positivity was 10% among unvaccinated patients, 7% among those who received an updated vaccine dose 7 to 59 days before admission, and 8% among those who received an updated vaccine dose 60 to 119 days before admission.
In the adjusted analysis, the updated COVID-19 vaccine was associated with an overall VE of 36% (95% CI, 25-46) for protection against COVID-19-related hospitalization. The updated vaccine conferred similar protection in the first 7 to 59 days after receipt (VE, 38%; 95% CI, 23-50) and between 60 and 119 days after receipt (VE, 95% CI, 16-47).
Limitations of this study include the potential misclassification of both vaccination and immunocompromised status, the lack of data on prior COVID-19 diagnoses, and the possibility that some SARS-CoV-2-positive patients were hospitalized for other conditions.
“CDC will continue to monitor VE of updated COVID-19 vaccines in populations at high risk, including those with immunocompromising conditions,” the researchers noted.
This article originally appeared on Infectious Disease Advisor
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