Friday, December 16, 2022

Two studies, one of seniors and the other of all ages, show Covid bivalent booster shots very effective at preventing severe disease

Katelyn Jetelina, right, interviews the CDC's Dr. Ruth Link-Gelles about boosters.

By Katelyn Jetelina
Your Local Epidemiologist

We got an early holiday present. One of the last puzzle pieces about the fall Covid-19 boosters was released today: data on the effectiveness against severe disease. We have nine lab studies and one real-world study showing the fall boosters provide:
  • Greater protection against infection and transmission, by boosting our first line of defense—neutralizing antibodies. (See my previous updates here.)
  • Broader protection, or the ability to create antibodies that “see” more virus parts and “attach” more strongly compared to the antibodies we have right now. (See my previous updates on this here.)
  • Longer protection against infection and severe disease, even just by a few months. We are still at the mercy of time for this, but have promising data from the Beta bivalent vaccine clinical trials.
Until now, we didn’t know whether they provided additional protection against severe disease and hospitalization. We now have three real world analyses, and things are looking good.

The CDC released studies answering the same question from two different perspectives. The first study , in 22 large hospitals in 18 states, found that among patients 65 and older with no Covid-19 vaccination, effectiveness of the fall booster against hospitalization was 84%; among who had received mRNA vaccines, effectiveness was 73%.

The second study, at nine hospitals in 11 states, looked at emergency room and urgent care visits (a proxy for more severe disease) for patients of all ages. It found that among people with no vaccination, effectiveness of the fall booster against emergency room or urgent-care visits was 56%. Among the vaccinated, effectiveness was less with more recent vaccination (reflecting the fact that vaccine protection wanes over time). If someone got their last mRNA shot two to four months ago, effectiveness was 31%. If the last dose was more than a year ago, effectiveness was 50%.

Dr. Ruth Link-Gelles, program lead of Covid-19 vaccine effectiveness at the CDC, told me, "These vaccines provide pretty substantial additional protection, especially if it's been a long time since you got you last monovalent dose." But we still don't know how long protection will last, so studies will continue.

Bottom line: The fall boosters work. There is now evidence fall boosters broaden protection, help against infection, protect against severe disease, and (we think and hope) provide longer protection. There is one major problem though: more than 150 million people are eligible for a fall booster in the U.S. and have yet to get one.

Link-Gelles blamed that on Covid fatigue and people seeing fewer hospitalizations and deaths from the disease, but she said now is good time to get boosted because of holiday gatherings, especially with grandparents, who are more vulnerable. She said 28 million Americans over 65 have not gotten a booster.

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