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Abstract

Background

Scarce European data in early 2021 suggested lower vaccine effectiveness (VE) against SARS-CoV-2 Omicron lineages than previous variants.

Aim

We aimed to estimate primary series (PS) and first booster VE against symptomatic BA.1/BA.2 infection and investigate potential biases.

Methods

This European test-negative multicentre study tested primary care patients with acute respiratory symptoms for SARS-CoV-2 in the BA.1/BA.2-dominant period. We estimated PS and booster VE among adults and adolescents (PS only) for all products combined and for Comirnaty alone, by time since vaccination, age and chronic condition. We investigated potential bias due to correlation between COVID-19 and influenza vaccination and explored effect modification and confounding by prior SARS-CoV-2 infection.

Results

Among adults, PS VE was 37% (95% CI: 24–47%) overall and 60% (95% CI: 44–72%), 43% (95% CI: 26–55%) and 29% (95% CI: 13–43%) < 90, 90–179 and ≥ 180 days post vaccination, respectively. Booster VE was 42% (95% CI: 32–51%) overall and 56% (95% CI: 47–64%), 22% (95% CI: 2–38%) and 3% (95% CI: −78% to 48%), respectively. Primary series VE was similar among adolescents. Restricting analyses to Comirnaty had little impact. Vaccine effectiveness was higher among older adults. There was no signal of bias due to correlation between COVID-19 and influenza vaccination. Confounding by previous infection was low, but sample size precluded definite assessment of effect modification.

Conclusion

Primary series and booster VE against symptomatic infection with BA.1/BA.2 ranged from 37% to 42%, with similar waning post vaccination. Comprehensive data on previous SARS-CoV-2 infection would help disentangle vaccine- and infection-induced immunity.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2024-03-28
2024-04-27
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COVID-19 vaccine effectiveness against symptomatic infection with SARS-CoV-2 BA.1/BA.2 lineages among adults and adolescents in a multicentre primary care study, Europe, December 2021 to June 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Charlotte+Lani%C3%A8ce+Delaunay&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lanièce Delaunay Charlotte</a>, <a href="/search?value1=Iv%C3%A1n+Mart%C3%ADnez-Baz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Martínez-Baz Iván</a>, <a href="/search?value1=No%C3%A9mie+S%C3%A8ve&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sève Noémie</a>, <a href="/search?value1=Lisa+Domegan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Domegan Lisa</a>, <a href="/search?value1=Clara+Mazagatos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mazagatos Clara</a>, <a href="/search?value1=Silke+Buda&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Buda Silke</a>, <a href="/search?value1=Adam+Meijer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Meijer Adam</a>, <a href="/search?value1=Irina+Kislaya&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kislaya Irina</a>, <a href="/search?value1=Catalina+Pascu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pascu Catalina</a>, <a href="/search?value1=AnnaSara+Carnahan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Carnahan AnnaSara</a>, <a href="/search?value1=Beatrix+Oroszi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Oroszi Beatrix</a>, <a href="/search?value1=Maja+Ili%C4%87&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ilić Maja</a>, <a href="/search?value1=Marine+Maurel&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Maurel Marine</a>, <a href="/search?value1=Aryse+Melo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Melo Aryse</a>, <a href="/search?value1=Virginia+Sandonis+Mart%C3%ADn&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sandonis Martín Virginia</a>, <a href="/search?value1=Camino+Trobajo-Sanmart%C3%ADn&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Trobajo-Sanmartín Camino</a>, <a href="/search?value1=Vincent+Enouf&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Enouf Vincent</a>, <a href="/search?value1=Adele+McKenna&option1=author&noRedirect=true" class="nonDisambigAuthorLink">McKenna Adele</a>, <a href="/search?value1=Gloria+P%C3%A9rez-Gimeno&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pérez-Gimeno Gloria</a>, <a href="/search?value1=Luise+Goerlitz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Goerlitz Luise</a>, <a href="/search?value1=Marit+de+Lange&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de Lange Marit</a>, <a href="/search?value1=Ana+Paula+Rodrigues&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rodrigues Ana Paula</a>, <a href="/search?value1=Mihaela+Lazar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lazar Mihaela</a>, <a href="/search?value1=Neus+Latorre-Margalef&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Latorre-Margalef Neus</a>, <a href="/search?value1=Gerg%C5%91+T%C3%BAri&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Túri Gergő</a>, <a href="/search?value1=Jes%C3%BAs+Castilla&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Castilla Jesús</a>, <a href="/search?value1=Alessandra+Falchi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Falchi Alessandra</a>, <a href="/search?value1=Charlene+Bennett&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bennett Charlene</a>, <a href="/search?value1=Virtudes+Gallardo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gallardo Virtudes</a>, <a href="/search?value1=Ralf+D%C3%BCrrwald&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dürrwald Ralf</a>, <a href="/search?value1=Dirk+Eggink&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Eggink Dirk</a>, <a href="/search?value1=Raquel+Guiomar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Guiomar Raquel</a>, <a href="/search?value1=Rodica+Popescu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Popescu Rodica</a>, <a href="/search?value1=Maximilian+Riess&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Riess Maximilian</a>, <a href="/search?value1=Judit+Krisztina+Horv%C3%A1th&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Horváth Judit Krisztina</a>, <a href="/search?value1=Itziar+Casado&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Casado Itziar</a>, <a href="/search?value1=M%C2%AA+del+Carmen++Garc%C3%ADa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">García Mª del Carmen </a>, <a href="/search?value1=Mari%C3%ABtte+Hooiveld&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hooiveld Mariëtte</a>, <a href="/search?value1=Ausenda+Machado&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Machado Ausenda</a>, <a href="/search?value1=Sabrina+Bacci&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bacci Sabrina</a>, <a href="/search?value1=Marlena+Kaczmarek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kaczmarek Marlena</a>, <a href="/search?value1=Esther+Kissling&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kissling Esther</a>, <a href="/search?value1=on+behalf+of+the+European+Primary+Care+Vaccine+Effectiveness+Group&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the European Primary Care Vaccine Effectiveness Group</a></span>. COVID-19 vaccine effectiveness against symptomatic infection with SARS-CoV-2 BA.1/BA.2 lineages among adults and adolescents in a multicentre primary care study, Europe, December 2021 to June 2022. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(13):pii=2300403. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.13.2300403" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.13.2300403</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 28 Jul 2023;&nbsp;&nbsp; <span class="generated">Accepted</span>: 14 Dec 2023 </span> </p>
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