TABLE 3. Characteristics of hospitalizations among immunocompetent adults aged ≥18 years with COVID-19–like illness,* by mRNA COVID-19 vaccination status and SARS-CoV-2 test result — nine states,† September–November 2022.
| Characteristic | Overall, no. (col %) | SARS-CoV-2
test result status, no. (row %) |
SMD¶ | mRNA
COVID-19 vaccination status.§ no. (row %) |
SMD¶ | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Case-patients (positive) | Control patients (negative) | Unvaccinated | Received 2,
3, or 4 MV doses only, interval since last dose (mos) |
Received BV booster dose ≥7 days earlier | |||||||
| 2–4 | 5–7 | 8–10 | ≥11 | ||||||||
|
All
hospitalizations
|
15,502 (100.0)
|
1,452 (9.4)
|
14,050 (90.6)
|
—
|
4,092 (26.4)
|
1,561 (10.1)
|
1,780 (11.5)
|
2,636 (17.0)
|
4,549 (29.3)
|
884 (5.7)
|
—
|
|
Site
| |||||||||||
| Baylor Scott & White
Health |
3,782
(24.4)
|
331
(8.8) |
3,451
(91.2) |
0.2 |
1,545
(40.9) |
117
(3.1) |
136
(3.6) |
433
(11.4) |
1,516
(40.1) |
35
(0.9) |
3.92 |
| Columbia University |
1,125
(7.2)
|
128
(11.4) |
997
(88.6) |
432
(38.4) |
69
(6.1) |
109
(9.7) |
200
(17.8) |
292
(26.0) |
23
(2.0) |
||
| HealthPartners |
1,504
(9.7)
|
165
(11.0) |
1,339
(89.0) |
311
(20.7) |
206
(13.7) |
183
(12.2) |
267
(17.8) |
349
(23.2) |
188
(12.5) |
||
| Intermountain Healthcare |
1,668 (10.8)
|
218 (13.1) |
1,450 (86.9) |
506 (30.3) |
145 (8.7) |
128 (7.7) |
266 (15.9) |
490 (29.4) |
133 (8.0) |
||
| KPNC |
5,489
(35.4)
|
438
(8.0) |
5,051
(92.0) |
582
(10.6) |
838
(15.3) |
1,076
(19.6) |
1,193
(21.7) |
1,384
(25.2) |
416
(7.6) |
||
| KPNW |
1,028
(6.6)
|
82
(8.0) |
946
(92.0) |
305
(29.7) |
135
(13.1) |
104
(10.1) |
181
(17.6) |
238
(23.2) |
65
(6.3) |
||
| University of Colorado |
906
(5.8)
|
90
(9.9) |
816
(90.1) |
411
(45.4) |
51
(5.6) |
44
(4.9) |
96
(10.6) |
280
(30.9) |
24
(2.6) |
||
|
Age group,
yrs
| |||||||||||
| 18–49 |
2,925 (18.9)
|
160 (5.5) |
2,765 (94.5) |
0.34 |
1,315 (45.0) |
72 (2.5) |
136 (4.6) |
502 (17.2) |
816 (27.9) |
84 (2.9) |
2.73 |
| 50–64 |
2,985 (19.3)
|
212 (7.1) |
2,773 (92.9) |
1,006 (33.7) |
223 (7.5) |
280 (9.4) |
567 (19.0) |
805 (27.0) |
104 (3.5) |
||
| 65–74 |
3,240 (20.9)
|
300 (9.3) |
2,940 (90.7) |
717 (22.1) |
385 (11.9) |
391 (12.1) |
526 (16.2) |
1,007 (31.1) |
214 (6.6) |
||
| 75–84 |
3,615 (23.3)
|
410 (11.3) |
3,205 (88.7) |
599 (16.6) |
475 (13.1) |
551 (15.2) |
636 (17.6) |
1,072 (29.7) |
282 (7.8) |
||
| ≥85 |
2,737 (17.7)
|
370 (13.5) |
2,367 (86.5) |
455 (16.6) |
406 (14.8) |
422 (15.4) |
405 (14.8) |
849 (31.0) |
200 (7.3) |
||
|
Sex
| |||||||||||
| Female |
8,393 (54.1)
|
747 (8.9) |
7,646 (91.1) |
0.06 |
2,147 (25.6) |
861 (10.3) |
966 (11.5) |
1,437 (17.1) |
2,500 (29.8) |
482 (5.7) |
0.19 |
| Male |
7,109 (45.9)
|
705 (9.9) |
6,404 (90.1) |
1,945 (27.4) |
700 (9.8) |
814 (11.5) |
1,199 (16.9) |
2,049 (28.8) |
402 (5.7) |
||
|
Race and
ethnicity
| |||||||||||
| Black or African American,
NH |
1,788 (11.5)
|
116 (6.5) |
1,672 (93.5) |
0.2 |
634 (35.5) |
138 (7.7) |
171 (9.6) |
247 (13.8) |
544 (30.4) |
54 (3.0) |
1.17 |
| Hispanic or Latino |
2,394 (15.4)
|
178 (7.4) |
2,216 (92.6) |
696 (29.1) |
211 (8.8) |
248 (10.4) |
488 (20.4) |
682 (28.5) |
69 (2.9) |
||
| Other,** NH |
1,500 (9.7)
|
117 (7.8) |
1,383 (92.2) |
279 (18.6) |
197 (13.1) |
239 (15.9) |
301 (20.1) |
379 (25.3) |
105 (7.0) |
||
| Unknown |
239 (1.5)
|
21 (8.8) |
218 (91.2) |
111 (46.4) |
13 (5.4) |
24 (10.0) |
29 (12.1) |
56 (23.4) |
6 (2.5) |
||
| White, NH |
9,581 (61.8)
|
1,020 (10.6) |
8,561 (89.4) |
2,372 (24.8) |
1,002 (10.5) |
1,098 (11.5) |
1,571 (16.4) |
2,888 (30.1) |
650 (6.8) |
||
|
Documented
prior SARS-CoV-2
infection††
| |||||||||||
| Yes |
2,444 (15.8)
|
141 (5.8) |
2,303 (94.2) |
0.2 |
641 (26.2) |
213 (8.7) |
251 (10.3) |
413 (16.9) |
819 (33.5) |
107 (4.4) |
0.18 |
| No |
13,058 (84.2)
|
1,311 (10.0) |
11,747 (90.0) |
3,451 (26.4) |
1,348 (10.3) |
1,529 (11.7) |
2,223 (17.0) |
3,730 (28.6) |
777 (6.0) |
||
|
SARS-CoV-2
status
| |||||||||||
| Positive test result
(case-patient) |
1,452 (9.4)
|
1,452 (100.0) |
0
(—) |
— |
434 (29.9) |
122 (8.4) |
165 (11.4) |
231 (15.9) |
444 (30.6) |
56 (3.9) |
0.26 |
| Negative test result (control
patient) |
14,050 (90.6)
|
0
(—) |
14,050 (100.0) |
3,658 (26.0) |
1,439 (10.2) |
1,615 (11.5) |
2,405 (17.1) |
4,105 (29.2) |
828 (5.9) |
||
|
No. of
monovalent mRNA vaccine doses received
| |||||||||||
| None |
4,092 (26.4)
|
434 (10.6) |
3,658 (89.4) |
0.1 |
4,092
(100.0) |
0
(—) |
0
(—) |
0
(—) |
0
(—) |
0
(—) |
— |
| 2 |
3,401 (21.9)
|
322 (9.5) |
3,079 (90.5) |
0
(—) |
48
(1.4) |
81 (2.4) |
194 (5.7) |
3,020 (88.8) |
58 (1.7) |
|
|
| 3 |
5,003 (32.3)
|
442 (8.8) |
4,561 (91.2) |
0
(—) |
213 (4.3) |
520 (10.4) |
2,442 (48.8) |
1,529 (30.6) |
299 (6.0) |
|
|
| 4 |
3,006 (19.4)
|
254 (8.4) |
2,752 (91.6) |
0
(—) |
1,300 (43.2) |
1,179 (39.2) |
0
(—) |
0
(—) |
527 (17.5) |
|
|
|
Most recent
dose product manufacturer
| |||||||||||
| Pfizer-BioNTech |
7,088 (45.7)
|
622 (8.8) |
6,466 (91.2) |
0.09 |
0
(—) |
986 (13.9) |
1,101 (15.5) |
1,439 (20.3) |
2,878 (40.6) |
684 (9.7) |
— |
| Moderna |
4,322 (27.9)
|
396 (9.2) |
3,926 (90.8) |
0
(—) |
575 (13.3) |
679 (15.7) |
1,197 (27.7) |
1,671 (38.7) |
200
(4.6) |
|
|
| None |
4,092
(26.4)
|
434
(10.6) |
3,658
(89.4) |
4,092
(100.0) |
0
(—) |
0
(—) |
0
(—) |
0
(—) |
0
(—) |
|
|
|
Any chronic
condition
| |||||||||||
| Yes |
14,649 (94.5)
|
1,410 (9.6) |
13,239 (90.4) |
0.14 |
3,748 (25.6) |
1,536 (10.5) |
1,743 (11.9) |
2,454 (16.8) |
4,322 (29.5) |
846 (5.8) |
0.84 |
| No |
853 (5.5)
|
42
(4.9) |
811 (95.1) |
344 (40.3) |
25
(2.9) |
37
(4.3) |
182 (21.3) |
227 (26.6) |
38 (4.5) |
||
|
≥1
chronic respiratory condition
| |||||||||||
| Yes |
9,246 (59.6)
|
921 (10.0) |
8,325 (90.0) |
0.09 |
2,324
(25.1) |
1,032 (11.2) |
1,150 (12.4) |
1,527 (16.5) |
2,673 (28.9) |
540 (5.8) |
0.43 |
| No |
6,256 (40.4)
|
531 (8.5) |
5,725 (91.5) |
1,768 (28.3) |
529 (8.5) |
630 (10.1) |
1,109 (17.7) |
1,876 (30.0) |
344 (5.5) |
||
|
≥1
chronic non-respiratory condition
| |||||||||||
| Yes |
14,119 (91.1)
|
1,369 (9.7) |
12,750 (90.3) |
0.13 |
3,530
(25.0) |
1,514 (10.7) |
1,707 (12.1) |
2,385 (16.9) |
4,157 (29.4) |
826 (5.9) |
1.07 |
| No |
1,383 (8.9)
|
83
(6.0) |
1,300 (94.0) |
562 (40.6) |
47 (3.4) |
73 (5.3) |
251 (18.1) |
392 (28.3) |
58 (4.2) |
||
|
ICU
admission
| |||||||||||
| Yes |
2,566 (16.6)
|
182
(7.1) |
2,384 (92.9) |
0.13 |
751 (29.3) |
229 (8.9) |
298 (11.6) |
447 (17.4) |
727 (28.3) |
114 (4.4) |
0.27 |
| No |
12,936 (83.4)
|
1,270 (9.8) |
11,666 (90.2) |
3,341
(25.8) |
1,332 (10.3) |
1,482 (11.5) |
2,189 (16.9) |
3,822 (29.5) |
770 (6.0) |
||
|
Receipt of
invasive mechanical ventilation
| |||||||||||
| Yes |
1,579 (10.2)
|
97
(6.1) |
1,482 (93.9) |
0.14 |
567
(35.9) |
111 (7.0) |
126 (8.0) |
226 (14.3) |
497
(31.5) |
52 (3.3) |
0.75 |
| No |
13,923 (89.8)
|
1,355 (9.7) |
12,568 (90.3) |
3,525
(25.3) |
1,450 (10.4) |
1,654 (11.9) |
2,410 (17.3) |
4,052 (29.1) |
832 (6.0) |
||
|
In-hospital
death§§
| |||||||||||
| Yes |
466
(3.0)
|
51
(10.9) |
415
(89.1) |
0.03 | 129
(27.7) |
61
(13.1) |
57
(12.2) |
56 (12.0) |
138 (29.6) |
25 (5.4) |
0.11 |
| No | 15,036 (97.0) | 1,401 (9.3) | 13,635 (90.7) | 3,963 (26.4) | 1,500 (10.0) | 1,723 (11.5) | 2,580 (17.2) | 4,411 (29.3) | 859 (5.7) | ||
Abbreviations: BV = bivalent; ICU = intensive care unit; KPNC = Kaiser Permanente Northern California; KPCHR = Kaiser Permanente Center for Health Research; MV = monovalent; NH = non-Hispanic; SMD = standardized mean or proportion difference.
* Hospitalizations with a discharge code consistent with COVID-19–like illness were included. COVID-19–like illness diagnoses included acute respiratory illness, respiratory signs or symptoms or febrile signs or symptoms using diagnosis codes from the International Classification of Diseases, Tenth Revision. Clinician-ordered molecular assays (e.g., real-time reverse transcription–polymerase chain reaction) for SARS-CoV-2 occurring ≤14 days before to <72 hours after the encounter date were included.
† California (Sep 13–Nov 18, 2022), Colorado (Sep 13–Nov 7, 2022), Minnesota and Wisconsin (Sep 13–Nov 18, 2022), New York (Sep 13–Nov 18, 2022), Oregon and Washington (Sep 13–Nov 14, 2022), Texas (Sep 13–Nov 13, 2022), and Utah (Sep 13–Nov 18, 2022).
§ Vaccination was defined as having received the last monovalent or bivalent dose within the specified range of months/days before the hospitalization encounter date, which was the date of respiratory specimen collection associated with the most recent positive or negative SARS-CoV-2 test result before the admission date or the admission date if testing only occurred after the admission.
¶ An absolute SMD >0.20 indicates a nonnegligible difference in variable distributions between hospitalizations for vaccinated versus unvaccinated patients or for patients with a positive SARS-Cov-2 test result versus patients with a negative SARS-CoV-2 test result. For mRNA COVID-19 vaccination status, a single SMD was calculated by averaging the absolute SMDs obtained from pairwise comparisons of each vaccinated category versus unvaccinated. Specifically, it was calculated as the average of the absolute value of the SMDs for 1) vaccinated with only monovalent doses, ≥11 months earlier versus unvaccinated, 2) vaccinated with only monovalent doses, 8–10 months earlier versus unvaccinated, 3) vaccinated with only monovalent doses 5–7 months earlier versus unvaccinated, 4) vaccinated with only monovalent doses 2–4 months earlier versus unvaccinated, and 5) vaccinated with bivalent booster ≥7 days earlier versus unvaccinated.
** Other race includes Asian, Hawaiian or other Pacific Islander, American Indian or Alaska Native, other not listed, and multiple races. Because of small numbers, these categories were combined.
†† Previous SARS-CoV-2 infection was defined as having a positive SARS-CoV-2 test result (molecular or antigen) documented in the electronic health record ≥15 days before the hospital admission date. This does not capture infections in which testing was not performed or testing was performed but not available in the electronic health record, e.g., at-home testing.
§§ In-hospital death was identified at each individual site and was defined as a death while hospitalized and ≤28 days after admission.