Abstract
Background
Adults in the United States (US) began receiving the viral vector COVID-19 vaccine, Ad26.COV2.S (Johnson & Johnson [Janssen]), in February 2021. We evaluated Ad26.COV2.S vaccine effectiveness (VE) against COVID-19 hospitalization and high disease severity during the first 10 months of its use.
Methods
In a multicenter case-control analysis of US adults (≥18 years) hospitalized March 11–December 15, 2021, we estimated VE against susceptibility to COVID-19 hospitalization (VEs), comparing odds of prior vaccination with a single dose Ad26.COV2.S vaccine between hospitalized cases with COVID-19 and controls without COVID-19. Among hospitalized patients with COVID-19, we estimated VE against disease progression (VEp) to death or invasive mechanical ventilation (IMV), comparing odds of prior vaccination between patients with and without progression.
Results
After excluding patients receiving mRNA vaccines, among 3,979 COVID-19 case-patients (5% vaccinated with Ad26.COV2.S) and 2.229 controls (13% vaccinated with Ad26.COV2.S), VEs of Ad26.COV2.S against COVID-19 hospitalization was 70% (95% CI: 63%–75%) overall, including 55% (29%–72%) among immunocompromised patients, and 72% (64%–77%) among immunocompetent patients, for whom VEs was similar at 14–90 days (73% [59%–82%]), 91–180 days (71% [60%–80%]), and 181–274 days (70% [54%–81%]) post-vaccination. Among hospitalized COVID-19 case-patients, VEp was 46% (18%–65%) among immunocompetent patients.
Conclusions
The Ad26.COV2.S COVID-19 vaccine reduced the risk of COVID-19 hospitalization by 72% among immunocompetent adults without waning through 6 months post-vaccination. After hospitalization for COVID-19, vaccinated immunocompetent patients were less likely to require IMV or die compared to unvaccinated immunocompetent patients.
Keywords: COVID-19, vaccine effectiveness, viral vector vaccines
Contributor Information
Nathaniel M. Lewis, CDC COVID-19 Response Team, Atlanta, GA, USA.
Wesley H. Self, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Manjusha Gaglani, Baylor Scott & White Health, Temple, Texas, USA; Texas A&M University College of Medicine, Temple, Texas, USA.
Adit A. Ginde, University of Colorado School of Medicine, Aurora, Colorado, USA.
David J. Douin, University of Colorado School of Medicine, Aurora, Colorado, USA.
H. Keipp Talbot, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Jonathan D. Casey, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Nicholas M. Mohr, University of Iowa, Iowa City, Iowa, USA.
Anne Zepeski, University of Iowa, Iowa City, Iowa, USA.
Shekhar A. Ghamande, Baylor Scott & White Health, Temple, Texas, USA.
Tresa A. McNeal, Baylor Scott & White Health, Temple, Texas, USA.
Nathan I. Shapiro, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Kevin W. Gibbs, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, USA.
D. Clark Files, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, USA.
David N. Hager, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Arber Shehu, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Matthew E. Prekker, Hennepin County Medical Center, Minneapolis, Minnesota, USA.
Heidi L. Erickson, Hennepin County Medical Center, Minneapolis, Minnesota, USA.
Michelle N. Gong, Montefiore Healthcare Center, Albert Einstein College of Medicine, Bronx, New York, USA.
Amira Mohamed, Montefiore Healthcare Center, Albert Einstein College of Medicine, Bronx, New York, USA.
Nicholas J. Johnson, University of Washington School of Medicine, Seattle, Washington, USA.
Vasisht Srinivasan, University of Washington School of Medicine, Seattle, Washington, USA.
Jay S. Steingrub, Baystate Medical Center, Springfield, Massachusetts, USA.
Ithan D. Peltan, Intermountain Medical Center and University of Utah, Salt Lake City, Utah, USA.
Samuel M. Brown, Intermountain Medical Center and University of Utah, Salt Lake City, Utah, USA.
Emily T. Martin, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Arnold S. Monto, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Akram Khan, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Laurence W. Busse, Emory University School of Medicine, Atlanta, Georgia, USA.
Caitlin C. ten Lohuis, Emory University School of Medicine, Atlanta, Georgia, USA.
Abhijit Duggal, Cleveland Clinic, Cleveland, Ohio, USA.
Jennifer G. Wilson, Stanford University School of Medicine, Palo Alto, California, USA.
Alexandra June Gordon, Stanford University School of Medicine, Palo Alto, California, USA.
Nida Qadir, David Geffen School of Medicine at UCLA, Ronald Reagan-UCLA Medical Center, Los Angeles, California, USA.
Steven Y. Chang, David Geffen School of Medicine at UCLA, Ronald Reagan-UCLA Medical Center, Los Angeles, California, USA.
Christopher Mallow, University of Miami, Miami, Florida, USA.
Carolina Rivas, University of Miami, Miami, Florida, USA.
Hilary M. Babcock, Washington University, St. Louis, Missouri, USA.
Jennie H. Kwon, Washington University, St. Louis, Missouri, USA.
Matthew C. Exline, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Adam S. Lauring, University of Michigan School of Medicine, Ann Arbor, Michigan, USA.
Natasha Halasa, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
James D. Chappell, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Carlos G. Grijalva, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Todd W. Rice, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Jillian P. Rhoads, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Ian D. Jones, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
William B. Stubblefield, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Adrienne Baughman, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Kelsey N. Womack, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Christopher J. Lindsell, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Kimberly W. Hart, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Yuwei Zhu, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Katherine Adams, CDC COVID-19 Response Team, Atlanta, GA, USA.
Manish M. Patel, CDC COVID-19 Response Team, Atlanta, GA, USA.
Mark W. Tenforde, CDC COVID-19 Response Team, Atlanta, GA, USA.
Supplementary Material
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