Duration of mRNA vaccine protection against SARS-CoV-2 Omicron BA.1 and BA.2 subvariants in Qatar

  1. Hiam Chemaitelly
  2. Houssein H. Ayoub
  3. Sawsan AlMukdad
  4. Peter Coyle
  5. Patrick Tang
  6. Hadi M. Yassine
  7. Hebah A. Al-Khatib
  8. Maria K. Smatti
  9. Mohammad R. Hasan
  10. Zaina Al-Kanaani
  11. Einas Al-Kuwari
  12. Andrew Jeremijenko
  13. Anvar Hassan Kaleeckal
  14. Ali Nizar Latif
  15. Riyazuddin Mohammad Shaik
  16. Hanan F. Abdul-Rahim
  17. Gheyath K. Nasrallah
  18. Mohamed Ghaith Al-Kuwari
  19. Adeel A. Butt
  20. Hamad Eid Al-Romaihi
  21. Mohamed H. Al-Thani
  22. Abdullatif Al-Khal
  23. Roberto Bertollini
  24. Laith J. Abu-Raddad

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Abstract

SARS-CoV-2 Omicron BA.1 and BA.2 subvariants are genetically divergent. We conducted a matched, test-negative, case-control study to estimate duration of protection of the second and third/booster doses of mRNA COVID-19 vaccines against BA.1 and BA.2 infections in Qatar. BNT162b2 effectiveness was highest at 46.6% (95% CI: 33.4–57.2%) against symptomatic BA.1 and at 51.7% (95% CI: 43.2–58.9%) against symptomatic BA.2 infections in the first three months after the second dose, but declined to ~10% or below thereafter. Effectiveness rebounded to 59.9% (95% CI: 51.2–67.0%) and 43.7% (95% CI: 36.5–50.0%), respectively, in the first month after the booster dose, before declining again. Effectiveness against COVID-19 hospitalization and death was 70–80% after the second dose and >90% after the booster dose. mRNA-1273 vaccine protection showed similar patterns. mRNA vaccines provide comparable, moderate, and short-lived protection against symptomatic BA.1 and BA.2 Omicron infections, but strong and durable protection against COVID-19 hospitalization and death.

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  1. Version published to 10.1038/s41467-022-30895-3
  2. ScreenIT

    SciScore for 10.1101/2022.03.13.22272308: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Hamad Medical Corporation and Weill Cornell Medicine-Qatar Institutional Review Boards approved this retrospective study with waiver of informed consent.
    Consent: Hamad Medical Corporation and Weill Cornell Medicine-Qatar Institutional Review Boards approved this retrospective study with waiver of informed consent.
    Field Sample Permit: From 147 random SARS-CoV-2-positive specimens all collected in December of 2021, RT-qPCR genotyping was able to assign a genotype in 129 samples.
    Sex as a biological variablenot detected.
    RandomizationClassification of infections by subvariant: Surveillance for SARS-CoV-2 variants in Qatar is mainly based on viral genome sequencing and multiplex RT-qPCR variant screening42 of random positive clinical samples2,13,30,32,43,44, complemented by deep sequencing of wastewater samples2,45.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses were conducted in STATA/SE version 17.051.
    STATA/SE
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has limitations. With the lower severity of Omicron infections20 and the young population of Qatar15,21, case numbers were insufficient to estimate the duration of protection against COVID-19 hospitalization and death for each subvariant separately. BA.1 and BA.2 ascertainment was based on proxy criteria, presence or absence of an S-gene “target failure” using the TaqPath PCR assay (Methods), but this method of ascertainment is well established not only for Omicron subvariants, but also for other variants such as Alpha22-24. Some Omicron infections may have been misclassified Delta infections, but this is not likely, as Delta incidence was limited during the study duration (Methods). Vaccine protection was assessed for only several months after the second dose, and only several weeks after the booster dose. Longer-term protection against symptomatic infection and COVID-19 hospitalization and death remain uncertain. Vaccine effectiveness reached small but statistically significant negative values at 7 months or more after the second dose. Negative estimated effectiveness likely reflects an effect of bias and not true negative biological effectiveness. This bias may have risen from vaccinated persons having a higher social contact rate or adhering less to safety measures than unvaccinated persons25-27. With the high vaccine coverage among adults in Qatar (>85%)13, this bias may have also risen because the reference group of unvaccinated individuals included mainly ch...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2022.03.13.22272308v1 on medRxiv