Population Immunity to Pre-Omicron and Omicron Severe Acute Respiratory Syndrome Coronavirus 2 Variants in US States and Counties Through 1 December 2021
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Abstract
Background
Both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) vaccination contribute to population-level immunity against SARS-CoV-2. This study estimated the immunological exposure and effective protection against future SARS-CoV-2 infection in each US state and county over 2020–2021 and how this changed with the introduction of the Omicron variant.
Methods
We used a Bayesian model to synthesize estimates of daily SARS-CoV-2 infections, vaccination data and estimates of the relative rates of vaccination conditional on infection status to estimate the fraction of the population with (1) immunological exposure to SARS-CoV-2 (ever infected with SARS-CoV-2 and/or received ≥1 doses of a COVID-19 vaccine), (2) effective protection against infection, and (3) effective protection against severe disease, for each US state and county from 1 January 2020 to 1 December 2021.
Results
The estimated percentage of the US population with a history of SARS-CoV-2 infection or vaccination as of 1 December 2021 was 88.2% (95% credible interval [CrI], 83.6%–93.5%). Accounting for waning and immune escape, effective protection against the Omicron variant on 1 December 2021 was 21.8% (95% CrI, 20.7%–23.4%) nationally and ranged between 14.4% (13.2%–15.8%; West Virginia) and 26.4% (25.3%–27.8%; Colorado). Effective protection against severe disease from Omicron was 61.2% (95% CrI, 59.1%–64.0%) nationally and ranged between 53.0% (47.3%–60.0%; Vermont) and 65.8% (64.9%–66.7%; Colorado).
Conclusions
While more than four-fifths of the US population had prior immunological exposure to SARS-CoV-2 via vaccination or infection on 1 December 2021, only a fifth of the population was estimated to have effective protection against infection with the immune-evading Omicron variant.
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SciScore for 10.1101/2021.12.23.21268272: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our modeled estimates rely on multiple publicly available data sources, each of which has its own limitations. For vaccination coverage, we used data from Merritt et al27,28, which endeavors to address known biases in the CDC vaccination data. We further adjusted these vaccination data to assure that no greater than 100% of the over 12 population could have been vaccinated by the end of our study period. While most indicators suggest …
SciScore for 10.1101/2021.12.23.21268272: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our modeled estimates rely on multiple publicly available data sources, each of which has its own limitations. For vaccination coverage, we used data from Merritt et al27,28, which endeavors to address known biases in the CDC vaccination data. We further adjusted these vaccination data to assure that no greater than 100% of the over 12 population could have been vaccinated by the end of our study period. While most indicators suggest lower cumulative infections among children, there is evidence that contradicts this and suggests a higher seroprevalence for children compared to adults40-43. For our infection rate estimates, we used a model which leverages case notification and COVID-19 mortality data from Johns Hopkins University and have incorporated modeled uncertainty in these estimates into our model of immunity. The model for infections assumes individuals can only be infected once, so possible reinfections and breakthrough infections amongst vaccinated individuals are not accounted for in our estimates of immunity. We estimated the relationship between prior infection and vaccination status using survey data that have been criticized for non-representativeness31. While this relationship was confirmed in independent survey data that have been validated against external benchmarks31, it is still possible that reporting biases could have distorted this relationship. If there is greater overlap between vaccinated and previously infected populations, then overall population i...
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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