Recombinant Adjuvanted Zoster Vaccine and Reduced Risk of Coronavirus Disease 2019 Diagnosis and Hospitalization in Older Adults
This article has been Reviewed by the following groups
Discuss this preprint
Start a discussion What are Sciety discussions?Listed in
- Evaluated articles (ScreenIT)
Abstract
Background
Some vaccines elicit nonspecific immune responses that may protect against heterologous infections. We evaluated the association between recombinant adjuvanted zoster vaccine (RZV) and coronavirus disease 2019 (COVID-19) outcomes at Kaiser Permanente Southern California.
Methods
In a cohort design, adults aged ≥50 years who received ≥1 RZV dose before 1 March 2020 were matched 1:2 to unvaccinated individuals and followed until 31 December 2020. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for COVID-19 outcomes were estimated using Cox proportional hazards regression. In a test-negative design, cases had a positive severe acute respiratory syndrome coronavirus 2 test and controls had only negative tests, during 1 March–31 December 2020. Adjusted odds ratios (aORs) and 95% CIs for RZV receipt were estimated using logistic regression.
Results
In the cohort design, 149 244 RZV recipients were matched to 298 488 unvaccinated individuals. The aHRs for COVID-19 diagnosis and hospitalization were 0.84 (95% CI, .81–.87) and 0.68 (95% CI, .64–.74), respectively. In the test-negative design, 8.4% of 75 726 test-positive cases and 13.1% of 340 898 test-negative controls had received ≥1 RZV dose (aOR, 0.84 [95% CI, .81–.86]).
Conclusions
RZV vaccination was associated with a 16% lower risk of COVID-19 diagnosis and 32% lower risk of hospitalization. Further study of vaccine-induced nonspecific immunity for potential attenuation of future pandemics is warranted.
Article activity feed
-
-
SciScore for 10.1101/2021.10.01.21264400: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The KPSC Institutional Review Board reviewed and approved the study with a waiver for the requirement of informed consent.
Consent: The KPSC Institutional Review Board reviewed and approved the study with a waiver for the requirement of informed consent.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Experimental Models: Organisms/Strains Sentences Resources Recipients of at least 1 dose of RZV as of 3/1/2020 were matched 1:2 with RZV unvaccinated individuals by age (50-59 years, 60-69 years, 70-79 years, and ≥80 years), sex, race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic … SciScore for 10.1101/2021.10.01.21264400: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The KPSC Institutional Review Board reviewed and approved the study with a waiver for the requirement of informed consent.
Consent: The KPSC Institutional Review Board reviewed and approved the study with a waiver for the requirement of informed consent.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Experimental Models: Organisms/Strains Sentences Resources Recipients of at least 1 dose of RZV as of 3/1/2020 were matched 1:2 with RZV unvaccinated individuals by age (50-59 years, 60-69 years, 70-79 years, and ≥80 years), sex, race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian, and other/unknown), and zip code. non-Hispanic Whitesuggested: NoneResults 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:While the mechanism for the reduced risk of heterologous infections following receipt of some vaccines is not clear, it is plausible that these vaccines induce a trained immune response that results in an improved cytokine response to subsequent exposures; this response may provide an antiviral effect against infection with SARS-CoV-2 or other viruses.[25] Induction of an innate immune response has been suggested as a means to control viral replication early in the course of infection to reduce the risk of severe disease.[4, 9, 25] This may be particularly important for viral infections such as SARS-CoV-2, which appear to attenuate the host innate immune response as a means of increasing viral replication, possibly increasing disease severity and enhancing viral transmission.[26, 27] Notably, induction of innate immunity by highly-effective COVID-19 vaccines has been proposed as a possible mechanism of early protection following vaccination prior to the development of a robust adaptive response.[28] Furthermore, innate immunity has been found to play an important role in the control of infection in coronavirus animal reservoirs and may similarly contribute to reduced severity of COVID-19 disease observed in children compared to adults.[29, 30] Our study found a durable reduction in the risk of COVID-19 infection following receipt of RZV vaccine, consistent with the durable protection against heterologous infections provided by trained immunity.[9] It is possible that the AS01...
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.
-
