Risk of hospitalization and mortality after breakthrough SARS-CoV-2 infection by vaccine type and previous SARS-CoV-2 infection utilizing medical claims data

  1. Meghana Kshirsagar
  2. Sumit Mukherjee
  3. Md Nasir
  4. Nicholas Becker
  5. Juan Lavista Ferres
  6. Barbra A. Richardson

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

We compare the risks of hospitalization (n=1121) and mortality (n=138) in a cohort of 17,881 breakthrough SARS-CoV-2 infections for the Pfizer, Moderna and Janssen vaccines for those with and without SARS-CoV-2 infections prior to vaccination. Cox regression analysis results in a lower hazard ratio for breakthroughs receiving the Moderna vaccine, but a significantly higher hazard ratio for breakthroughs receiving the Janssen vaccine, as compared to breakthroughs who got the Pfizer vaccine. Further, the risk of hospitalization (P<0.001) and death (P<0.05) were lower among breakthroughs who had a SARS-CoV-2 infection prior to vaccination, independent of age, sex, comorbidities, and vaccine type.

Note

We do not study the role of natural immunity in SARS-CoV-2 infections, as our cohort does not contain unvaccinated individuals.

Article activity feed

  1. Version published to 10.1101/2021.12.08.21267483v2 on medRxiv
  2. ScreenIT

    SciScore for 10.1101/2021.12.08.21267483: (What is this?)

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

    Table 1: Rigor

    EthicsConsent: Ethics approval and consent to participate: This study does not constitute as human subjects research due to the usage and reporting of only deidentified observational data as determined by the ethics committee of the University of Washington School of Medicine.
    IRB: Ethics approval and consent to participate: This study does not constitute as human subjects research due to the usage and reporting of only deidentified observational data as determined by the ethics committee of the University of Washington School of Medicine.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    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:
    Limitations of our study include, first, a lack of access to data on unvaccinated individuals or those that had a negative SARS-CoV-2 test result. Second, the medical claims data that our cohort comes from, consists of mostly privately insured individuals and is thus likely to miss people with the most adverse outcomes. Our findings add to the growing literature regarding SARS-CoV-2 breakthrough infections and protection provided by previous SARS-CoV-2 infections against severe disease. This study reinforces the need for booster vaccination shots to protect against more severe COVID-19 among those initially receiving the Janssen vaccine and provides new information regarding the role of prior SARS-CoV-2 infection and lower risk of more severe breakthrough infections.

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.12.08.21267483v1 on medRxiv