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Effectiveness of the second COVID-19 booster against Omicron: a large-scale cohort study in Chile

Author

Listed:
  • Alejandro Jara

    (Pontificia Universidad Católica de Chile
    Center for the Discovery of Structures in Complex Data (MiDaS))

  • Cristobal Cuadrado

    (Ministerio de Salud de Chile
    Universidad de Chile)

  • Eduardo A. Undurraga

    (Pontificia Universidad Católica de Chile
    Multidisciplinary Initiative for Collaborative Research in Bacterial Resistance (MICROB-R)
    Research Center for Integrated Disaster Risk Management (CIGIDEN)
    CIFAR)

  • Christian García

    (Ministerio de Salud de Chile)

  • Manuel Nájera

    (Ministerio de Salud de Chile)

  • María Paz Bertoglia

    (Ministerio de Salud de Chile)

  • Verónica Vergara

    (Ministerio de Salud de Chile)

  • Jorge Fernández

    (Ministerio de Salud de Chile)

  • Heriberto García-Escorza

    (Ministerio de Salud de Chile)

  • Rafael Araos

    (Multidisciplinary Initiative for Collaborative Research in Bacterial Resistance (MICROB-R)
    Universidad del Desarrollo
    Advanced Center for Chronic Diseases (ACCDiS))

Abstract

In light of the ongoing COVID-19 pandemic and the emergence of new SARS-CoV-2 variants, understanding the effectiveness of various booster vaccination regimens is pivotal. In Chile, using a prospective national cohort of 3.75 million individuals aged 20 or older, we evaluate the effectiveness against COVID-19-related intensive care unit (ICU) admissions and death of mRNA-based second vaccine boosters for four different three-dose background regimes: BNT162b2 primary series followed by a homologous booster, and CoronaVac primary series followed by an mRNA booster, a homologous booster, and a ChAdOx-1 booster. We estimate the vaccine effectiveness weekly from February 14 to August 15, 2022, by determining hazard ratios of immunization over non-vaccination, accounting for relevant confounders. The overall adjusted effectiveness of a second mRNA booster shot is 88.2% (95%CI, 86.2–89.9) against ICU admissions and 90.5% (95%CI 89.4–91.4) against death. Vaccine effectiveness shows a mild decrease for all regimens and outcomes, probably linked to the introduction of BA.4 and BA.5 Omicron sub-lineages and the waning of immunity. Based on our findings, individuals might not need additional boosters for at least 6 months after receiving a second mRNA booster shot in this setting.

Suggested Citation

  • Alejandro Jara & Cristobal Cuadrado & Eduardo A. Undurraga & Christian García & Manuel Nájera & María Paz Bertoglia & Verónica Vergara & Jorge Fernández & Heriberto García-Escorza & Rafael Araos, 2023. "Effectiveness of the second COVID-19 booster against Omicron: a large-scale cohort study in Chile," Nature Communications, Nature, vol. 14(1), pages 1-7, December.
    • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-41942-y
    DOI: 10.1038/s41467-023-41942-y
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    References listed on IDEAS

    as
    1. Tal Patalon & Yaki Saciuk & Asaf Peretz & Galit Perez & Yoav Lurie & Yasmin Maor & Sivan Gazit, 2022. "Waning effectiveness of the third dose of the BNT162b2 mRNA COVID-19 vaccine," Nature Communications, Nature, vol. 13(1), pages 1-7, December.
    2. Sandile Cele & Laurelle Jackson & David S. Khoury & Khadija Khan & Thandeka Moyo-Gwete & Houriiyah Tegally & James Emmanuel San & Deborah Cromer & Cathrine Scheepers & Daniel G. Amoako & Farina Karim , 2022. "Omicron extensively but incompletely escapes Pfizer BNT162b2 neutralization," Nature, Nature, vol. 602(7898), pages 654-656, February.
    3. Smriti Mallapaty, 2021. "China’s COVID vaccines have been crucial — now immunity is waning," Nature, Nature, vol. 598(7881), pages 398-399, October.
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