Two doses of J&J, Pfizer vaccines effective against Omicron variant
A study of more than 160,000 COVID-19 tests of South African healthcare workers concludes that two doses of the Johnson & Johnson (J&J) and Pfizer/BioNTech vaccines are about 71% effective against hospitalization caused by Omicron 1 to 2 months after the second dose, with little waning at 5 months or longer.
Investigators from the South African Medical Research Council led the study, published yesterday in the New England Journal of Medicine (NEJM). They used a test-negative design to estimate the effectiveness of two doses of the J&J or Pfizer vaccine against hospitalization or intensive care unit (ICU) admission with an Omicron variant infection from Nov 15, 2021, to Jan 14, 2022.
The team analyzed the results of 162,637 polymerase chain reaction (PCR) COVID-19 tests, of which 93,854 (57.7%) were from participants given two doses of either the Pfizer vaccine at least 42 days apart or J&J vaccine 4 to 6 months apart.
Test positivity was 34%, with 1.6% of patients hospitalized and 0.5% admitted to an ICU. Among J&J recipients, estimated vaccine effectiveness (VE) against COVID-19 hospitalization was 55% (95% confidence interval [CI], 22% to 74%) by 13 days after the second dose, 74% (95% CI, 57% to 84%) at 14 to 27 days, and 72% (95% CI, 59% to 81%) at 1 or 2 months.
Of Pfizer vaccinees, VE was 81% (95% CI, 41% to 94%) by 13 days after the second dose, 88% (95% CI, 62% to 96%) at 14 to 27 days, 70% (95% CI, 64% to 76%) at 1 or 2 months, 71% (95% CI, 68% to 74%) at 3 or 4 months, and 67% (95% CI, 63% to 71%) at 5 or more months.
VE against ICU admission in J&J vaccinees was 69% (95% CI, 26% to 87%) at 14 to 27 days and 82% (95% CI, 57% to 93%) at 1 or 2 months after the second dose. Among Pfizer vaccinees, VE against ICU admission was 70% (95% CI, 56% to 79%) at 1 or 2 months, 73% (95% CI, 67% to 77%) at 3 or 4 months, and 71% (95% CI, 65% to 76%) at 5 or more months.
"These data provide reassurance about the continued value of the national Covid-19 vaccine program during a surge in the omicron variant," the authors wrote.
May 4 NEJM research letter
Recent cancer, active treatment tied to higher risk of worse COVID-19
Patients diagnosed as having cancer within 1 year after testing positive for COVID-19 and those undergoing treatment are at a 10% higher risk for infection-related hospitalization and 17% higher risk of death than other patients, suggests a study published yesterday in PLOS One.
University of Texas researchers led the study, which involved mining the electronic health records of 271,639 adults who tested positive for COVID-19 at more than 700 hospitals and 7,000 clinics in the United States from Jun 1 to Dec 31, 2020. Of these patients, 18,460 had one or more cancer diagnoses, 8,034 had a history of cancer, and 10,426 were newly diagnosed with cancer within 1 year of COVID-19 diagnosis. Relative to other patients, those with cancer were older and more likely to be male, to be White Medicare enrollees, and to have more underlying conditions.
Compared with other patients, those with cancer were at higher risk for COVID-19 death by 30 days (relative risk [RR], 1.07; 95% confidence interval [CI], 1.01 to 1.14) and hospitalization (RR, 1.04; 95% CI, 1.01 to 1.07). But the two groups didn't differ significantly in terms of ICU admission or ventilator use.
Recent cancer diagnoses were tied to a higher risk of worse COVID-19 outcomes (RR for death, 1.17 [95% CI, 1.08 to 1.25]; RR for hospitalization, 1.10 [95% CI, 1.06 to 1.14]), especially in those with metastatic disease and blood, liver, and lung cancers.
Death among COVID-19 patients with recent cancer diagnoses was linked to receipt of chemotherapy or radiation therapy within 3 months before infection. Other risk factors for death were older age, Black race, Medicare enrollment, residence in southern states, diabetes, and cardiovascular, liver, and kidney diseases.
In a University of Texas news release, senior author Guo-Qiang Zhang, PhD, said the results confirm that cancer patients generally have poorer COVID-19 outcomes but also identified subgroups of cancer patients not at elevated risk. "This is an important finding for the health care system as they intervene based on the appropriate risk assessment and for cancer survivors to understand their specific risks associated with COVID-19," he said.
May 4 PLOS One study
May 4 University of Texas news release