COVID-19-Associated Hospitalizations Among Vaccinated and Unvaccinated Adults 18 Years or Older in 13 US States, January 2021 to April 2022

JAMA Internal Medicine - Tập 182 Số 10 - Trang 1071 - 2022
Fiona Havers1,2, Huong Pham2, Christopher A. Taylor2, Michael Whitaker2, Kadam Patel3,2, Onika Anglin3,2, Anita Kambhampati2, Jennifer Milucky2, Elizabeth R. Zell4,2, Heidi L. Moline1,2, Shua J. Chai5,6, Pam Daily Kirley5, Nisha B. Alden7, Isaac Armistead7, Kimberly Yousey‐Hindes8, James Meek8, Kyle P. Openo9,10, Evan J. Anderson11,12,10, Libby Reeg13, Alexander Kohrman13, Ruth Lynfield14, Kathryn Como‐Sabetti14, Elizabeth M. Davis15, Cory Cline15, Alison Muse16, Grant Barney16, Sophrena Bushey17, Christina B. Felsen17, Laurie M. Billing18, Eli Shiltz18, Melissa Sutton19, Nasreen Abdullah19, H. Keipp Talbot20, William Schaffner20, Mary Hill21, Andrea George21, Aron J. Hall2, Stephanie R. Bialek1,2, Neil Murthy1,2, Bhavini Patel Murthy1,2, Meredith McMorrow1,2
1Public Health Service Commissioned Corps, Rockville, Maryland
2US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
3General Dynamics Information Technology, Atlanta, Georgia
4Stat-Epi Associates, Inc, Ponte Vedra Beach, Florida
5California Emerging Infections Program, Oakland;
6Field Services Branch, Division of State and Local Readiness, Center for Preparedness and Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
7Colorado Department of Public Health and Environment, Denver
8Connecticut Emerging Infections Program, Yale School of Public Health, New Haven
9Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, Georgia
10Georgia Emerging Infections Program, Georgia Department of Public Health, Atlanta
11Atlanta Veterans Affairs Medical Center, Atlanta, Georgia
12Departments of Medicine and Pediatrics, Emory School of Medicine, Atlanta, Georgia
13Michigan Department of Health and Human Services, Lansing
14Minnesota Department of Health, St. Paul
15New Mexico Department of Health, Santa Fe;
16New York State Department of Health, Albany
17University of Rochester School of Medicine and Dentistry, Rochester, New York
18Ohio Department of Health, Columbus
19Public Health Division, Oregon Health Authority, Portland
20Vanderbilt University Medical Center, Nashville, Tennessee
21Salt Lake County Health Department, Salt Lake City, Utah

Tóm tắt

ImportanceUnderstanding risk factors for hospitalization in vaccinated persons and the association of COVID-19 vaccines with hospitalization rates is critical for public health efforts to control COVID-19.ObjectiveTo determine characteristics of COVID-19–associated hospitalizations among vaccinated persons and comparative hospitalization rates in unvaccinated and vaccinated persons.Design, Setting, and ParticipantsFrom January 1, 2021, to April 30, 2022, patients 18 years or older with laboratory-confirmed SARS-CoV-2 infection were identified from more than 250 hospitals in the population-based COVID-19–Associated Hospitalization Surveillance Network. State immunization information system data were linked to cases, and the vaccination coverage data of the defined catchment population were used to compare hospitalization rates in unvaccinated and vaccinated individuals. Vaccinated and unvaccinated patient characteristics were compared in a representative sample with detailed medical record review; unweighted case counts and weighted percentages were calculated.ExposuresLaboratory-confirmed COVID-19–associated hospitalization, defined as a positive SARS-CoV-2 test result within 14 days before or during hospitalization.Main Outcomes and MeasuresCOVID-19–associated hospitalization rates among vaccinated vs unvaccinated persons and factors associated with COVID-19–associated hospitalization in vaccinated persons were assessed.ResultsUsing representative data from 192 509 hospitalizations (see Table 1 for demographic information), monthly COVID-19–associated hospitalization rates ranged from 3.5 times to 17.7 times higher in unvaccinated persons than vaccinated persons regardless of booster dose status. From January to April 2022, when the Omicron variant was predominant, hospitalization rates were 10.5 times higher in unvaccinated persons and 2.5 times higher in vaccinated persons with no booster dose, respectively, compared with those who had received a booster dose. Among sampled cases, vaccinated hospitalized patients with COVID-19 were older than those who were unvaccinated (median [IQR] age, 70 [58-80] years vs 58 [46-70] years, respectively; P < .001) and more likely to have 3 or more underlying medical conditions (1926 [77.8%] vs 4124 [51.6%], respectively; P < .001).Conclusions and RelevanceIn this cross-sectional study of US adults hospitalized with COVID-19, unvaccinated adults were more likely to be hospitalized compared with vaccinated adults; hospitalization rates were lowest in those who had received a booster dose. Hospitalized vaccinated persons were older and more likely to have 3 or more underlying medical conditions and be long-term care facility residents compared with hospitalized unvaccinated persons. The study results suggest that clinicians and public health practitioners should continue to promote vaccination with all recommended doses for eligible persons.

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JAMA Internal Medicine

Tập 182 Số 10

1071

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