{"id":2055,"date":"2022-07-06T00:00:00","date_gmt":"2022-07-06T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/effectiveness-of-a-fourth-dose-of-covid-19-mrna-vaccine-against-the-omicron-variant-among-long-term-care-residents-in-ontario-canada-test-negative-design-study\/"},"modified":"2023-08-23T15:54:34","modified_gmt":"2023-08-23T19:54:34","slug":"effectiveness-of-a-fourth-dose-of-covid-19-mrna-vaccine-against-the-omicron-variant-among-long-term-care-residents-in-ontario-canada-test-negative-design-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/effectiveness-of-a-fourth-dose-of-covid-19-mrna-vaccine-against-the-omicron-variant-among-long-term-care-residents-in-ontario-canada-test-negative-design-study\/","title":{"rendered":"Effectiveness of a fourth dose of COVID-19 mRNA vaccine against the omicron variant among long term care residents in Ontario, Canada: test negative design study"},"content":{"rendered":"<p><strong>Objectives<\/strong> \u2014 To estimate the marginal effectiveness of a fourth versus third dose and the vaccine effectiveness of mRNA COVID-19 vaccines BNT162b2 and mRNA-1273 against any infection, symptomatic infection, and severe outcomes (hospital admission or death) related to the omicron variant.<\/p>\n<p><strong>Design<\/strong> \u2014 Test negative design.<\/p>\n<p><strong>Setting<\/strong> \u2014 Long term care facilities in Ontario, Canada, 30 December 2021 to 27 April 2022.<\/p>\n<p><strong>Participants<\/strong> \u2014 After exclusions, 61 344 residents aged 60 years or older across 626 long term care facilities in Ontario, Canada who were tested for SARS-CoV-2 were included.<\/p>\n<p><strong>Main Outcome Measures<\/strong> \u2014 Laboratory confirmed omicron SARS-CoV-2 infection (any and symptomatic) by reverse transcription polymerase chain reaction (RT-PCR), and hospital admission or death. Multivariable logistic regression was used to estimate marginal effectiveness (four versus three doses) and vaccine effectiveness (two, three, or four doses versus no doses) while adjusting for personal characteristics, comorbidities, week of test, and previous positive SARS-CoV-2 test result more than 90 days previously.<\/p>\n<p><strong>Results<\/strong> \u2014 13 654 residents who tested positive for omicron SARS-CoV-2 infection and 205 862 test negative controls were included. The marginal effectiveness of a fourth dose (95% of vaccine recipients received mRNA-1273 as the fourth dose) seven days or more after vaccination versus a third dose received 84 or more days previously was 19% (95% confidence interval 12% to 26%) against infection, 31% (20% to 41%) against symptomatic infection, and 40% (24% to 52%) against severe outcomes. Vaccine effectiveness in vaccine recipients (compared with unvaccinated) increased with each additional dose, and for a fourth dose was 49% (95% confidence interval 43% to 54%) against infection, 69% (61% to 76%) against symptomatic infection, and 86% (81% to 90%) against severe outcomes.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 The findings suggest that compared with a third dose of mRNA COVID-19 vaccine, a fourth dose improved protection against infection, symptomatic infection, and severe outcomes among long term care residents during an omicron dominant period. A fourth vaccine dose was associated with strong protection against severe outcomes in vaccinated residents compared with unvaccinated residents, although the duration of protection remains unknown.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objectives \u2014 To estimate the marginal effectiveness of a fourth versus third dose and the vaccine effectiveness of mRNA COVID-19 vaccines BNT162b2 and mRNA-1273 against any infection, symptomatic infection, and severe outcomes (hospital admission or death) related to the omicron variant. Design \u2014 Test negative design. Setting \u2014 Long term care facilities in Ontario, Canada, [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-2055","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Grewal R, Kitchen SA, Nguyen L, Buchan SA, Wilson SE, Costa AP, Kwong JC. <em>BMJ<\/em>. 2022; 378:e071502. Epub 2022 Jul 6.","source_url":"https:\/\/www.bmj.com\/content\/378\/bmj-2022-071502","ices_scientist":[1149,1161,1126,16240],"site":[6733],"research_program":[6745],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"2A08789F-582E-4A6C-9A5D-02A2C32812E8","sitecore_item_name":"Effectiveness-of-a-fourth-dose-of-covid-19-mRNA-vaccine-against-the-omicron-variant","sitecore_field_values":"{\n  \"Title\": \"Effectiveness of a fourth dose of covid-19 mRNA vaccine against the omicron variant among long term care residents in Ontario, Canada: test negative design study\",\n  \"Short title\": \"Effectiveness of a fourth dose of\",\n  \"Summary\": \"The findings suggest that compared with a 3rd dose of mRNA covid-19 vaccine, a 4th dose improved protection among long term care residents during an omicron dominant period.\",\n  \"Citation\": \"<p>Grewal R, Kitchen SA, Nguyen L, Buchan SA, Wilson SE, Costa AP, Kwong JC. <em>BMJ<\/em>. 2022; 378:e071502. Epub 2022 Jul 6. DOI: <a href=\"https:\/\/doi.org\/10.1136\/bmj-2022-071502\" title=\"opens external link\">https:\/\/doi.org\/10.1136\/bmj-2022-071502<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Objectives<\/strong> &mdash; To estimate the marginal effectiveness of a fourth versus third dose and the vaccine effectiveness of mRNA covid-19 vaccines BNT162b2 and mRNA-1273 against any infection, symptomatic infection, and severe outcomes (hospital admission or death) related to the omicron variant.<\/p>n<p><strong>Design<\/strong> &mdash; Test negative design.<\/p>n<p><strong>Setting<\/strong> &mdash; Long term care facilities in Ontario, Canada, 30 December 2021 to 27 April 2022.<\/p>n<p><strong>Participants<\/strong> &mdash; After exclusions, 61 344 residents aged 60 years or older across 626 long term care facilities in Ontario, Canada who were tested for SARS-CoV-2 were included.<\/p>n<p><strong>Main Outcome Measures<\/strong> &mdash; Laboratory confirmed omicron SARS-CoV-2 infection (any and symptomatic) by reverse transcription polymerase chain reaction (RT-PCR), and hospital admission or death. Multivariable logistic regression was used to estimate marginal effectiveness (four versus three doses) and vaccine effectiveness (two, three, or four doses versus no doses) while adjusting for personal characteristics, comorbidities, week of test, and previous positive SARS-CoV-2 test result more than 90 days previously.<\/p>n<p><strong>Results<\/strong> &mdash; 13 654 residents who tested positive for omicron SARS-CoV-2 infection and 205 862 test negative controls were included. The marginal effectiveness of a fourth dose (95% of vaccine recipients received mRNA-1273 as the fourth dose) seven days or more after vaccination versus a third dose received 84 or more days previously was 19% (95% confidence interval 12% to 26%) against infection, 31% (20% to 41%) against symptomatic infection, and 40% (24% to 52%) against severe outcomes. Vaccine effectiveness in vaccine recipients (compared with unvaccinated) increased with each additional dose, and for a fourth dose was 49% (95% confidence interval 43% to 54%) against infection, 69% (61% to 76%) against symptomatic infection, and 86% (81% to 90%) against severe outcomes.<\/p>n<p><strong>Conclusions<\/strong> &mdash; The findings suggest that compared with a third dose of mRNA covid-19 vaccine, a fourth dose improved protection against infection, symptomatic infection, and severe outcomes among long term care residents during an omicron dominant period. A fourth vaccine dose was associated with strong protection against severe outcomes in vaccinated residents compared with unvaccinated residents, although the duration of protection remains unknown.<\/p>n<p><a href=\"https:\/\/www.bmj.com\/content\/378\/bmj-2022-071502\" title=\"opens external link\">View full text<\/a><\/p>\",\n  \"Research Programs\": \"{91C9D48C-5B00-4FE5-9ABD-875AEA8F8FAE}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{14489280-87E2-4E37-BCF5-35BDF557014F}|{6E4F2826-B98E-411B-85E5-410869830E14}|{5EF9EEB7-BC22-4C59-A015-0CAC2A1B54EA}\",\n  \"Posted Date\": \"20220706T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/July\/Effectiveness-of-a-fourth-dose-of-covid-19-mRNA-vaccine-against-the-omicron-variant"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - 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