key: cord-0752613-4jbcluwf
authors: McLean, Huong Q.; McClure, David L.; King, Jennifer P.; Meece, Jennifer K.; Pattinson, David; Neumann, Gabriele; Kawaoka, Yoshihiro; Rolfes, Melissa A.; Belongia, Edward A.
title: mRNA COVID‐19 vaccine effectiveness against SARS‐CoV‐2 infection in a prospective community cohort, rural Wisconsin, November 2020 to December 2021
date: 2022-02-18
journal: Influenza Other Respir Viruses
DOI: 10.1111/irv.12970
sha: 0d5046f0c13f5fea2e2975b9a809025863ba545b
doc_id: 752613
cord_uid: 4jbcluwf

Reduced COVID‐19 vaccine effectiveness (VE) has been observed with increasing predominance of SARS‐CoV‐2 Delta (B.1.617.2) variant. Two‐dose VE against laboratory‐confirmed SARS‐CoV‐2 infection (symptomatic and asymptomatic) was estimated using Cox proportional hazards models with time‐varying vaccination status in a prospective rural community cohort of 1266 participants aged ≥12 years. Between November 3, 2020 and December 7, 2021, VE was 56% for mRNA COVID‐19 vaccines overall, 65% for Moderna, and 50% for Pfizer‐BioNTech. VE when Delta predominated (June to December 2021) was 54% for mRNA COVID‐19 vaccines overall, 59% for Moderna, and 52% for Pfizer‐BioNTech.

Participants were randomly sampled community-dwelling individuals living in the Marshfield Epidemiologic Study Area (central region), a 14 zip code region in central Wisconsin that includes Marshfield and surrounding area. The population is $53,000, and 89% receive most of their care from Marshfield Clinic Health System (MCHS). 7 Further description of cohort eligibility are in the supporting information.

Each week, all participants reported the absence or presence of specific symptoms. Anterior nasal swabs were self-collected (or parentcollected) for each qualifying illness episode. In addition, approximately half of the cohort was assigned to collect swabs weekly for the first 26 weeks. Further details on assignment to symptomatic versus weekly nasal swab collection are provided in the supporting information. A qualifying illness was a new illness onset in the past 7 days and at least one of the following symptoms: cough, fever or chills, sore throat, muscle or body aches, loss of smell or taste, shortness of breath, or diarrhea. Participants were instructed to also report any new respiratory symptoms by phone as soon as symptoms developed. 

Of 1518 cohort participants, 1266 (83%) were aged ≥ 12 years and included in this VE analysis. By the end of follow-up, almost half (48%) received two doses of Pfizer-BioNTech vaccine, 26% received two doses of Moderna vaccine, and 26% were unvaccinated. Older adults, females, Non-Hispanic White participants, those who received the 2020-2021 influenza vaccine, and those who work in healthcare were more likely to be vaccinated (Table 1) (14) 45 (14) 11 (9) 18 

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All authors report no potential conflicts.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention.

The peer review history for this article is available at https://publons. com/publon/10.1111/irv.12970.

The data that support the findings of this study are available upon reasonable request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.