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Abstract: SA-OR25

Monovalent and Bivalent mRNA Vaccine Effectiveness Against Severe COVID-19 Associated with Omicron Variant in Maintenance Dialysis Patients

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Li, Nien Chen, Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Manley, Harold, Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Harford, Antonia, Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Shieu, Monica, Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Hsu, Caroline M., Tufts Medical Center, Boston, Massachusetts, United States
  • Miskulin, Dana, Tufts Medical Center, Boston, Massachusetts, United States
  • Weiner, Daniel E., Tufts Medical Center, Boston, Massachusetts, United States
  • Johnson, Doug, Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Lacson, Eduardo K., Dialysis Clinic Inc, Nashville, Tennessee, United States
Background

Recent data suggest that SARS-CoV-2 bivalent (BV) booster is more effective than monovalent (MV) booster against severe Omicron infection. We compared the effectiveness (VE) of BV and MV booster regimens in a national population of maintenance dialysis patients.

Methods

All adult patients receiving maintenance dialysis during the Omicron era (12/19/21-2/12/23) at Dialysis Clinic, Inc. (DCI) facilities who had COVID-19 during this time were included. Vaccination status was categorized as unvaccinated or received MV or BV booster <180 or ≥180 days prior to COVID. A logistic model was used to determine odds ratio (OR) of hospitalization/death within 30 days of infection by vaccination status. The model was adjusted for COVID prior to the Omicron period, age, sex, dialysis vintage, COPD, thyroid disease, PVD, diabetes, and immunocompromising conditions, and weighted by the natural log transformation of exposure time at risk.

Results

Among 3,853 eligible patients, mean age was 63 (±15) years; 55% were male and 31% Black. Figure 1 shows ORs of hospitalization or death within 30 days of infection by vaccination status. Relative to unvaccinated, the VE, defined as 100*(1-OR)%, was 44% (95% CI 30-56%) for MV booster doses received more than 180 days before Omicron infection; was 55% (42-65%) for MV received within 180 days; and was 83% (62-93%) for BV received within 180 days of infection. Relative to MV received more than 180 days before infection, the VE for MV and BV received within 180 days of infection were 20% (0.2-35%) and 70% (33-87%), respectively. The VE was 63% (16-84%) for BV relative to MV when both were received within 180 days of infection.

Conclusion

Bivalent SARS-CoV-2 vaccine is more effective than monovalent vaccine against severe Omicron infection in maintenance dialysis patients. Vaccine effectiveness declines after 180 days in this population suggesting a need for revaccination.