COVID-19 risk substantially reduced in seniors who receive 4th mRNA booster Seniors Coronavirus Disease COVID SARSCoV2 Singapore Omicron AnnalsofIM sporeMOH NUSingapore NTUsg
The continual emergence of Omicron subvariants and the waning immune responses after the third vaccination have prompted several nations to recommend second booster vaccinations for persons at increased risk of COVID-19 severity outcomes. Despite high COVID-19 vaccination coverage, COVID-19 cases have resurged in Singapore in July 2022 due to Omicron BA.5 infections.
The study comprised individuals aged ≥80 years, residing in nursing homes, or those with increased susceptibility to COVID-19 severity who had received initial booster vaccinations five months prior to the study commencement and were invited for the second booster administration with Moderna’s mRNA-1273 or Pfizer-BioNTech’s BNT162b2 vaccines.
SARS-CoV-2 testing was performed for all individuals who presented with acute pulmonary symptoms to healthcare facilities. Physicians evaluated the need for hospital admission based on risk factors and clinical presentations. COVID-19 cases were considered severe if they required supplemental oxygen, ICU admission, or led to death.
For COVID-19 severity, among controls, the number of events and incidence per million person days were 115 and 52, respectively, which were reduced after the second booster to 40 and 18, respectively. Stratified analysis based on time elapsed since the previous COVID-19 vaccination demonstrated that VE-S and VE-H persisted at high values, whereas VE-I reduced. VE-I waning could have been observed due to the shift of variant predominance from Omicron BA.2 toward Omicron BA.
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