For immunocompromised adults, the updated 2023-2024 COVID-19 vaccine reduced the risk of hospitalization compared to not getting vaccinated, according to CDC data.
Vaccine efficacy against hospitalization was 38% between 7 and 59 days after receiving the updated XBB. 1. 5 monovalent COVID vaccine, and 34% between 60 and 119 days after receiving it, reported Ruth Link-Gelles, PhD, of CDC’s National Center for Immunization and Respiratory Diseases and colleagues in the weekly morbidity and mortality report.
However, despite the positive effect, only 18 percent of people in this high-risk population had received the updated COVID vaccine, “representing a missed opportunity to save severe COVID-19,” the authors wrote.
Camille Kotton, MD, an infectious disease specialist at Massachusetts General Hospital in Boston, told MedPage Today, “I’m very disappointed. . . that only 18% of immunocompromised patients took advantage of the COVID-19 opportunity. We want a greater message from the CDC and medical organizations to get other people up to date on their vaccines. “
Previous CDC data found that among other people who are not immunocompromised, the updated vaccine was about 50% effective at preventing severe illness. The lower vaccine efficacy in severely immunocompromised Americans is not surprising, since most are likely to have a diminished immune reaction to vaccination, the authors write.
The CDC recommends that Americans with moderate to severe immunosuppression receive an updated 2023-2024 COVID vaccine and receive additional doses 2 months or more after the last dose of the vaccine to prevent severe illness. However, many experts who treat other people in this population recently told MedPage Today that they had a COVID shot every 6 months or so.
“We’re seeing significant differences between people who are vaccinated and those who aren’t. I strongly advocate that my patients stay up-to-date on their vaccinations,” Kotton said.
In addition to vaccination, another option that may now be available to save COVID or cure immunocompromised Americans is pemivibart (Pemgarda), a monoclonal antibody that recently gained emergency use authorization (EUA) from the FDA. This represents a welcome development, as after the FDA withdrew the EUA for the monoclonal antibody tixagevimab-cilgavimab (Evusheld) in January 2023, other people with moderate or severe immune weakness had to rely on COVID vaccines, mask-wearing, improved ventilation, and keeping distance. to prevent infection and serious illness.
In the existing analysis, Link-Gelles and his team analyzed insights from the CDC’s VISION Vaccine Effectiveness Network to assess the efficacy of updated COVID vaccines in preventing hospitalization in immunocompromised adults. Knowledge of COVID-associated hospitalization has been analyzed at six sites since September. 2023 to February 2024. Among 14,586 immunocompromised patients hospitalized with COVID-like illness, 1,392 case patients and 13,194 patients were included.
The patients were Americans who had a positive SARS-CoV-2 molecular test result and a negative, undetermined, or unknown result for breathing syncytial virus and influenza. Control patients were those who had a negative SARS-CoV-2 molecular test result and a negative or unknown influenza control result.
Overall, 66% of the adults in the study were 65 or older, and 72% of those hospitalized with COVID were in this age group. The study population was predominantly white (69%) and 51% were women. In patient cases, 14% had received an updated COVID vaccine dose, compared to 18% of patients.
The most common types of immunocompromised situations were malignant diseases of false organs (36% of patients and 43% of patients) and other immune situations or immunodeficiencies (38% and 35%). Rheumatological or inflammatory disorders were also not unusual (30% of cases). patients and 25% of patients). In addition to having immunocompromised disease, most had at least two comorbidities.
Katherine Kahn works at MedPage Today and covers the speed of infectious diseases. She has been a doctor for over 15 years.
Link-Gelles has become aware of potential conflicts of interest; Several other study authors reported ties to industry, Pfizer added.
Kotton reported on potential conflicts of interest.