Effectiveness of a booster dose of COVID-19 vaccines during an outbreak
of SARS-CoV-2 Omicron BA.2 in China: A case-control study
Abstract
ABSTRACT Background: Real-world evidence on the
effectiveness of COVID-19 vaccines marketed in China against the Omicron
BA.2 variant remains scarce. Methods: A case-control study was
conducted to estimate the vaccine effectiveness (VE) of COVID-19
vaccines marketed in China, including inactivated vaccines, an Ad5-nCoV
vaccine, and a recombinant protein vaccine. The study included 414
participants infected with SARS-CoV-2 as cases and 828 individuals in
close contact with COVID-19 patients as controls during the outbreak of
the Omicron variant in April 2022 in Lu’an City, Anhui Province, China.
Controls were selected from core close contacts based on a random
sampling method with consecutive negative test results. Each case
corresponded to two controls. Results: A total of 414 cases and
828 controls were included in this study. Compared to unvaccinated
participants, the overall VE against Omicron BA.2 variant infection in
the vaccinated group with any COVID-19 vaccine was 35.0% (95% CI:
−9.1–61.3%), whereas the VE for booster vaccination was 51.6% (95%
CI: 15.2–72.4%). Subgroup analysis showed that the overall VE of the
Ad5-nCoV vaccine (65.8%, 95% CI: 12.8–86.6%) during the outbreak was
higher than that of the inactivated vaccine (35.5%,
95%CI:-8.6–61.7%) and recombinant protein vaccine (13.0%,
95%CI:-76.1–57%). COVID-19 vaccines offered 46.8% (95% CI:
9.5–68.7%) protection for infection within 6 months, and no protection
after 6 months. The VE of heterologous booster vaccination (76.4%, 95%
CI: 14.3–93.5%) was considerably higher than that of homologous
booster vaccination (51.8%, 95% CI: 9.6–74.3%). Conclusion:
Booster vaccination of COVID-19 vaccines marketed in China offered more
protection than full vaccination. A booster vaccination campaign for a
booster dose after three doses of a recombinant protein vaccine must be
urgently conducted. Keywords COVID-19 vaccines; Omicron;
vaccine effectiveness; inactivated vaccine; Ad5-nCoV vaccine;
recombinant protein vaccine