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COVID booster adds substantial protection against Omicron hospitalization

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Three doses of an mRNA COVID-19 vaccine during a time of Omicron variant predominance were tied to a 59% lower odds of hospitalization than two doses, although protection waned over time, finds a US case-control study published late last week in JAMA.A team led by a University of Chicago researcher used electronic health record data to estimate the odds of COVID-related hospitalization after the receipt of only the primary vaccination series (two doses) or a third (booster) dose of an mRNA vaccine among adults admitted to hospitals in the Providence Health & Services network in one of six Western states from Oct 1, 2021, to Jul 26, 2022.

During the study period, 81% of cases were attributed to the Omicron variant.Each of the 3,062 COVID-19 patients were matched 1:4 with 12,248 control patients admitted to the hospital for non-COVID indications within 3 days of the case-patient in the same geographic region and received a second vaccine dose (Pfizer/BioNTech or Moderna) within 7 days of the case-patient.

Average age was 70.8 years in case-patients and 67.1 in controls, and proportions of men were 52.6% and 46.7%, respectively.Protection waned after 4 or 5 monthsA multivariable analysis showed an association between a third dose and reduced odds of COVID-19 hospitalization (34.7% of case-patients vs 49.3% of controls; adjusted odds ratio [aOR], 0.41, or a 59% reduction).

The odds of hospitalization depended on time since the third dose (aOR at less than 50 days, 0.24; 50 to 100 days, 0.24; 101 to 150 days, 0.47; and after 150 days, 0.72).The researchers noted that studies comparing COVID-19 rates among recipients of a booster dose and their unvaccinated counterparts have found 55% to 99% lower odds of COVID-19 among those

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