Effectiveness of Heterologous and Homologous Ad26.COV2.S Vaccine Boosting in Preventing COVID-19-Related Outcomes Among Individuals with a Completed Primary Vaccination Series in the United States

<b>Background/Objectives:</b> COVID-19 vaccines have significantly reduced the mortality and morbidity associated with SARS-CoV-2. In the fall of 2021, the U.S. Food and Drug Administration amended its emergency use authorization guidelines for COVID-19 vaccines to allow the administrati...

Full description

Saved in:
Bibliographic Details
Main Authors: Mawuli Nyaku, Lara S. Yoon, Deborah Ricci, Lexie Rubens, Paige Sheridan, Monica Iyer, Thomas Zhen, Raymond A. Harvey, Ann Madsen
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Vaccines
Subjects:
Online Access:https://www.mdpi.com/2076-393X/13/2/166
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849718831167045632
author Mawuli Nyaku
Lara S. Yoon
Deborah Ricci
Lexie Rubens
Paige Sheridan
Monica Iyer
Thomas Zhen
Raymond A. Harvey
Ann Madsen
author_facet Mawuli Nyaku
Lara S. Yoon
Deborah Ricci
Lexie Rubens
Paige Sheridan
Monica Iyer
Thomas Zhen
Raymond A. Harvey
Ann Madsen
author_sort Mawuli Nyaku
collection DOAJ
description <b>Background/Objectives:</b> COVID-19 vaccines have significantly reduced the mortality and morbidity associated with SARS-CoV-2. In the fall of 2021, the U.S. Food and Drug Administration amended its emergency use authorization guidelines for COVID-19 vaccines to allow the administration of booster vaccine doses based on sound scientific evidence of the increase in effectiveness conferred by boosters. The effectiveness of the Ad26.COV2.S COVID-19 booster vaccine during the periods of Delta and Omicron variant dominance is unknown. This study used real-world data to estimate the effectiveness of booster heterologous or homologous Ad26.COV2.S vaccination compared to that of a primary Ad26.COV2.S or mRNA COVID-19 vaccination series. <b>Methods:</b> A retrospective, observational, longitudinal cohort study design was used with a total eligible sample population consisting of 72,461,026 individuals in the HealthVerity dataset. The study cohort consisted of individuals ≥18 years in the United States with evidence of a COVID-19 primary vaccination series (Ad26.COV2.S or mRNA) administered between 1 January 2021 and 6 July 2022. Two exposure groups were considered based on retrospective database classification: a heterologous Ad26.COV2.S booster and a homologous Ad26.COV2.S booster. Individuals eligible for the referent groups, defined as those with a primary vaccine series alone, were identified through exact matching by age, sex, time since primary series vaccine, location, and Gagne comorbidity score. Propensity score-matched Cox proportional hazards models were used to evaluate outcomes, including COVID-19-related hospitalization and medically attended COVID-19. <b>Results:</b> Depending on the comparison group of interest, the adjusted hazard ratios for COVID-19-related hospitalization ranged from 0.63 (95% CI: 0.56, 0.72) to 0.82 (95% CI: 0.75, 0.90), and 0.93 (95% CI: 0.90, 0.96) to 0.94 (95% CI: 0.91, 0.97) for medically attended COVID-19, both favoring booster vaccination. <b>Conclusions:</b> The results of this study demonstrate the effectiveness of an Ad26.COV2.S booster vaccination compared to primary series vaccination in preventing COVID-19 hospitalization and medically attended COVID-19 for at least 12 months. This study adds to the scientific evidence that demonstrates the importance of COVID-19 booster vaccinations to support public health policy.
format Article
id doaj-art-d074eeebe509420bb692fffca0a29e5d
institution DOAJ
issn 2076-393X
language English
publishDate 2025-02-01
publisher MDPI AG
record_format Article
series Vaccines
spelling doaj-art-d074eeebe509420bb692fffca0a29e5d2025-08-20T03:12:16ZengMDPI AGVaccines2076-393X2025-02-0113216610.3390/vaccines13020166Effectiveness of Heterologous and Homologous Ad26.COV2.S Vaccine Boosting in Preventing COVID-19-Related Outcomes Among Individuals with a Completed Primary Vaccination Series in the United StatesMawuli Nyaku0Lara S. Yoon1Deborah Ricci2Lexie Rubens3Paige Sheridan4Monica Iyer5Thomas Zhen6Raymond A. Harvey7Ann Madsen8Johnson & Johnson Innovative Medicine, Data Science and Digital Health, Spring House, PA 19002, USAAetion Inc., New York, NY 10001, USAJohnson & Johnson Innovative Medicine, Data Science and Digital Health, Spring House, PA 19002, USAAetion Inc., New York, NY 10001, USAAetion Inc., New York, NY 10001, USAAetion Inc., New York, NY 10001, USAAetion Inc., New York, NY 10001, USAJohnson & Johnson Innovative Medicine, Data Science and Digital Health, Spring House, PA 19002, USAAetion Inc., New York, NY 10001, USA<b>Background/Objectives:</b> COVID-19 vaccines have significantly reduced the mortality and morbidity associated with SARS-CoV-2. In the fall of 2021, the U.S. Food and Drug Administration amended its emergency use authorization guidelines for COVID-19 vaccines to allow the administration of booster vaccine doses based on sound scientific evidence of the increase in effectiveness conferred by boosters. The effectiveness of the Ad26.COV2.S COVID-19 booster vaccine during the periods of Delta and Omicron variant dominance is unknown. This study used real-world data to estimate the effectiveness of booster heterologous or homologous Ad26.COV2.S vaccination compared to that of a primary Ad26.COV2.S or mRNA COVID-19 vaccination series. <b>Methods:</b> A retrospective, observational, longitudinal cohort study design was used with a total eligible sample population consisting of 72,461,026 individuals in the HealthVerity dataset. The study cohort consisted of individuals ≥18 years in the United States with evidence of a COVID-19 primary vaccination series (Ad26.COV2.S or mRNA) administered between 1 January 2021 and 6 July 2022. Two exposure groups were considered based on retrospective database classification: a heterologous Ad26.COV2.S booster and a homologous Ad26.COV2.S booster. Individuals eligible for the referent groups, defined as those with a primary vaccine series alone, were identified through exact matching by age, sex, time since primary series vaccine, location, and Gagne comorbidity score. Propensity score-matched Cox proportional hazards models were used to evaluate outcomes, including COVID-19-related hospitalization and medically attended COVID-19. <b>Results:</b> Depending on the comparison group of interest, the adjusted hazard ratios for COVID-19-related hospitalization ranged from 0.63 (95% CI: 0.56, 0.72) to 0.82 (95% CI: 0.75, 0.90), and 0.93 (95% CI: 0.90, 0.96) to 0.94 (95% CI: 0.91, 0.97) for medically attended COVID-19, both favoring booster vaccination. <b>Conclusions:</b> The results of this study demonstrate the effectiveness of an Ad26.COV2.S booster vaccination compared to primary series vaccination in preventing COVID-19 hospitalization and medically attended COVID-19 for at least 12 months. This study adds to the scientific evidence that demonstrates the importance of COVID-19 booster vaccinations to support public health policy.https://www.mdpi.com/2076-393X/13/2/166COVID-19adenovirus vaccinebooster vaccinereal-world datareal-world evidence
spellingShingle Mawuli Nyaku
Lara S. Yoon
Deborah Ricci
Lexie Rubens
Paige Sheridan
Monica Iyer
Thomas Zhen
Raymond A. Harvey
Ann Madsen
Effectiveness of Heterologous and Homologous Ad26.COV2.S Vaccine Boosting in Preventing COVID-19-Related Outcomes Among Individuals with a Completed Primary Vaccination Series in the United States
Vaccines
COVID-19
adenovirus vaccine
booster vaccine
real-world data
real-world evidence
title Effectiveness of Heterologous and Homologous Ad26.COV2.S Vaccine Boosting in Preventing COVID-19-Related Outcomes Among Individuals with a Completed Primary Vaccination Series in the United States
title_full Effectiveness of Heterologous and Homologous Ad26.COV2.S Vaccine Boosting in Preventing COVID-19-Related Outcomes Among Individuals with a Completed Primary Vaccination Series in the United States
title_fullStr Effectiveness of Heterologous and Homologous Ad26.COV2.S Vaccine Boosting in Preventing COVID-19-Related Outcomes Among Individuals with a Completed Primary Vaccination Series in the United States
title_full_unstemmed Effectiveness of Heterologous and Homologous Ad26.COV2.S Vaccine Boosting in Preventing COVID-19-Related Outcomes Among Individuals with a Completed Primary Vaccination Series in the United States
title_short Effectiveness of Heterologous and Homologous Ad26.COV2.S Vaccine Boosting in Preventing COVID-19-Related Outcomes Among Individuals with a Completed Primary Vaccination Series in the United States
title_sort effectiveness of heterologous and homologous ad26 cov2 s vaccine boosting in preventing covid 19 related outcomes among individuals with a completed primary vaccination series in the united states
topic COVID-19
adenovirus vaccine
booster vaccine
real-world data
real-world evidence
url https://www.mdpi.com/2076-393X/13/2/166
work_keys_str_mv AT mawulinyaku effectivenessofheterologousandhomologousad26cov2svaccineboostinginpreventingcovid19relatedoutcomesamongindividualswithacompletedprimaryvaccinationseriesintheunitedstates
AT larasyoon effectivenessofheterologousandhomologousad26cov2svaccineboostinginpreventingcovid19relatedoutcomesamongindividualswithacompletedprimaryvaccinationseriesintheunitedstates
AT deborahricci effectivenessofheterologousandhomologousad26cov2svaccineboostinginpreventingcovid19relatedoutcomesamongindividualswithacompletedprimaryvaccinationseriesintheunitedstates
AT lexierubens effectivenessofheterologousandhomologousad26cov2svaccineboostinginpreventingcovid19relatedoutcomesamongindividualswithacompletedprimaryvaccinationseriesintheunitedstates
AT paigesheridan effectivenessofheterologousandhomologousad26cov2svaccineboostinginpreventingcovid19relatedoutcomesamongindividualswithacompletedprimaryvaccinationseriesintheunitedstates
AT monicaiyer effectivenessofheterologousandhomologousad26cov2svaccineboostinginpreventingcovid19relatedoutcomesamongindividualswithacompletedprimaryvaccinationseriesintheunitedstates
AT thomaszhen effectivenessofheterologousandhomologousad26cov2svaccineboostinginpreventingcovid19relatedoutcomesamongindividualswithacompletedprimaryvaccinationseriesintheunitedstates
AT raymondaharvey effectivenessofheterologousandhomologousad26cov2svaccineboostinginpreventingcovid19relatedoutcomesamongindividualswithacompletedprimaryvaccinationseriesintheunitedstates
AT annmadsen effectivenessofheterologousandhomologousad26cov2svaccineboostinginpreventingcovid19relatedoutcomesamongindividualswithacompletedprimaryvaccinationseriesintheunitedstates