Laboratory-Confirmed COVID-19 Among Adults Hospitalized with COVID-19-Like Illness with Infection-Induced or mRNA Vaccine-Induced SARS-CoV-2 Immunity - Nine States, January-September 2021.

Catherine H Bozio ,Monica Dickerson,Ousseny Zerbo,Rachael M Porter,Matthew E Levy,William F Fadel,Jennifer R Verani,Bruce Fireman,Eric P Griggs,Edward Stenehjem,Meredith Mcmorrow,Lenee Blanton,Manjusha Gaglani,Natalie Olson,Brian E Dixon,Charlene Mcevoy,Andrea Steffens,Sarah E Reese,Julie Arndorfer,Kempapura Murthy,Stephanie J Schrag,Mark G Thompson,Toan C Ong,Palak Patel,Anupam B Kharbanda,Kristin Dascomb,Sue Reynolds,Malini B Desilva,Jungmi Han,Jill Ferdinands,Chandni Raiyani,Jeremiah Williams,Nancy Grisel,Nicola P Klein,Kristin Goddard,Shaun J Grannis,Alicia M Fry,Suchitra Rao,Ned Lewis,Stephanie A Irving,Allison L Naleway,Patrick K Mitchell,Karthik Natarajan,Eduardo Azziz‐Baumgartner ,Rebecca Birch ,Peter J Embí ,Kristen Butterfield ,Sarah Ball ,I‐Chia Liao ,Elizabeth Rowley ,Nimish R Valvi ,Michelle A Barron ,Deying Yang

doi:10.15585/mmwr.mm7044e1

Abstract

Previous infection with SARS-CoV-2 (the virus that causes COVID-19) or COVID-19 vaccination can provide immunity and protection from subsequent SARS-CoV-2 infection and illness. CDC used data from the VISION Network* to examine hospitalizations in adults with COVID-19-like illness and compared the odds of receiving a positive SARS-CoV-2 test result, and thus having laboratory-confirmed COVID-19, between unvaccinated patients with a previous SARS-CoV-2 infection occurring 90-179 days before COVID-19-like illness hospitalization, and patients who were fully vaccinated with an mRNA COVID-19 vaccine 90-179 days before hospitalization with no previous documented SARS-CoV-2 infection. Hospitalized adults aged ≥18 years with COVID-19-like illness were included if they had received testing at least twice: once associated with a COVID-19-like illness hospitalization during January-September 2021 and at least once earlier (since February 1, 2020, and ≥14 days before that hospitalization). Among COVID-19-like illness hospitalizations in persons whose previous infection or vaccination occurred 90-179 days earlier, the odds of laboratory-confirmed COVID-19 (adjusted for sociodemographic and health characteristics) among unvaccinated, previously infected adults were higher than the odds among fully vaccinated recipients of an mRNA COVID-19 vaccine with no previous documented infection (adjusted odds ratio [aOR]=5.49; 95% confidence interval [CI]=2.75-10.99). These findings suggest that among hospitalized adults with COVID-19-like illness whose previous infection or vaccination occurred 90-179 days earlier, vaccine-induced immunity was more protective than infection-induced immunity against laboratory-confirmed COVID-19. All eligible persons should be vaccinated against COVID-19 as soon as possible, including unvaccinated persons previously infected with SARS-CoV-2.

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