{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T19:03:49Z","timestamp":1793300629152,"version":"4.5.0"},"reference-count":44,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n The incidence of SARS-CoV-2 infection, including among individuals who have received 2 doses of COVID-19 vaccine, increased substantially following the emergence of the Omicron variant in Ontario, Canada. Understanding the estimated effectiveness of 2 or 3 doses of COVID-19 vaccine against outcomes associated with Omicron and Delta infections may aid decision-making at the individual and population levels.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To estimate vaccine effectiveness (VE) against symptomatic infections due to the Omicron and Delta variants and severe outcomes (hospitalization or death) associated with these infections.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This test-negative case-control study used linked provincial databases for SARS-CoV-2 laboratory testing, reportable disease, COVID-19 vaccination, and health administration in Ontario, Canada. Participants were individuals aged 18 years or older who had COVID-19 symptoms or severe outcomes (hospitalization or death) and were tested for SARS-CoV-2 between December 6 and 26, 2021.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Receipt of 2 or 3 doses of the COVID-19 vaccine and time since last dose.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The main outcomes were symptomatic Omicron or Delta infection and severe outcomes (hospitalization or death) associated with infection. Multivariable logistic regression was used to estimate the effectiveness of 2 or 3 COVID-19 vaccine doses by time since the latest dose compared with no vaccination. Estimated VE was calculated using the formula VE\u2009=\u2009(1\u2009\u2013\u2009[adjusted odds ratio])\u2009\u00d7\u2009100%.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 134\u202f435 total participants, 16\u202f087 were Omicron-positive cases (mean [SD] age, 36.0 [14.1] years; 8249 [51.3%] female), 4261 were Delta-positive cases (mean [SD] age, 44.2 [16.8] years; 2199 [51.6%] female), and 114\u202f087 were test-negative controls (mean [SD] age, 42.0 [16.5] years; 67\u202f884 [59.5%] female). Estimated VE against symptomatic Delta infection decreased from 89% (95% CI, 86%-92%) 7 to 59 days after a second dose to 80% (95% CI, 74%-84%) after 240 or more days but increased to 97% (95% CI, 96%-98%) 7 or more days after a third dose. Estimated VE against symptomatic Omicron infection was 36% (95% CI, 24%-45%) 7 to 59 days after a second dose and 1% (95% CI, \u20138% to 10%) after 180 days or longer, but 7 or more days after a third dose, it increased to 61% (95% CI, 56%-65%). Estimated VE against severe outcomes was high 7 or more days after a third dose for both Delta (99%; 95% CI, 98%-99%) and Omicron (95%; 95% CI, 87%-98%).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this study, in contrast to high estimated VE against symptomatic Delta infection and severe outcomes after 2 doses of COVID-19 vaccine, estimated VE was modest and short term against symptomatic Omicron infection but better maintained against severe outcomes. A third dose was associated with improved estimated VE against symptomatic infection and with high estimated VE against severe outcomes for both variants. Preventing infection due to Omicron and potential future variants may require tools beyond the currently available vaccines.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.32760","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T12:27:51Z","timestamp":1663849671000},"page":"e2232760","source":"Crossref","is-referenced-by-count":233,"title":["Estimated Effectiveness of COVID-19 Vaccines Against Omicron or Delta Symptomatic Infection and Severe Outcomes"],"prefix":"10.1001","volume":"5","author":[{"given":"Sarah A.","family":"Buchan","sequence":"first","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, Canada"},{"name":"ICES, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Chung","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Brown","sequence":"additional","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, Canada"},{"name":"ICES, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Austin","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deshayne B.","family":"Fell","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada"},{"name":"School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada"},{"name":"Children\u2019s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan B.","family":"Gubbay","sequence":"additional","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, Canada"},{"name":"Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharifa","family":"Nasreen","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin L.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, Canada"},{"name":"ICES, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E.","family":"Sundaram","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina","family":"Tadrous","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada"},{"name":"Women\u2019s College Hospital, Toronto, Ontario, Canada"},{"name":"Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumanan","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada"},{"name":"Bruy\u00e8re Research Institute, Ottawa, Ontario, Canada"},{"name":"Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, Canada"},{"name":"ICES, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey C.","family":"Kwong","sequence":"additional","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, Canada"},{"name":"ICES, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2022,9,22]]},"reference":[{"key":"zoi220933r4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2119358","article-title":"Third BNT162b2 vaccination neutralization of SARS-CoV-2 Omicron infection.","author":"Nemet","year":"2021","journal-title":"N Engl J Med"},{"key":"zoi220933r6","article-title":"Reduced neutralisation of SARS-CoV-2 Omicron B.1.1.529 variant by post-immunisation serum.","author":"Dejnirattisai","year":"2021","journal-title":"Lancet"},{"issue":"7","key":"zoi220933r7","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1056\/NEJMc2119236","article-title":"SARS-CoV-2 Omicron variant neutralization in serum from vaccinated and convalescent persons.","volume":"386","author":"R\u00f6ssler","year":"2022","journal-title":"N Engl J Med"},{"key":"zoi220933r14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2119270","article-title":"Effectiveness of 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