#Texas journaly 2 full

For example, two studies conducted at Kaiser Permanente Southern California show that VE-I decreased from 95% at 14 to 60 days to 79% at 151 to 180 days after vaccination for ages 18 to 64 years ( 29), and from 80% at 1 month to 43% at 5 months after vaccination for ages ≥65 years ( 31). Other US studies ( 29– 31), many conducted in large health care systems, similarly show declining VE-I as the Delta variant rose to dominance, with notable declines in older adults. The Delta variant is more infectious than other variants, likely because of increased viral load and transmission before symptoms ( 28). Although others have demonstrated high VE-I and VE-D in veterans during vaccine rollout through mid-March 2021 ( 27), our results suggest that vaccines are less effective in preventing infection associated with the Delta variant. Patterns of breakthrough SARS-CoV-2 infection among vaccinated veterans show a worrisome temporal trend, overlapping with the emergence of Delta as the dominant variant in the United States in July 2021. *Associations at each month were estimated from contrasts by using product terms for vaccination status by time in Cox proportional hazards models, including indicator terms for vaccination status (Janssen, Moderna, or Pfizer-BioNTech) product terms and age, sex, race, ethnicity, and comorbidity (Charlson Comorbidity score, overweight, type II diabetes, chronic obstructive pulmonary disease, bronchitis, acute respiratory failure, and chronic lung disease).

#Texas journaly 2 full

Vaccination status is modeled as time-varying, assigning follow-up time for veterans before the date of full vaccination as “unvaccinated time” and time after the date of full vaccination as “vaccinated time” vaccination is defined as (i) a single Janssen vaccine, (ii) two Moderna vaccines, or (iii) two Pfizer-BioNTech vaccines. Significance levels for all product terms were P < 0.0001. Time dependence was tested in Cox proportional hazards models by including product terms for vaccination status (Janssen, Moderna, Pfizer-BioNTech, or unvaccinated) by log(time)-Janssen*log(time), Moderna*log(time), Pfizer-BioNTech*log(time)-and adjusted for age, sex, race, ethnicity, and comorbidity (Charlson Comorbidity score, overweight, type II diabetes, chronic obstructive pulmonary disease, bronchitis, acute respiratory failure, and chronic lung disease). For unvaccinated veterans, infection was assessed beginning in 1 February 2021, coincident with broadscale vaccine eligibility in the VA. For vaccinated veterans, infection was assessed 15 days after the last vaccine that established full vaccination status. Breakthrough infections, illness, hospitalizations, and deaths have since continued to emerge in vaccine recipients.Īdjusted hazard ratio <1.0 indicates lower risk of infection for vaccine, shown compared with unvaccinated. Initial reports, including follow-up of the Pfizer-BioNTech and Moderna trials ( 6– 8), suggested sustained vaccine protection ( 9), but three reports by the US Centers for Disease Control and Prevention (CDC) in August 2021 ( 10– 12) demonstrated that protection against infection had declined in mid-summer as the Delta variant rose to dominance protection against hospitalization and death remained high ( 13– 15). However, by July 2021, the United States experienced a surge in cases of COVID-19, dominated by the B.1.617.2 (Delta) variant ( 4, 5). Vaccines have also reduced the incidence of asymptomatic infection and associated infectivity ( 3). The mRNA vaccines BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) and the viral vector vaccine JNJ-78436735 (Janssen) have effectively prevented clinically recognized disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since their rollout in the United States in late 2020 ( 1, 2).