Protection of Homologous and Heterologous Vaccine Boosters Against COVID-19 in Singapore

Tan SHX, Pung R, Wang L, et al. Association of Homologous and Heterologous Vaccine Boosters With COVID-19 Incidence and Severity in Singapore. JAMA. Published online February 11, 2022. doi:10.1001/jama.2022.1922

22 Pages Posted: 5 Jan 2022 Last revised: 7 Mar 2022

See all articles by Sharon Tan

Sharon Tan

National University of Singapore (NUS) - Saw Swee Hock School of Public Health

Rachael Pung

Government of the Republic of Singapore - Communicable Diseases Division

Lin-Fa Wang

Duke NUS Medical School

David Chien Lye

National Centre for Infectious Diseases

Benjamin Ong

Ministry of Health, Singapore

Alex R. Cook

National University of Singapore (NUS) - Saw Swee Hock School of Public Health; National University Health System (NUHS)

Kelvin Bryan Tan

Ministry of Health, Singapore

Date Written: November 16, 2021

Abstract

Despite fully vaccinating over 80% of the total population in Singapore, COVID-19 cases surged in September 2021 with the relaxation of social distancing, isolation and quarantine measures. A COVID-19 vaccine booster program (with 30mcg BNT162b2 or 50mcg mRNA-1273) was launched on September 15, 2021 for older adults aged 60 years and above who completed their primary vaccination at least 6 months prior. Using a Poisson regression, we estimated the incidence rate ratio of confirmed infections and severe disease between booster and non-booster groups, and compared the effectiveness of homologous and heterologous boosting. Rates of confirmed and severe infections were 73% (95% CI, 71% to 75%) and 95% (95% CI, 91% to 97%) lower respectively among the booster group. Heterologous boosting conferred greater protection, with the PPM (Moderna booster after Pfizer-BioNTech primary series) group obtaining 82% (95% CI, 77% to 86%) booster effectiveness, versus 73% (95% CI, 71% to 74%) for the PPP (three Pfizer-BioNTech shots) group. Our study confirms the effectiveness of a mRNA vaccine booster dose against infections and severe diseases.

Note:
Funding: Nil.

Declaration of Interests: Nil.

Keywords: Coronavirus Disease 2019, COVID-19, severe acute respiratory syndrome coronavirus 2, SARS-CoV-2, Vaccination

Suggested Citation

Tan, Sharon and Pung, Rachael and Wang, Lin-Fa and Lye, David Chien and Ong, Benjamin and Cook, Alex R. and Tan, Kelvin Bryan, Protection of Homologous and Heterologous Vaccine Boosters Against COVID-19 in Singapore (November 16, 2021). Tan SHX, Pung R, Wang L, et al. Association of Homologous and Heterologous Vaccine Boosters With COVID-19 Incidence and Severity in Singapore. JAMA. Published online February 11, 2022. doi:10.1001/jama.2022.1922, Available at SSRN: https://ssrn.com/abstract=3995101 or http://dx.doi.org/10.2139/ssrn.3995101

Sharon Tan (Contact Author)

National University of Singapore (NUS) - Saw Swee Hock School of Public Health ( email )

12 Science Drive 2
#10-01
117549
Singapore

Rachael Pung

Government of the Republic of Singapore - Communicable Diseases Division ( email )

12 College Road
169852
Singapore

Lin-Fa Wang

Duke NUS Medical School

Singapore

David Chien Lye

National Centre for Infectious Diseases

Singapore

Benjamin Ong

Ministry of Health, Singapore ( email )

College of Medicine
16 College Road
Singapore, 169854
Singapore

Alex R. Cook

National University of Singapore (NUS) - Saw Swee Hock School of Public Health ( email )

12 Science Drive 2
#10-01
117549
Singapore

National University Health System (NUHS) ( email )

1E, Kent Ridge Road
119228
Singapore

Kelvin Bryan Tan

Ministry of Health, Singapore ( email )

College of Medicine
16 College Road
Singapore, 169854
Singapore

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