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Relative Vaccine Protection, Disease Severity and Symptoms Associated with Infection with SARS-CoV-2 Omicron Subvariant Ba.2.86 and Descendent Jn.1: A Danish Nationwide Register-Based Study

30 Pages Posted: 8 Feb 2024

See all articles by Ida Rask Moustsen-Helms

Ida Rask Moustsen-Helms

Statens Serum Institut

Peter Bager

Statens Serum Institut - Department of Epidemiology Research

Tine Graakjær Larsen

Statens Serum Institut

Frederik Trier Møller

Statens Serum Institut

Lasse Skafte Vestergaard

Statens Serum Institut

Lasse Engbo Christiansen

Statens Serum Institut - Department of Epidemiology Research

Sophie Madeleine Gubbels

Statens Serum Institut - Department of Data Management and Analysis

Ramona Trebbien

Statens Serum Institut

Vithiagaran Gunalan

Statens Serum Institut - Virus Research & Development Laboratory

Aleksander Ring

Statens Serum Institut

Marc Bennedbaek

Statens Serum Institut - Virus Research & Development Laboratory

Casper Westergaard

Statens Serum Institut

Leandro Andrés Escobar-Herrera

Statens Serum Institut

Nina Steenhard

Statens Serum Institut

Esben Mørk Hartmann

Statens Serum Institut

Lene Nielsen

Herlev Hospital

Dorte Terp Andersen

Southwest Jutland Hospital

Marianne Kragh Thomsen

Aarhus University - Department of Infectious Diseases

Ea Sofie Marmolin

Vejle Hospital

Thomas Vognbjerg Sydenham

Odense University Hospital

Silje Vermedal Hoeg

Odense University Hospital

Mette Pinholt

University of Copenhagen - Hvidovre Hospital

Josefine Tange Møller

Zealand University Hospital

Tina Vasehus Madsen

Slagelse University Hospital

David Fuglsang-Damgaard

Aalborg University Hospital

Pikka Jokelainen

University of Southern Denmark

Tyra Grove Krause

Statens Serum Institut

Henrik Ullum

Statens Serum Institut

Bolette Søborg

Statens Serum Institut - Infectious Disease Epidemiology & Prevention

Palle Valentiner-Branth

Statens Serum Institut - Infectious Disease Epidemiology & Prevention

Morten Rasmussen

Statens Serum Institut - Virus Research & Development Laboratory

Christian Holm Hansen

Statens Serum Institut - Infectious Disease Epidemiology & Prevention

More...

Abstract

Background: Using nation-wide Danish register data, we investigated whether BA.2.86, including JN.1, differed from other circulating variants in terms of ability to escape vaccine protection, risk of severe disease, and self-reported symptoms.

Methods: We included all Danish residents over 65 years of age with a positive SARS-CoV-2 PCR test and available genomic variant data between October 1, 2023 and December 10, 2023. Data from clinical testing, sentinel and self-sampling-based surveillance were linked with national electronic civil, vaccination and hospitalisation registers. Relative vaccine protection and risk of hospitalisation were analysed in case-control studies adjusted for time, comorbidities, and prior vaccination history among other potential confounders. 

Findings: Of the 2,540 COVID-19 cases included in the study, 989 (39%) were infected with the BA.2.86 variant, including 592 JN.1 infections. The adjusted odds of infection with BA.2.86 versus a non-BA.2.86-related variant, were 1.56 (95% CI 1.24–1.96) times higher, and the odds of infection due to JN.1 as opposed to a non-BA.2.86-related variant, were 1.64 (1.24–2.17) times higher for XBB.1.5 vaccinated cases compared to unvaccinated cases. The severity analysis showed no evidence of association between variant and risk of COVID-19 hospitalisation (OR 1.03, 95% CI 0.83–1.28 for BA.2.86 and OR 1.08, 95% CI 0.81–1.43 for JN.1*). Similarly, we found no evidence of differences by variant across self-reported symptoms.

Interpretation:BA.2.86, and in particular the JN.1 sublineage, were less sensitive to vaccine-induced immune protection from the XBB.1.5 updated vaccine, but with no evidence of increased disease severity or different symptom profiles.

Funding: This study was conducted as part of the Danish COVID-19 surveillance. Additional characterisation was supported by co-funding from the European Union’s EU4Health programme under Grant Agreement Nr 101102733 DURABLE. TGL is a fellow of the ECDC Fellowship Programme, supported financially by the European Centre for Disease Prevention and Control.

Declaration of Interest: We have no competing interests to declare.

Ethical Approval: This study was performed under the authority task of the Danish National Infectious Disease Control Institute, which allows Statens Serum Institut to perform analyses on data from existing national COVID-19 surveillance systems. According to Danish law, ethical approval or individual consent is not required for anonymized aggregated register-based studies.

Keywords: COVID-19, variant, severity, vaccine effectiveness

Suggested Citation

Moustsen-Helms, Ida Rask and Bager, Peter and Graakjær Larsen, Tine and Møller, Frederik Trier and Skafte Vestergaard, Lasse and Engbo Christiansen, Lasse and Gubbels, Sophie Madeleine and Trebbien, Ramona and Gunalan, Vithiagaran and Ring, Aleksander and Bennedbaek, Marc and Westergaard, Casper and Andrés Escobar-Herrera, Leandro and Steenhard, Nina and Mørk Hartmann, Esben and Nielsen, Lene and Andersen, Dorte Terp and Thomsen, Marianne Kragh and Marmolin, Ea Sofie and Sydenham, Thomas Vognbjerg and Vermedal Hoeg, Silje and Pinholt, Mette and Tange Møller, Josefine and Madsen, Tina Vasehus and Fuglsang-Damgaard, David and Jokelainen, Pikka and Grove Krause, Tyra and Ullum, Henrik and Søborg, Bolette and Valentiner-Branth, Palle and Rasmussen, Morten and Hansen, Christian Holm, Relative Vaccine Protection, Disease Severity and Symptoms Associated with Infection with SARS-CoV-2 Omicron Subvariant Ba.2.86 and Descendent Jn.1: A Danish Nationwide Register-Based Study. Available at SSRN: https://ssrn.com/abstract=4716761 or http://dx.doi.org/10.2139/ssrn.4716761

Peter Bager

Statens Serum Institut - Department of Epidemiology Research

Tine Graakjær Larsen

Statens Serum Institut ( email )

Denmark

Frederik Trier Møller

Statens Serum Institut ( email )

Denmark

Lasse Skafte Vestergaard

Statens Serum Institut ( email )

Denmark

Lasse Engbo Christiansen

Statens Serum Institut - Department of Epidemiology Research ( email )

Sophie Madeleine Gubbels

Statens Serum Institut - Department of Data Management and Analysis ( email )

Copenhagen
Denmark

Ramona Trebbien

Statens Serum Institut ( email )

Vithiagaran Gunalan

Statens Serum Institut - Virus Research & Development Laboratory ( email )

Aleksander Ring

Statens Serum Institut ( email )

Denmark

Marc Bennedbaek

Statens Serum Institut - Virus Research & Development Laboratory ( email )

Casper Westergaard

Statens Serum Institut ( email )

Denmark

Leandro Andrés Escobar-Herrera

Statens Serum Institut ( email )

Denmark

Nina Steenhard

Statens Serum Institut ( email )

Esben Mørk Hartmann

Statens Serum Institut ( email )

Denmark

Lene Nielsen

Herlev Hospital ( email )

Denmark

Dorte Terp Andersen

Southwest Jutland Hospital ( email )

Marianne Kragh Thomsen

Aarhus University - Department of Infectious Diseases ( email )

Ea Sofie Marmolin

Vejle Hospital ( email )

Vejle
Denmark

Thomas Vognbjerg Sydenham

Odense University Hospital ( email )

Silje Vermedal Hoeg

Odense University Hospital ( email )

Mette Pinholt

University of Copenhagen - Hvidovre Hospital ( email )

Josefine Tange Møller

Zealand University Hospital ( email )

Tina Vasehus Madsen

Slagelse University Hospital ( email )

David Fuglsang-Damgaard

Aalborg University Hospital ( email )

Pikka Jokelainen

University of Southern Denmark ( email )

Tyra Grove Krause

Statens Serum Institut

Denmark

Henrik Ullum

Statens Serum Institut ( email )

Bolette Søborg

Statens Serum Institut - Infectious Disease Epidemiology & Prevention ( email )

Copenhagen
Denmark

Palle Valentiner-Branth

Statens Serum Institut - Infectious Disease Epidemiology & Prevention

Morten Rasmussen

Statens Serum Institut - Virus Research & Development Laboratory ( email )

Copenhagen
Denmark

Christian Holm Hansen

Statens Serum Institut - Infectious Disease Epidemiology & Prevention