By Stan Deresinski, MD, FACP, FIDSA
Clinical Professor of Medicine, Stanford University
SYNOPSIS: Vaccine booster doses were highly effective in preventing infection, whether symptomatic or asymptomatic, with the Omicron variant of SARS-CoV-2 in National Basketball Association players and staff.
SOURCE: Tai CG, Maragakis LL, Connolly S, et al. Association between COVID-19 booster vaccination and Omicron infection in a highly vaccinated cohort of players and staff in the National Basketball Association. JAMA 2022; June 2. doi: 10.1001/jama.2022.9479. [Online ahead of print].
Tai and colleagues examined the efficacy of booster vaccination in the prevention of infection with the Omicron variant of SARS-CoV-2 in players and staff of the National Basketball Association (NBA). Those included had been tested by polymerase chain reaction (PCR) two or more times between Dec. 1, 2021, and Jan. 15, 2022. Testing was performed during daily surveillance when multiple team cases occurred, after a known exposure, and upon development of symptoms. Vaccination and booster doses were required of staff, with the latter to have been completed by Jan. 5, 2022, while players were not required to be vaccinated. Masking was required except while playing basketball. Two-thirds of the 2,613 players and staff were followed for the entire 45-day period of study, providing 74,165 and 10,890 person-days of observation of fully boosted and vaccinated but not boosted, respectively. Fully boosted individuals were at significantly lower risk of acquiring confirmed infection than unboosted ones, with an adjusted hazard ratio (HR), 0.43; 95% confidence interval (CI), 0.35-0.53; P < 0.001. There were no deaths and no hospitalizations. Genomic sequencing was performed on 339 viral isolates, and 93% were Omicron subvariants.
COMMENTARY
The ability of Omicron to evade immune protection resulting from either natural infection or vaccination continues to be of concern. The study confirms the efficacy of boosting against both symptomatic and asymptomatic infections in a young, healthy population. However, as the authors pointed out, the study period occurred in temporal proximity to boosting and does not take into account waning immunity over time — which may require a second booster dose, as is now recommended for older individuals.
At any rate, this program allowed the NBA to uneventfully complete its season.
Vaccine booster doses were highly effective in preventing infection, whether symptomatic or asymptomatic, with the omicron variant of SARS-CoV-2 in National Basketball Association players and staff.
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