Recombinant adjuvanted zoster vaccine and reduced risk of COVID-19 diagnosis, hospitalization in older adults

 Katia J. Bruxvoort, Bradley Ackerson, Lina S. Sy, Amit Bhavsar, Hung Fu Tseng, Ana Florea, Yi Luo, Yun Tian, Zendi Solano, Robyn Widenmaier, Meng Shi, Robbert Van Der Most, Johannes Eberhard Schmidt, Jasur Danier, Thomas Breuer, Lei Qian

doi: https://doi.org/10.1101/2021.10.01.21264400

This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

PDF: https://www.medrxiv.org/content/10.1101/2021.10.01.21264400v1.full.pdf

Abstract

Background Vaccines may elicit long-term boosting of innate immune responses that can help protect against COVID-19. We evaluated the association between recombinant adjuvanted zoster vaccine (RZV) and COVID-19 outcomes at Kaiser Permanente Southern California.

Methods In a cohort design, adults aged ≥50 years who received ≥1 RZV dose prior to 3/1/2020 were matched 1:2 to unvaccinated individuals and followed until 12/31/2020. Adjusted hazard ratios (aHR) and 95% confidence intervals (CIs) for COVID-19 outcomes were estimated using Cox proportional hazards regression. In a test-negative design, cases had a positive SARS-CoV-2 test and controls had only negative tests, from 3/1/2020-12/31/2020. Adjusted odds ratios (aOR) and 95% CIs for prior receipt of RZV were estimated using logistic regression.

Results In the cohort design, 149,244 RZV recipients were matched to 298,488 unvaccinated individuals. The aHRs (95% CI) for COVID-19 diagnosis and hospitalization were 0.84 (0.81-0.87) and 0.68 (0.64-0.74), respectively. In the test-negative design, 8.4% of 75,726 test-positive cases and 13.1% of 340,898 test-negative controls had received ≥1 RZV dose. The aOR (95% CI) was 0.84 (0.81-0.86).

Conclusion RZV vaccination was associated with a 16% lower risk of COVID-19 diagnosis and 32% lower risk of hospitalization, suggesting RZV elicits heterologous protection, possibly through trained immunity.

Competing Interest Statement

Dr. Ackerson, Dr. Bruxvoort, Dr. Florea, Dr. Luo, Dr. Qian, Ms. Solano, Ms. Sy, Ms. Tian, and Dr. Tseng received research funding from the GSK group of companies for work related to this paper. Dr. Ackerson, Dr. Bruxvoort, Dr. Qian, Ms. Solano, and Ms. Sy received research funding from Dynavax for work unrelated to this paper. Dr. Ackerson, Dr. Bruxvoort, Dr. Luo, Ms. Sy, and Dr. Tseng received research funding from Seqirus for work unrelated to this paper. Dr. Bruxvoort, Dr. Florea, and Ms. Solano received research funding from Gilead for work unrelated to this paper. Dr. Ackerson, Dr. Bruxvoort, Dr. Florea, Dr. Luo, Dr. Qian, Ms. Sy, Ms. Tian, and Dr. Tseng received research funding from Moderna for work unrelated to this paper. Dr. Ackerson, Dr. Bruxvoort, and Dr. Florea received research funding from Pfizer for work unrelated to this paper. KPSC received fees for consultation work with Johnson and Johnson by Dr. Tseng. Dr. Bhavsar, Ms. Widenmaier, Mr. Shi, Dr. Van Der Most, Dr. Schmidt, Dr. Danier, and Dr. Breuer were employees of the GSK group of companies at the time of the study conduct. Ms. Widenmaier, Dr. Van Der Most, Dr. Schmidt, Dr. Danier, and Dr. Breuer hold shares in the GSK group of companies. All authors do not have any non-financial relationships and activities to declare. This work was supported by GlaxoSmithKline Biologicals SA. Costs associated with manuscript editorial and coordination support were covered by GlaxoSmithKline Biologicals SA. The authors thank the members of Kaiser Permanente for helping to improve care through the use of information collected through our electronic health record systems. Editorial and coordination support was provided by Adrian Kremer (Modis c/o GSK).

Clinical Trial

This is a non-interventional observational trial that has been registered on the GSK-registry trial posting

Funding Statement

This work was supported by GlaxoSmithKline Biologicals SA. Costs associated with manuscript editorial and coordination support were covered by GlaxoSmithKline Biologicals SA. The authors thank the members of Kaiser Permanente for helping to improve care through the use of information collected through our electronic health record systems. Editorial and coordination support was provided by Adrian Kremer (Modis c/o GSK).

https://www.medrxiv.org/content/10.1101/2021.10.01.21264400v1