Top 5 Takeaways

1. Effectiveness of Vaccination: COVID-19 vaccines are highly effective in preventing severe outcomes and deaths, with only 0.015% experiencing severe outcomes and 0.0033% dying among those vaccinated.
2. Risk Factors Identified: Severe outcomes were more common in individuals aged ≥65 years, those who were immunosuppressed, and those with underlying conditions such as pulmonary, liver, kidney, neurologic, cardiac diseases, and diabetes.
3. Targeted Interventions Needed: Older adults, immunosuppressed individuals, and those with underlying conditions should receive targeted interventions like chronic disease management, additional vaccine doses, and effective pharmaceutical therapy.
4. Monoclonal Antibody Therapy: Among those who received anti–SARS-CoV-2 monoclonal therapy, none experienced severe outcomes, highlighting its potential benefit.
5. Vaccination Coverage Priority: Increasing COVID-19 vaccination coverage remains a critical public health priority to mitigate severe outcomes.

Original Article Author and Citation

Corresponding Author

Sameer S. Kadri, sameer.kadri@nih.gov

Suggested Citation

Yek C, Warner S, Wiltz JL, et al. Risk Factors for Severe COVID-19 Outcomes Among Persons Aged ≥18 Years Who Completed a Primary COVID-19 Vaccination Series — 465 Health Care Facilities, United States, December 2020–October 2021. MMWR Morb Mortal Wkly Rep 2022;71:19–25. DOI: http://dx.doi.org/10.15585/mmwr.mm7101a4

Summary

This study evaluated the frequency and risk factors for severe COVID-19 outcomes among 1,228,664 individuals who completed a primary COVID-19 vaccination series between December 2020 and October 2021. Severe outcomes were rare, with 0.015% experiencing severe outcomes and 0.0033% dying. Risk factors included age ≥65 years, immunosuppression, and six other underlying conditions. All individuals with severe outcomes had at least one risk factor, and 78% of those who died had at least four.

Methods

Data from 465 facilities in the Premier Healthcare Database Special COVID-19 Release were analyzed. The study included individuals who completed primary vaccination and excluded those with partial vaccination. Severe outcomes were defined as acute respiratory failure, need for noninvasive ventilation, ICU admission, or death. Logistic regression was used to estimate the odds of severe versus nonsevere outcomes, considering various covariates.

Discussion

The study found that severe COVID-19 outcomes were rare among vaccinated individuals but were more likely in those aged ≥65 years, immunosuppressed, or with underlying conditions. The findings underscore the importance of targeted interventions for at-risk populations and the need for increased vaccination coverage. The study also highlighted the potential benefits of monoclonal antibody therapy in preventing severe outcomes.

Conclusion

Severe COVID-19 outcomes after primary vaccination are rare but more likely in certain high-risk groups. Targeted interventions and increased vaccination coverage are essential to mitigate these risks. The study’s findings provide valuable insights for public health strategies to protect vulnerable populations.

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