SARS-CoV-2 vaccine protection and deaths among US veterans during 2021

We report severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine effectiveness against infection (VE-I) and death (VE-D) by vaccine type in 780,225 veterans in the Veterans Health Administration, covering 2.7% of the US population. From February to October 2021, VE-I declined for all vaccine types, and the decline was greatest for the Janssen vaccine, resulting in a VE-I of 13.1%. Although breakthrough infection increased risk of death, vaccination remained protective against death in persons who became infected during the Delta variant surge. From July to October 2021, VE-D for age <65 years was 73.0% for Janssen, 81.5% for Moderna, and 84.3% for Pfizer-BioNTech; VE-D for age >= 65 years was 52.2% for Janssen, 75.5% for Moderna, and 70.1% for Pfizer-BioNTech. Findings support continued efforts to increase vaccination, booster campaigns, and multiple additional layers of protection against infection.

Automated summary

This study reports the effectiveness of vaccines against SARS-CoV-2 infection and death in veterans, with a decline in vaccine effectiveness observed for all vaccine types. The decline was greatest for the Janssen vaccine. However, vaccination remained protective against death for individuals who became infected during the Delta variant surge. The study also found variations in the vaccine effectiveness against death among different age groups.