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Covid19NCT04912700

The Impact of Vaccination on Severity of Illness in COVID-19

An observational study of Covid19, run by Corewell Health East at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

With the FDA's emergency use authorization declaration in December of 2020, the Pfizer-BioNtech vaccine became the first of several vaccines to kick off the mass vaccination effort across the United States against CoronaVIrus Disease 2019 (COVID-19). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Covid19
What is being tested?
COVID-19 vaccine
Type of treatment
Vaccines
How many people
11,834 participants
Where
1 siteUnited States
Study dates
1 Jun 2021to 7 Jun 2021
Phase
Observational
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Consecutive patients during study period with COVID-19 infection and EC visit.

Who may be able to join

  • All patients presenting to Beaumont Health emergency departments who have tested positive for COVID-19 between December 15, 2020 and April 30, 2021 with available vaccination data through state of Michigan registry.

Who cannot join

  • Patients who have previously tested positive for COVID-19 prior to the study period will be excluded.
  • Patients with missing vaccine status will be excluded.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Beaumont Hospital - Royal Oak

    Royal Oak, Michigan, 48073

Other trials in United States

About this study

Official title: The Impact of Vaccination on Severity of Illness in COVID-19: A Multicenter Cohort Study

With the FDA's emergency use authorization declaration in December of 2020, the Pfizer-BioNtech vaccine became the first of several vaccines to kick off the mass vaccination effort across the United States against CoronaVIrus Disease 2019 (COVID-19). Subsequently, Moderna as well as Johnson and Johnson both had vaccines receive emergency use authorization. While the Pfizer and the Moderna vaccines both utilize novel mRNA technology, Johnson and Johnson's vaccine uses a viral vector that has been used previously in both the approved European Ebola vaccine and a trial vaccine for HIV. However, none of these vaccine types have previously been approved in the United States. While preliminary data from safety and efficacy trials have shown positive results, actual-world data on its effectiveness is still lacking. Several small cohort studies and one large trial from Israel are currently the only insights into the actual rates of infection, hospitalization, and severe illness among vaccinated individuals. As COVID-19 variants, with the potential to reduce vaccine efficacy, continue to emerge worldwide, there is a need of more data regarding the real-world effectiveness of our current mass vaccination efforts.

Vaccination efforts in the State of Michigan have been ongoing since December 2020. Given that approximately 33.7% of the state's population is either partially or fully vaccinated, it is unclear why the number of cases has risen so dramatically or if immunization efforts can help the situation.

Given the current situation in the State of Michigan, this study will evaluate the efficacy of COVID-19 vaccination on rates of hospital visits and severe illness when breakthrough Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) infection occurs in a region with high incidence of variant strain disease.

Read the detailed description

A retrospective chart review of all patients presenting to Beaumont Health System emergency departments between December 15, 2020 and April 30, 2021 who tested positive for COVID-19 will be performed. The primary aim is to compare the rate of Emergency Department (ED) presentations/hospitalizations among unvaccinated, partially vaccinated, and fully vaccinated patients presenting to an emergency center (EC). Secondarily, the rates of individual clinical outcomes of COVID-19 infection for hospitalized patients will be compared among unvaccinated, partially vaccinated, and fully vaccinated patients, including the proportion of COVID-positive patients who develop severe disease, require admission to the hospital, and rates of those requiring intensive care unit (ICU) admission, mechanical ventilation, extracorporeal membrane oxygenation (ECMO), renal replacement therapy (RRT), supplemental oxygenation, or noninvasive ventilation, as well as the rate of in-hospital mortality and the hospital length of stay. Exploratory outcomes may include comparisons among fully-vaccinated individuals receiving each of the three types of vaccines, and investigation of demographic, epidemiological, clinical and laboratory predictors of hospitalization. For each individual, data collected will include vital signs (temperature, blood pressure, heart rate, respiratory rate, pulse oximetry), demographics (age, gender, existing medical conditions), home medications, chief complaint from emergency provider note, duration of symptoms in days at the time of presentation from emergency provider note, chest X-ray or chest computed tomography (CT) results, and laboratory values. For patients who were admitted, data collected will include initial hospital admission unit (regular medical or surgical floor, progressive floor, intensive care unit), change in unit type during admission, oxygen therapy (none, nasal cannula, supplemental high flow oxygen, ventilator), days on high flow oxygen, days on ventilator, specific inpatient medical therapies, laboratory values, imaging results, hospital length of stay, and disposition from hospital (home, rehabilitation unit, death).

Conditions
Covid19
Being tested
COVID-19 vaccine
Keywords
vaccination, efficacy, severe outcomes, mortality, variants, breakthrough infection, COVID-19, SARS-Cov-2 virus
Medical subject headings
COVID-19, Breakthrough Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • COVID-19 vaccineBiological

    Also called Pfizer vaccine, Moderna vaccine, Johnson & Johnson vaccine

    Full or partial reception of vaccine

Study groups in NCT04912700
Study groupRoleWhat they receive
UnvaccinatedUnvaccinated individuals are defined as having positive laboratory COVID-19 testing with no record of immunization against COVID-19 or first-dose vaccination after symptom onset.
Partially vaccinatedPartially vaccinated individuals are defined as having positive laboratory COVID-19 testing and symptom onset after a single dose of either mRNA (Pfizer, Moderna) vaccine, or < 14 days after the second dose of either mRNA vaccine (Pfizer, Moderna) or < 14 days after the administration of the single dose of viral vector vaccine (Johnson \& Johnson).
Receives: Biological: COVID-19 vaccine
Fully vaccinatedFully vaccinated individuals are defined as having positive laboratory testing for COVID-19 and symptom onset >14 days since administration of second dose of either mRNA vaccine, or >14 days since administration of viral vector vaccine (Johnson \& Johnson).
Receives: Biological: COVID-19 vaccine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Emergency Center (EC) Encounters and/or Hospitalizations With Positive COVID-19 Test

    Number of participants with encounters at emergency center (EC) and /or hospitalizations with positive COVID-19 test

    Measured: During the period from December 15, 2020 through April 30, 2021 (up to 5 months)

Secondary outcomes (11)
  1. Number of Patients With Severe Infection

    Patient with any of the following: ICU admission, mechanical ventilation, or in-hospital mortality

    Measured: During EC visit or hospitalization, from date of presentation until May 15, 2021 (up to 5 months)

  2. Number of Patients With ICU Admission

    Number of patients admitted to ICU during hospital stay

    Measured: During hospitalization, from date of admission until May 15, 2021 (up to 5 months)

  3. Number of Patients Requiring Mechanical Ventilation

    Number of patients who required mechanical ventilation

    Measured: During EC visit or in-patient hospitalization, from date of presentation until May 15, 2021 (up to 5 months)

  4. Number of Patients With In-hospital Mortality

    Number of patients who died during EC visit or hospital admission

    Measured: During EC visit or in-patient hospitalization, from date of presentation until May 15, 2021 (up to 5 months)

  5. Number of Hospitalized Patients Requiring Extracorporeal Membrane Oxygenation (ECMO)

    Number of hospitalized patients requiring ECMO

    Measured: During hospitalization, from date of admission until May 15, 2021 (up to 5 months)

  6. Number of Hospitalized Patients Requiring Renal Replacement Therapy (RRT)

    Number of hospitalized patients requiring RRT

    Measured: During hospitalization, from date of presentation until May 15, 2021 (up to 5 months)

  7. Number of Hospitalized Patients Requiring Supplemental Oxygen

    Number of hospitalized patients requiring supplemental oxygen, by type

    Measured: During hospitalization, from date of admission until May 15, 2021 (up to 5 months)

  8. Number of Hospitalized Patients Requiring Non-invasive Ventilation

    Number of hospitalized patients requiring non-invasive ventilation

    Measured: During EC visit or hospitalization, from date of presentation until May 15, 2021 (up to 5 months)

  9. Number of Hospitalized Patients Requiring Vasopressors

    Number of hospitalized patients with hypotension requiring vasopressors

    Measured: During EC visit or hospitalization, from date of presentation until May 15, 2021 (up to 5 months)

  10. Number of Patients Discharged From Hospital to Home, Skilled Nursing Facility, Rehabilitation Facility, or Hospice.

    Number of patients discharged from in-patient hospital admission to home, skilled nursing facility, rehabilitation facility, or hospice.

    Measured: During the period from December 15, 2020 through May 15, 2021 (up to 5 months)

  11. Hospital Length of Stay

    Number of days from admission after emergency center (EC) visit and positive COVID-19 test, until discharge

    Measured: During the period from December 15, 2020 through May 15, 2021 (up to 5 months)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Jun 2021
  2. Study start1 Jun 2021
  3. Primary completion7 Jun 2021
  4. Study completion7 Jun 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Retrospective
Enrolment
11,834 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04912700
Sponsor's protocol ID
2021-118
Status last verified
Sep 2021
First submitted
1 Jun 2021
Last updated
30 Sep 2021
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: No plan at this point.

Publications

  • Azar AM. Emergency Use Authorization Declaration. Published online 2020. https://www.federalregister.gov/documents/2020/04/01/2020-06905/emergency-use-authorization-declaration

  • US Food and Drug Administration. FDA Issues Emergency Use Authorization for Third COVID-19 Vaccine. Accessed April 10, 2021. https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-third-covid-19-vaccine

  • Lurie N, Saville M, Hatchett R, Halton J. Developing Covid-19 Vaccines at Pandemic Speed. N Engl J Med. 2020 May 21;382(21):1969-1973. doi: 10.1056/NEJMp2005630. Epub 2020 Mar 30. No abstract available.

    PubMed 32227757
  • Emary KRW, Golubchik T, Aley PK, Ariani CV, Angus B, Bibi S, Blane B, Bonsall D, Cicconi P, Charlton S, Clutterbuck EA, Collins AM, Cox T, Darton TC, Dold C, Douglas AD, Duncan CJA, Ewer KJ, Flaxman AL, Faust SN, Ferreira DM, Feng S, Finn A, Folegatti PM, Fuskova M, Galiza E, Goodman AL, Green CM, Green CA, Greenland M, Hallis B, Heath PT, Hay J, Hill HC, Jenkin D, Kerridge S, Lazarus R, Libri V, Lillie PJ, Ludden C, Marchevsky NG, Minassian AM, McGregor AC, Mujadidi YF, Phillips DJ, Plested E, Pollock KM, Robinson H, Smith A, Song R, Snape MD, Sutherland RK, Thomson EC, Toshner M, Turner DPJ, Vekemans J, Villafana TL, Williams CJ, Hill AVS, Lambe T, Gilbert SC, Voysey M, Ramasamy MN, Pollard AJ; COVID-19 Genomics UK consortium; AMPHEUS Project; Oxford COVID-19 Vaccine Trial Group. Efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine against SARS-CoV-2 variant of concern 202012/01 (B.1.1.7): an exploratory analysis of a randomised controlled trial. Lancet. 2021 Apr 10;397(10282):1351-1362. doi: 10.1016/S0140-6736(21)00628-0. Epub 2021 Mar 30.

    PubMed 33798499
  • Dagan N, Barda N, Kepten E, Miron O, Perchik S, Katz MA, Hernan MA, Lipsitch M, Reis B, Balicer RD. BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting. N Engl J Med. 2021 Apr 15;384(15):1412-1423. doi: 10.1056/NEJMoa2101765. Epub 2021 Feb 24.

    PubMed 33626250
  • Daniel W, Nivet M, Warner J, Podolsky DK. Early Evidence of the Effect of SARS-CoV-2 Vaccine at One Medical Center. N Engl J Med. 2021 May 20;384(20):1962-1963. doi: 10.1056/NEJMc2102153. Epub 2021 Mar 23. No abstract available.

    PubMed 33755374
  • Amit S, Regev-Yochay G, Afek A, Kreiss Y, Leshem E. Early rate reductions of SARS-CoV-2 infection and COVID-19 in BNT162b2 vaccine recipients. Lancet. 2021 Mar 6;397(10277):875-877. doi: 10.1016/S0140-6736(21)00448-7. Epub 2021 Feb 18. No abstract available.

    PubMed 33610193
  • Sanders RW, de Jong MD. Pandemic moves and countermoves: vaccines and viral variants. Lancet. 2021 Apr 10;397(10282):1326-1327. doi: 10.1016/S0140-6736(21)00730-3. Epub 2021 Mar 30. No abstract available.

    PubMed 33798497
  • State of Michigan COVID-19 Vaccine Dashboard. https://www.michigan.gov/coronavirus/0,9753,7-406-98178_103214-547150--,00.html. Retrieved 25 April 2021.

Questions about this trial

What is this clinical trial studying?

An observational study of Covid19, run by Corewell Health East at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 30 Sep 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 30 Sep 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Emergency Center (EC) Encounters and/or Hospitalizations With Positive COVID-19 Test (time frame: During the period from December 15, 2020 through April 30, 2021 (up to 5 months)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04912700, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Sep 2021.

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