Effectiveness of Bivalent Boosters Over Nine and Half Months in Nebraska

On September 1, 2022, Moderna and Pfizer–BioNTech bivalent vaccines replaced existing monovalent vaccines as booster doses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for persons aged 12 and older in the United States. We assessed the effectiveness of these bivalent boosters against Omicron infection and severe outcomes (COVID-19 hospitalization and death) over a 9.5-month period using line-level data from the state of Nebraska. We found that the relative effectiveness of bivalent boosters, compared with one fewer vaccine dose, against Omicron infection and subsequent death was 39.0% (95% confidence interval [CI], 35.7 to 42.2) and 70.0% (95% CI, 38.8 to 85.3), respectively, at four weeks post administration and gradually waned afterward. Vaccine effectiveness was broadly similar against different Omicron subvariants.