hhumetrox = Enterprise iBlueButton TENSIO SOSQR News About Blog Contact ae Executive Summary Project Salus provides answers to these questions Deol questions which requre VE tbh sti ce apenas atedvon enews {ovine eM Ur trod 65 8 oe vcinted sort Ako reskvegh hsp mcrae wth tine ‘dapsed:tce mRNA vccnaton with odds ncrening 12 Is vaccine effectiveness (VE) ‘25 et 6 month post weston waning overtime? a] VE spunst Ont breakthrough horpalintion 62) exceeds Ts VE reduced for the Delta ‘Ve gant Ont ncn (98). arlene? Pir COVID9 infection has a mer protective elect ez | the need vary by spsins beathrough hsptaluaton ‘sub-population?, ‘Olde age roupe 75.348 85 adler) experienced further ‘eduction nvacine protection agai oxpalation osptaaton rat (21% ys 32%) and death rat (2% v8 12) of shueredin Covi 39, hop dated om CO reentton AIP Mec hit 0221 ‘mers Far oS Boe of CMD I9 ote, humere eR —____~ arinn os G las Cneg hhumetrex Enterprise i@lueButton TENSIO SOSQR News About Blog Contact Effectiveness of mRNA COVID-19 Vaccines Against the Delta Variant Among 5.6M Medicare Beneficiaries 65 Years and Older Weekly update of September 28, 2021 UMETRI< oO Project Salus AchumetRoc Enterprise iBlueButton TENSIO SOSQR News About Blog Contact saic Salus Platform for COVID-19 Analyses Project alae VE Study Attributes Other Platform Applications _————— Cus Exposure ‘SM ay ncanae wah Period of study Tanager 2285 Breakthrough Key Metrics eK arakhouph ee humetRoc Enterprise iBlueButton TENSIO SOSQR News About Blog Contact saic Salus Platform for COVID-19 Analyses Project alae VE Study Attributes Other Platform Applications _————— Cus Exposure ‘SM ay ncanae wah Period of study Tanager 2285 Breakthrough Key Metrics eK arakhouph eehumetRv Enterprise i2lueButton TENSIO SOSQR News About Blog Contact saic Salus Breakthrough Analysis Methodology and Limitations Projet Sole + Breakthrough case definition: new COVID-19 diagnosis (by COVID-19 ICD-10 code) occurring no earlier than 2-weeks post the second vaccine dose (see appendix for more details on case definition) + Breakthrough analysis methodology: to estimate weekiy breakthrough cases and hospitalizations we ‘multiplied our Medicare claim-based weekly breakthrough case counts and hospitalization counts by the corresponding weekly ratio ofthe claims-based vaccination rate to the CDC vaccination rate to compensate {or missing COVID-19 vaccination data from Medicare claim data (Medicare claims only provide ~45% of the published CDC vaccination rate inthe 65 and over age grou) + Breakthrough data limitations: * Possible overestimation of breakthrough rates due to breakthroughs clinically defined with a COVID-19, iagnoss but not confiemed by PCR or antigen test (unavailable in claim data) + Possible overestimation of breakthrough rates due to assuming identical breakthrough rates between individuals with claim-based vaccination data and those lacking vaccination data thie claims + Overestimation of breakthrough rates would lead to underestimating vaccine VE against breakthrough infections and breakthrough hospitalizations humere humeti me Enterprise iBlueButton TENSIO SOSOR News About Blog Contact sai COVID-19 Case Definitions + COVID-19 case definition: COVID-19 ICD-10-CM code UO71 found in any claim type. Date of diagnosis based on first claim with UO71. Note: 29% have either a COVID-19 PCR or antigen test ina claim, ‘+ COVID-19 breakthrough infection definition: COVID-19 diagnosis more than 2 weeks after second dose ‘of mRNA vaccine or single dose of J8J vaccine with no COVID-19 ICD-10 code UO71 between frst and second dose of mRNA vaccine. Note: 36% of breakthrough cases have either a COVID-19 PCR or antigen test in aclaim, ‘+ COVID-19 hospitalization definitions: (1) Inpatient claim with primary admitting diagnosis ICD.10-¢ code U071 with data of admission within 14 days after COVID-19 diagnosis or date of discharge within 10 days of post hospitalization COVID-19 diagnosis OR (2) Carrer claim with ICD10 code UO71 and place cof service code = 21 and date of service either 14 days after COVID-19 diagnosis or 10 days before COVID-19 diagnosis. ‘+ COVID-19 associated death definitions: (1) Inpatient claim patient discharge status code = 41 (expired in facility) OR (2) MBSF file Date of Death are within 60 days of COVID-19 diagnosis. 85% of COVID-19 deaths using this definition occurred within 30 days and 72% within 20 days of COVID-19 diagnosis,hhumet = Enterprise iBlueButton TENSIO SOSQR News About Slog Contact 3AIC Key Breakthrough vs. Pre-Vaccination COVID-19 Metrics ‘Among 5.6M fully vaccine immunized Salus cohort members aged 65 and older (2.7M Pfizer and 2.9M Moderna), as of September 10, 2021: + 2.9% cumulative breakthrough rate ‘+ 21% hospitalization rate in breakthrough infections, reduced by one third of 32% hospitalization rate March ~ December 2020 + 31% breakthrough hospitalizations include ICU care, equivalent to 3296 ICU rate March ~ December 2020 + 2.19% death rate in breakthrough infections, reduced six-fold from 12% death rate March - December 2020 humere! hhumetro Enterprise iBlueButton TENSIO SOSQR News About Blog Contact 3Aic Total & Breakthrough Cases in the 65 Years and Older Salus Cohort Projet Sahn = = [Fede vaen cane] \ . ‘predominant, COVIOI9 cases (Siena etal inte + Inthe Bo vacated 65 ‘| population an estimated 71% ~ Vi, ll 2 {ally sacinte nd ahumetTrRoe — Enterprise iBlueButton TENSIO SOSQR News About Blog Contact sac Project Salas Westy rskthrough ats per 006 Is MRNA Vaccine Effectiveness Against Delta Breakthrough Infection Waning Over Time in 65 Years and Older Salus Cohort? ctl illill ough infection rats 5 month post vacation hugerrne humetr = Enterprise BlueButton TENSIO SOSQR News About Blog Contact 3aic Age Distribution of Vaccinated Groups in the Projet Sab 65 Years and Older Cohort 5-6 months post vaccination 65 to 74 24% age groups 75 to 84 33% 85&older | 43% 3-4 months post vaccination 65 to 74 51% age groups 75 to 84 35% 85 & older 14% humerrnEnterprise iBlueButton TENSIO SOSQR News About Blog Contact Does Age Affect Vaccine Effectiveness Against Breakthrough [fears Infections in the 65 Years and Older Cohort? oe [> fest minor consibon| «| theretuced cde ‘ | protctonscenn the ou Ee . oe inated 5 month go 7 “= h in age oe . j- pz 3 P i» H de , 2 # Bad ~ humerrne hhumetroe = Enterprise iBlueBution TENSIO SOSQR News About Blog Contact saic Are There Differences in Waning Effectiveness Between Pfizer- Prole'Sslss BioNTech and Moderna Vaccines in the 65 Years and Older Cohort ? Wining mit are seen with both Poe leech and Moderna vaccines hring Osa pce ofthe pandemic eae = Moderna vaccine offers etter ange = protection than Pier vacene or Irdiadule achated 4 months por for seas ending after ay 31 5 | 5 . Teeowah econ ae ohliblli MD = Weey reshtvough ates per 006 5aie Project Salus Enterprise iBlueButton TENSIO SOSQR News About Blog Contact Total & Breakthrough Hospitalizations in the 65 Years and Older Cohort Inti om vaccinated 65+ COvi019hosptatzations| ‘more than dubled reversing the for trend of dereaing osptaluatins snc Al population, a estimated 60% of (COM 18 hoxptalantons ocurred Inflly wccinted nda nthe AE an eno humetrRoe = Enterprise iBlueButton TENSIO SOSQR News About Blog Contact aaic Is Vaccine Protection Against Breakthrough Hospitalization oe Waning Over Time in the 65 Years and Older Cohort? + VE against breakthrough ~ ‘hospitalization is significantly e Iwo month prt g “vaccination than 3-4 months i ‘Post vaccination je nage boo ow :— 3 + Ie hhh - [cee ze monhehumetroe Enterprise iBlueButton TENSIO SOSQR News About Blog Contact, saic Are there Age Differences in Vaccine Protection Against Project Sas i hhumetroc Enterprise BlueButton TENSIO SOSQR News About Blog Contact JAI Whats the Vaccine Effectiveness Against the Delta Variant in bare the Salus Cohort? — Using the CDC Screening Approach [> aw calaloted VEsgsinet | Screening Method: Relationship between %of population inate acne |" etn vaccinated, estimated vaccine effectiveness, and % of cases (tacteems (VE vaccinated sttsamst [+ ead Espa | Ee) a =m 7 hosptaliaton 1 so aim TE vescrening method joe cre vest tremteonesennen) $18 ews ov peprtn epon 0m CG ae IK = $% of Population Vaccinated (PPV) St tin ren humerne "remnant rho tet .TRIX: Enterprise iBlueButton TENSIO SOSQR News About Blog Contact aaic ——_ How Does mRNA Vaccine Effectiveness in 65+ Salus Cohort Project See with 5.6M Vaccines Compared to Published Estimates? ex ST TA aa a) a O° pero e eer omen 207 se" cae mayan os ard stents : Boat soar “ nt Pte Boeck cine @ Moderna vaccine © Pfizer BioTech or Moderna @ Phizer-BioNTech, Moderna, oF Janssen * VE of both mRNA vaccines in this 65+ cohort Is lower than previously reported In smaller study sizes for both COVID-19 infection and hospitalization *_VE for mRNA vaccines i higher against hospitalization than against infection huMeTRDC Enterprise IBlueButton TENSIO SOSQR News About Blog Contact gaic Risk Model for Breakthrough Hospitalization Projet Sate ws — ~ = isk of breakthrough hospitalization increases with | Peron = {ire lapse sine mii acnaton wth de a = ‘nt inrentingto 5 tS onthe pst cation ow + Por COMO iwtcon haa mao protecive —r—ont = hee agset breationgh hoon Scr & + Teele tepupinakinte 75-4 ad apn inte a = ernest or = + kneel cn be do ray th ovr 68 =r = forsdaiontoteatslct hse moa ned of = = citrine de