mRNA vaccine effectiveness against SARS-CoV-2 B.1.617.2 (Delta) and B.1.1.529 (Omicron) variant transmission from home care cases to household contacts in South Korea

Objectives: Household contacts of confirmed cases of coronavirus disease 2019 (COVID-19) are exposed to a high risk of viral transmission, and secondary incidence is an important indicator of community transmission. This study analyzed the secondary attack rate and mRNA vaccine effectiveness against transmission (VET) for index cases (patients treated at home) confirmed to be infected with the Delta and Omicron variants. Methods: The subjects of the study were 4,450 index cases and 10,382 household contacts. Logistic regression analysis was performed to compare the secondary attack rate by vaccination status, and adjusted relative risk and 95% confidence intervals were identified. Results: The secondary attack rate of the Delta variant was 27.3%, while the secondary attack rate of the Omicron variant was 29.8%. For the Delta variant, groups with less than 90 days and more than 90 days after 2 doses of mRNA vaccination both showed a VET of 37%. For the Omicron variant, a 64% VET was found among those with less than 90 days after 2 doses of mRNA vaccination. Conclusion: This study provides useful data on the secondary attack rate and VET of mRNA vaccines for household contacts of COVID-19 cases in South Korea.