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Background The Omicron variant of SARS-CoV-2 evades immunity conferred by vaccines and previous infections. Methods We used a Cox proportional hazards model and a logistic regression on individual-level population-wide data from the Czech Republic to estimate risks of infection and hospitalization, including severe states. Results A recent (≤ 2 months) full vaccination reached VE 43% (95% CI: 42-44) against infection by Omicron compared to 73% (CI: 72-74) against Delta. A recent booster increased VE to 56% (CI: 55-56) against Omicron infection compared to 90% (CI: 90-91) for Delta. The VE against Omicron hospitalization of a recent full vaccination was 45% (95% CI: 29-57), with a recent booster 87% (CI: 84-88). The VE against the need for oxygen therapy due to Omicron was 57% (CI: 32-72) for recent vaccination, 90% (CI: 87-92) for a recent booster. Post-infection protection against Omicron hospitalization declined from 68% (CI: 68-69) at ≤ 6 months to 13% (CI: 11-14) at &amp;gt; 6 months after a previous infection. The OR for Omicron relative to Delta was 0.36 (CI: 0.34-0.38) for hospitalization, 0.24 (CI: 0.22-0.26) for oxygen, and 0.24 (CI: 0.21-0.28) for ICU admission. Discussion Recent vaccination still brings substantial protection against severe outcome for Omicron.

Protection by Vaccines and Previous Infection Against the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2