Comparative effectiveness of mRNA-1273 and BNT162b2 against symptomatic SARS-CoV-2 infection.

Abstract

BACKGROUND:

mRNA coronavirus disease 2019 (COVID-19) vaccines are safe and effective, but increasing reports of breakthrough infections highlight the need to vigilantly monitor and compare the effectiveness of these vaccines.

METHODS:

We retrospectively compared protection against symptomatic infection conferred by mRNA-1273 and BNT162b2 at Mayo Clinic sites from December 2020 to September 2021. We used a test-negative case-control design to estimate vaccine effectiveness (VE) and to compare the odds of symptomatic infection after full vaccination with mRNA-1273 versus BNT162b2, while adjusting for age, sex, race, ethnicity, geography, comorbidities, and calendar time of vaccination and testing.

FINDINGS:

Both vaccines were highly effective over the study duration (VEmRNA-1273: 84.1%, 95% confidence interval [CI]: 81.6%-86.2%; VEBNT162b2: 75.6%, 95% CI: 72.2%-78.7%), but their effectiveness was reduced during July-September (VEmRNA-1273: 75.6%, 95% CI: 70.1%-80%; VEBNT162b2: 63.5%, 95% CI: 55.8%-69.9%) as compared to December-May (VEmRNA-1273: 93.7%, 95% CI: 90.4%-95.9%; VEBNT162b2: 85.7%, 95% CI: 81.4%-88.9%). Adjusted for demographic characteristics, clinical comorbidities, time of vaccination, and time of testing, the odds of experiencing a symptomatic breakthrough infection were lower after full vaccination with mRNA-1273 than with BNT162b2 (odds ratio: 0.60; 95% CI: 0.55-0.67).

CONCLUSIONS:

Both mRNA-1273 and BNT162b2 strongly protect against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It is imperative to continue monitoring and comparing available vaccines over time and with respect to emerging variants to inform public and global health decisions.

FUNDING:

This study was funded by nference.

• Authors: Arjun Puranik, Patrick J Lenehan, Eli Silvert, Michiel J M Niesen, Juan Corchado-Garcia, John C O'Horo, Abinash Virk, Melanie D Swift, Joel E Gordon, Leigh Lewis Speicher, Holly L Geyer, Walter Kremers, John Halamka, Andrew D Badley, A J Venkatakrishnan, Venky Soundararajan
• Journal: Med (New York, N.Y.) (Med (N Y)) Vol. 3 Issue 1 Pg. 28-41.e8 (Jan 14 2022) ISSN: 2666-6340 [Electronic] United States
• PMID: 34927113 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: © 2021 The Authors.

Chemical References

• COVID-19 Vaccines
• 2019-nCoV Vaccine mRNA-1273
• BNT162 Vaccine

Topics

• 2019-nCoV Vaccine mRNA-1273
• BNT162 Vaccine
• COVID-19 (prevention & control)
• COVID-19 Vaccines (therapeutic use)
• Humans
• Retrospective Studies
• SARS-CoV-2 (genetics)