TY - JOUR
T1 - Comparative effectiveness of mRNA-1273 and BNT162b2 against symptomatic SARS-CoV-2 infection
AU - Puranik, Arjun
AU - Lenehan, Patrick J.
AU - Silvert, Eli
AU - Niesen, Michiel J.M.
AU - Corchado-Garcia, Juan
AU - O'Horo, John C.
AU - Virk, Abinash
AU - Swift, Melanie D.
AU - Gordon, Joel E.
AU - Speicher, Leigh Lewis
AU - Geyer, Holly L
AU - Kremers, Walter
AU - Halamka, John
AU - Badley, Andrew D.
AU - Venkatakrishnan, A. J.
AU - Soundararajan, Venky
N1 - Funding Information:
A.P., P.J.L., E.S., M.J.M.N., J.C.O., A.J.V., and V.S. are employees of nference and have financial interests in the company. nference is collaborating or has collaborated with Moderna, Pfizer, Janssen, and other bio-pharmaceutical companies on data science initiatives unrelated to this study. These collaborations had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. J.C.O. receives personal fees from Elsevier and Bates College and receives small grants from nference, Inc., outside the submitted work. A.D.B. is supported by grants from NIAID (grants AI110173 and AI120698), Amfar (no. 109593), and Mayo Clinic (HH Shieck Khalifa Bib Zayed Al-Nahyan Named Professorship of Infectious Diseases). A.D.B. is a paid consultant for Abbvie, Gilead, Freedom Tunnel, Pinetree Therapeutics, Primmune, Immunome, and Flambeau Diagnostics; is a paid member of the DSMB for Corvus Pharmaceuticals, Equilium, and Excision Biotherapeutics; has received fees for speaking for Reach MD and Medscape; owns equity for scientific advisory work in Zentalis and nference; and is founder and President of Splissen Therapeutics. M.D.S. received grant funding from Pfizer via Duke University for a vaccine side effect registry. J.C.O., A.V., M.D.S., J.E.G., L.L.S., H.L.G., W.K., J.H., and A.D.B. are employees of the Mayo Clinic. The Mayo Clinic may stand to gain financially from the successful outcome of the research. This research has been reviewed by the Mayo Clinic Conflict of Interest Review Board and is being conducted in compliance with Mayo Clinic Conflict of Interest policies.
Funding Information:
The authors thank Murali Aravamudan for his feedback on this manuscript. Conceptualization, A.P. P.J.L. A.J.V. and V.S.; methodology, A.P. P.J.L. M.J.M.N. J.C.O. A.V. M.D.S. J.E.G. L.L.S. H.L.G. W.K. and A.J.V.; software, A.P. and E.S.; formal analysis, A.P. and P.J.L.; investigation, A.P. and P.J.L.; data curation, A.P. E.S. and J.C.-G.; writing ? original draft, A.P. P.J.L. M.J.M.N. and A.V.; writing ? review and editing, A.P. E.S. M.J.M.N. J.C.O. A.V. M.D.S. J.E.G. L.L.S. H.L.G. W.K. J.H. A.D.B. A.J.V. and V.S.; visualization, P.J.L. J.C.-G. and A.J.V.; resources, J.C.O.; supervision, A.D.B. and V.S.; funding acquisition, V.S. A.P. performed statistical analyses. A.P. and J.C.O. had unrestricted access to all data. P.J.L. A.P. M.J.M.N. and A.V. prepared the first draft of the manuscript, which was reviewed and edited by all other authors. All authors agreed to submit the manuscript, read and approved the final draft, and take full responsibility of its content, including the accuracy of the data and statistical analysis. A.P. P.J.L. E.S. M.J.M.N. J.C.O. A.J.V. and V.S. are employees of nference and have financial interests in the company. nference is collaborating or has collaborated with Moderna, Pfizer, Janssen, and other bio-pharmaceutical companies on data science initiatives unrelated to this study. These collaborations had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. J.C.O. receives personal fees from Elsevier and Bates College and receives small grants from nference, Inc. outside the submitted work. A.D.B. is supported by grants from NIAID (grants AI110173 and AI120698), Amfar (no. 109593), and Mayo Clinic (HH Shieck Khalifa Bib Zayed Al-Nahyan Named Professorship of Infectious Diseases). A.D.B. is a paid consultant for Abbvie, Gilead, Freedom Tunnel, Pinetree Therapeutics, Primmune, Immunome, and Flambeau Diagnostics; is a paid member of the DSMB for Corvus Pharmaceuticals, Equilium, and Excision Biotherapeutics; has received fees for speaking for Reach MD and Medscape; owns equity for scientific advisory work in Zentalis and nference; and is founder and President of Splissen Therapeutics. M.D.S. received grant funding from Pfizer via Duke University for a vaccine side effect registry. J.C.O. A.V. M.D.S. J.E.G. L.L.S. H.L.G. W.K. J.H. and A.D.B. are employees of the Mayo Clinic. The Mayo Clinic may stand to gain financially from the successful outcome of the research. This research has been reviewed by the Mayo Clinic Conflict of Interest Review Board and is being conducted in compliance with Mayo Clinic Conflict of Interest policies.
Publisher Copyright:
© 2021 The Authors
PY - 2022/1/14
Y1 - 2022/1/14
N2 - 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.
AB - 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.
KW - BNT162b2
KW - COVID-19
KW - SARS-CoV-2
KW - Translation to population health
KW - comparative effectiveness
KW - mRNA vaccines
KW - mRNA-1273
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U2 - 10.1016/j.medj.2021.12.002
DO - 10.1016/j.medj.2021.12.002
M3 - Article
AN - SCOPUS:85122280846
VL - 3
SP - 28-41.e8
JO - Med
JF - Med
SN - 2666-6359
IS - 1
ER -