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

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

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)28-41.e8
Issue number1
StatePublished - Jan 14 2022


  • BNT162b2
  • COVID-19
  • SARS-CoV-2
  • Translation to population health
  • comparative effectiveness
  • mRNA vaccines
  • mRNA-1273

ASJC Scopus subject areas

  • Medicine(all)


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