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Odds of Testing Positive for SARS-CoV-2 Following Receipt of 3 vs 2 Doses of the BNT162b2 mRNA Vaccine.
Patalon, Tal; Gazit, Sivan; Pitzer, Virginia E; Prunas, Ottavia; Warren, Joshua L; Weinberger, Daniel M.
  • Patalon T; Kahn Sagol Maccabi Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel.
  • Gazit S; Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.
  • Pitzer VE; Kahn Sagol Maccabi Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel.
  • Prunas O; Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.
  • Warren JL; Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, Connecticut.
  • Weinberger DM; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, Connecticut.
JAMA Intern Med ; 182(2): 179-184, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1540033
ABSTRACT
Importance With the evidence of waning immunity of the mRNA vaccine BNT162b2 (Pfizer-BioNTech), a nationwide third-dose (booster) vaccination campaign was initiated in Israel during August 2021; other countries have begun to administer a booster shot as well.

Objective:

To evaluate the initial short-term additional benefit of a 3-dose vs a 2-dose regimen against infection of SARS-CoV-2. Design, Setting, and

Participants:

This preliminary retrospective case-control study used 2 complementary approaches a test-negative design and a matched case-control design. Participants were included from the national centralized database of Maccabi Healthcare Services, an Israeli healthcare maintenance organization covering 2.5 million members. Data were collected between March 1, 2020, and October 4, 2021, and analyses focused on the period from August 1, 2021, to October 4, 2021, because the booster dose was widely administered from August 1 onward. Exposures Either 2 doses or 3 doses of the BNT162b2 vaccine. Main Outcomes and

Measures:

The reduction in the odds of a positive SARS-CoV-2 polymerase chain reaction (PCR) test at different time intervals following receipt of the booster dose (0-6, 7-13, 14-20, 21-27, and 28-65 days) compared with receiving only 2 doses.

Results:

The study population included 306 710 members of Maccabi Healthcare Services who were 40 years and older (55% female) and received either 2 or 3 doses of the BNT162b2 vaccine and did not have a positive PCR test result for SARS-CoV-2 prior to the start of the follow-up period. During this period, there were 500 232 PCR tests performed, 227 380 among those who received 2 doses and 272 852 among those who received 3 doses, with 14 989 (6.6%) and 4941 (1.8%) positive test results in each group, respectively. Comparing those who received a booster and those who received 2 doses, there was an estimated odds ratio of 0.14 (95% CI, 0.13-0.15) 28 to 65 days following receipt of the booster (86% reduction in the odds of testing positive for SARS-CoV-2). Conclusion and Relevance Previous studies have demonstrated that vaccine-derived protection against SARS-CoV-2 wanes over time. In this case-control analysis, we showed an association between receipt of the booster dose and a reduction in the odds of testing positive for SARS-CoV-2, potentially counteracting waning immunity in the short term. Further monitoring of data from this population is needed to determine the duration of immunity following the booster.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / SARS-CoV-2 / COVID-19 / BNT162 Vaccine Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Adult / Female / Humans / Male Language: English Journal: JAMA Intern Med Year: 2022 Document Type: Article Affiliation country: Jamainternmed.2021.7382

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / SARS-CoV-2 / COVID-19 / BNT162 Vaccine Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Adult / Female / Humans / Male Language: English Journal: JAMA Intern Med Year: 2022 Document Type: Article Affiliation country: Jamainternmed.2021.7382