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Comparative Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Against the Delta Variant.
Risk, Malcolm; Shen, Chen; Hayek, Salim S; Holevinski, Lynn; Schiopu, Elena; Freed, Gary; Akin, Cem; Zhao, Lili.
  • Risk M; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA.
  • Shen C; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA.
  • Hayek SS; Division of Cardiology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
  • Holevinski L; Data Office for Clinical and Translation Research, Office of Research, Ann Arbor, Michigan, USA.
  • Schiopu E; Rheumatology, Internal Medicine, Ann Arbor, Michigan, USA.
  • Freed G; Department of Pediatrics and Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan, USAand.
  • Akin C; Division of Allergy, University of Michigan, Ann Arbor, Michigan, USA.
  • Zhao L; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA.
Clin Infect Dis ; 75(1): e623-e629, 2022 08 24.
Article in English | MEDLINE | ID: covidwho-1795355
ABSTRACT

BACKGROUND:

There is a lack of data regarding how the Delta variant of coronavirus disease 2019 (COVID-19) has impacted the effectiveness of the BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), and Ad26.COV2.S (Johnson & Johnson-Janssen) vaccines at preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 hospitalization.

METHODS:

We compared the effectiveness of the three vaccines during the pre- and post-Delta variant period (before and after 1 July 2021) in a large cohort of vaccinated and unvaccinated patients in the Michigan Medicine healthcare system. We assessed vaccine effectiveness (VE) using 2 analyses an inverse propensity weighted (IPW) Kaplan-Meier (KM) analysis based on time from vaccination, and a Cox model based on calendar time with vaccination as a time-varying covariate.

RESULTS:

Compared to Ad26.COV2.S recipients, the risk of hospitalization for COVID-19 in the post-Delta variant period was lower for BNT162b2 recipients (hazard ratio [HR] = 0.37; 95% confidence interval [CI] [.14-.98]; P = .05) and mRNA-1273 recipients (HR = 0.21; 95% CI [.07-.64]; P = .006). Recipients of the mRNA-1273 vaccine had a lower risk of SARS-CoV-2 infection than Ad26.COV2.S recipients (HR = 0.6; 95% CI [.43-.83]; P = .003) and BNT162b2 recipients (HR = 0.64; 95% CI [.54-.76]; P < .001). After 1 July, efficacy against SARS-CoV-2 infection declined for Ad26.COV2.S recipients (VE = 76% before; VE = 49% after; P = .02), BNT162b2 recipients (VE = 87% before; VE = 52% after; P < .001), and mRNA-1273 recipients (VE = 92% before; VE = 70% after; P < .001). Waning immunity and the Delta variant contributed independently and significantly to this decline.

CONCLUSIONS:

Although there is a substantial decline in effectiveness, the approved COVID-19 vaccines remain effective against infection and hospitalization due to the Delta variant. The mRNA-based vaccines are more effective than the Ad26.COV2.S vaccine.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines / Variants Limits: Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines / Variants Limits: Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid