Comparative Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Against the Delta Variant.
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]â =â 0.37; 95% confidence interval [CI] [.14-.98]; Pâ =â .05) and mRNA-1273 recipients (HRâ =â 0.21; 95% CI [.07-.64]; Pâ =â .006). Recipients of the mRNA-1273 vaccine had a lower risk of SARS-CoV-2 infection than Ad26.COV2.S recipients (HRâ =â 0.6; 95% CI [.43-.83]; Pâ =â .003) and BNT162b2 recipients (HRâ =â 0.64; 95% CI [.54-.76]; Pâ <â .001). After 1 July, efficacy against SARS-CoV-2 infection declined for Ad26.COV2.S recipients (VEâ =â 76% before; VEâ =â 49% after; Pâ =â .02), BNT162b2 recipients (VEâ =â 87% before; VEâ =â 52% after; Pâ <â .001), and mRNA-1273 recipients (VEâ =â 92% before; VEâ =â 70% after; Pâ <â .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.Keywords
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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