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Comparative Effectiveness of BNT162b2 and mRNA-1273 Vaccines Against COVID-19 Infection Among Patients With Systemic Autoimmune Rheumatic Diseases on Immunomodulatory Medications.
Cook, Claire E; Patel, Naomi J; Fu, Xiaoqing; Wang, Xiaosong; Kawano, Yumeko; Vanni, Kathleen M M; Qian, Grace; Banasiak, Emily; Kowalski, Emily; Choi, Hyon K; Zhang, Yuqing; Sparks, Jeffrey A; Wallace, Zachary S.
  • Cook CE; C.E. Cook, MPH, X. Fu, MS, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital.
  • Patel NJ; N.J. Patel, MD, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Harvard Medical School.
  • Fu X; C.E. Cook, MPH, X. Fu, MS, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital.
  • Wang X; X. Wang, MS, K.M.M. Vanni, BA, G. Qian, BA&Sc, E. Banasiak, BA, E. Kowalski, BS, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital.
  • Kawano Y; Y. Kawano, MD, J.A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, and Harvard Medical School.
  • Vanni KMM; X. Wang, MS, K.M.M. Vanni, BA, G. Qian, BA&Sc, E. Banasiak, BA, E. Kowalski, BS, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital.
  • Qian G; X. Wang, MS, K.M.M. Vanni, BA, G. Qian, BA&Sc, E. Banasiak, BA, E. Kowalski, BS, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital.
  • Banasiak E; X. Wang, MS, K.M.M. Vanni, BA, G. Qian, BA&Sc, E. Banasiak, BA, E. Kowalski, BS, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital.
  • Kowalski E; X. Wang, MS, K.M.M. Vanni, BA, G. Qian, BA&Sc, E. Banasiak, BA, E. Kowalski, BS, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital.
  • Choi HK; H.K. Choi, MD, DrPH, Y. Zhang, ScD, Z.S. Wallace, MD, MSc, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, US
  • Zhang Y; H.K. Choi, MD, DrPH, Y. Zhang, ScD, Z.S. Wallace, MD, MSc, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, US
  • Sparks JA; Y. Kawano, MD, J.A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, and Harvard Medical School; zswallace@mgh.harvard.edu jsparks@bwh.harvard.edu.
  • Wallace ZS; H.K. Choi, MD, DrPH, Y. Zhang, ScD, Z.S. Wallace, MD, MSc, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, US
J Rheumatol ; 50(5): 697-703, 2023 05.
Article in English | MEDLINE | ID: covidwho-2201166
ABSTRACT

OBJECTIVE:

To compare the effectiveness of mRNA vaccines (BNT162b2 vs mRNA-1273) against coronavirus disease 2019 (COVID-19) infection among patients with systemic autoimmune rheumatic diseases (SARDs) on immunomodulatory medications.

METHODS:

We identified patients with SARDs being treated with disease-modifying antirheumatic drugs (DMARDs) and/or glucocorticoids in the Mass General Brigham healthcare system who received either BNT162b2 or mRNA-1273 as their initial vaccine series. Patients were followed until positive SARS-CoV-2 test, death, or February 22, 2022. We compared the risk of breakthrough infection between BNT162b2 and mRNA-1273 vaccine recipients using time-stratified, overlap propensity score (PS)-weighted Cox proportional hazard models.

RESULTS:

We identified 9838 patients with SARDs who received BNT162b2 or mRNA-1273. Demographic and clinical characteristics were similar in both groups after overlap weighting mean age 61 years, 75% female, 52% with rheumatoid arthritis, 74% receiving conventional synthetic DMARDs, and 43% receiving biologic DMARDs. Of 5516 BNT162b2 and 4322 mRNA-1273 recipients, 446 and 329 had a breakthrough infection, respectively. The corresponding time-stratified PS-weighted rate difference of breakthrough infection was 0.71 (95% CI -0.70 to 2.12) per 1000 person-months with a weighted hazard ratio (HR) of 1.12 (95% CI 0.90 to 1.39). When follow-up was censored prior to the Omicron wave, there was a trend toward higher breakthrough risk with BNT162b2 vs mRNA-1273 (weighted HR 1.34, 95% CI 0.91 to 1.98).

CONCLUSION:

Among patients with SARDs, the risk of breakthrough COVID-19 infection is similar after receiving either BNT162b2 or mRNA-1273. Patients with SARDs initiating the vaccine series should be encouraged to receive whichever mRNA vaccine is available.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthritis, Rheumatoid / Antirheumatic Agents / COVID-19 Type of study: Cohort study / Experimental Studies / Prognostic study / Randomized controlled trials Topics: Vaccines / Variants Limits: Female / Humans / Male / Middle aged Language: English Journal: J Rheumatol Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthritis, Rheumatoid / Antirheumatic Agents / COVID-19 Type of study: Cohort study / Experimental Studies / Prognostic study / Randomized controlled trials Topics: Vaccines / Variants Limits: Female / Humans / Male / Middle aged Language: English Journal: J Rheumatol Year: 2023 Document Type: Article