Comparative Effectiveness of Bivalent (Original/Omicron BA.4/BA.5) COVID-19 Vaccines in Adults
Author:
Kopel Hagit1, Nguyen Van Hung2, Boileau Catherine2, Bogdanov Alina3, Winer Isabelle3, Ducruet Thierry2, Zeng Ni3, Bonafede Mac3, Esposito Daina B.1ORCID, Martin David1, Rosen Andrew1, Van de Velde Nicolas1, Vermund Sten H.4ORCID, Gravenstein Stefan5, Mansi James A.1ORCID
Affiliation:
1. Moderna, Inc., Cambridge, MA 02139, USA 2. VHN Consulting Inc., Montreal, QC H2V 3L8, Canada 3. Veradigm, Chicago, IL 60654, USA 4. Yale School of Public Health, Yale University, New Haven, CT 06510, USA 5. Alpert Medical School and School of Public Health, Brown University, Providence, RI 02903, USA
Abstract
The emergence of Omicron variants coincided with declining vaccine-induced protection against SARS-CoV-2. Two bivalent mRNA vaccines, mRNA-1273.222 (Moderna) and BNT162b2 Bivalent (Pfizer-BioNTech), were developed to provide greater protection against the predominate circulating variants by including mRNA that encodes both the ancestral (original) strain and BA.4/BA.5. We estimated their relative vaccine effectiveness (rVE) in preventing COVID-19-related outcomes in the US using a nationwide dataset linking primary care electronic health records and pharmacy/medical claims data. The study population (aged ≥18 years) received either vaccine between 31 August 2022 and 28 February 2023. We used propensity score weighting to adjust for baseline differences between groups. We estimated the rVE against COVID-19-related hospitalizations (primary outcome) and outpatient visits (secondary) for 1,034,538 mRNA-1273.222 and 1,670,666 BNT162b2 Bivalent vaccine recipients, with an adjusted rVE of 9.8% (95% confidence interval: 2.6–16.4%) and 5.1% (95% CI: 3.2–6.9%), respectively, for mRNA-1273.222 versus BNT162b2 Bivalent. The incremental relative effectiveness was greater among adults ≥ 65; the rVE against COVID-19-related hospitalizations and outpatient visits in these patients was 13.5% (95% CI: 5.5–20.8%) and 10.7% (8.2–13.1%), respectively. Overall, we found greater effectiveness of mRNA-1273.222 compared with the BNT162b2 Bivalent vaccine in preventing COVID-19-related hospitalizations and outpatient visits, with increased benefits in older adults.
Subject
Pharmacology (medical),Infectious Diseases,Drug Discovery,Pharmacology,Immunology
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