BNT162b2 and mRNA-1273 COVID-19 vaccine effectiveness against the SARS-CoV-2 Delta variant in Qatar

Tang, Patrick; Hasan, Mohammad Rubayet; Chemaitelly, Hiam; Yassine, Hadi M.; Benslimane, Fatiha; Al-Khatib, Hebah A.; AlMukdad, Sawsan; Coyle, Peter; Ayoub, Houssein H.; Kanaani, Zaina Al; Kuwari, Einas Al; Jeremijenko, Andrew; Kaleeckal, Anvar Hassan; Latif, Ali Nizar; Shaik, Riyazuddin Mohammad; Rahim, Hanan F. Abdul; Nasrallah, Gheyath K.; Al‐Kuwari, Mohamed Ghaith; Romaihi, Hamad Eid Al; Butt, Adeel A.; Al-Thani, Mohamed H.; Khal, Abdullatif Al; Bertollini, Roberto; Abu‐Raddad, Laith J.

doi:10.1038/s41591-021-01583-4

Cited by 398 publications

(378 citation statements)

References 42 publications

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“…During the delta phase of the pandemic, breakthrough infections among fully vaccinated people have occurred, 17 18 but the effectiveness of covid-19 vaccines against severe disease has remained robust. 20 21 33 34 In our study, vaccine effectiveness against admission to hospital with the delta variant was high (97.6%). Only five fully vaccinated people with the delta variant were admitted to hospital, no fully vaccinated people with non-delta variants were admitted, and no deaths in hospital occurred among any fully vaccinated people.…”

Section: Discussionmentioning

confidence: 51%

Effectiveness of mRNA-1273 against delta, mu, and other emerging variants of SARS-CoV-2: test negative case-control study

Bruxvoort

Qian

et al. 2021

BMJ

208

203

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Objectives To evaluate the effectiveness of the mRNA-1273 vaccine against SARS-CoV-2 variants and assess its effectiveness against the delta variant by time since vaccination. Design Test negative case-control study. Setting Kaiser Permanente Southern California (KPSC), an integrated healthcare system. Participants Adult KPSC members with a SARS-CoV-2 positive test sent for whole genome sequencing or a negative test from 1 March 2021 to 27 July 2021. Interventions Two dose or one dose vaccination with mRNA-1273 (Moderna covid-19 vaccine) ≥14 days before specimen collection versus no covid-19 vaccination. Main outcome measures Outcomes included infection with SARS-CoV-2 and hospital admission with covid-19. In pre-specified analyses for each variant type, test positive cases were matched 1:5 to test negative controls on age, sex, race/ethnicity, and specimen collection date. Conditional logistic regression was used to compare odds of vaccination among cases versus controls, with adjustment for confounders. Vaccine effectiveness was calculated as (1–odds ratio)×100%. Results The study included 8153 cases and their matched controls. Two dose vaccine effectiveness was 86.7% (95% confidence interval 84.3% to 88.7%) against infection with the delta variant, 98.4% (96.9% to 99.1%) against alpha, 90.4% (73.9% to 96.5%) against mu, 96-98% against other identified variants, and 79.9% (76.9% to 82.5%) against unidentified variants (that is, specimens that failed sequencing). Vaccine effectiveness against hospital admission with the delta variant was 97.5% (92.7% to 99.2%). Vaccine effectiveness against infection with the delta variant declined from 94.1% (90.5% to 96.3%) 14-60 days after vaccination to 80.0% (70.2% to 86.6%) 151-180 days after vaccination. Waning was less pronounced for non-delta variants. Vaccine effectiveness against delta infection was lower among people aged ≥65 years (75.2%, 59.6% to 84.8%) than those aged 18-64 years (87.9%, 85.5% to 89.9%). One dose vaccine effectiveness was 77.0% (60.7% to 86.5%) against infection with delta. Conclusions Two doses of mRNA-1273 were highly effective against all SARS-CoV-2 variants, especially against hospital admission with covid-19. However, vaccine effectiveness against infection with the delta variant moderately declined with increasing time since vaccination.

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Section: Discussionmentioning

confidence: 51%

Effectiveness of mRNA-1273 against delta, mu, and other emerging variants of SARS-CoV-2: test negative case-control study

Bruxvoort

Qian

et al. 2021

BMJ

208

203

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“…Moreover, we estimated how HRs of infection after vaccination depended on time after the vaccine application (adjusted for sex, age and time since the last infection), how HRs of hospital admission or death depended on time after the vaccine application (adjusted for sex and age), and how HRs of reinfection in unvaccinated individiuals depended on time since the previous infection (adjusted for sex and age). In all these cases, we estimated the vaccine effectiveness (VE, regarding a previous infection as a "vaccine") as VE = 1 − HR (Chemaitelly and others, 2021;Cohn and others, 2021;Tartof and others, 2021). Subjects were withdrawn from the study at the time of their (covid or non-covid) death.…”

Section: Discussionmentioning

confidence: 99%

Real-life protection provided by vaccination, booster doses and previous infection against covid-19 infection, hospitalisation or death over time in the Czech Republic: a whole country retrospective view

Berec

Šmíd²,

Přibylová

et al. 2021

Preprint

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SummaryBackgroundEvidence is accumulating that the effectiveness of covid-19 vaccines against infection wanes, reaching relatively low values after 6 months. Published studies demonstrating this effect based their findings on a limited range of vaccines or subset of populations, and did not include booster vaccine doses or immunity obtained due to covid-19 infection. Here we evaluate effectiveness of covid-19 vaccines, booster doses or previous infection against covid-19 infection, hospital admission or death for the whole population in the Czech Republic.MethodsData used in this study cover the whole population of the Czech Republic reported as infected and/or vaccinated between the first detected case on March 1, 2020 and November 20, 2021 (for reinfections), or December 26, 2020 and November 20, 2021 (for vaccinations), including hospital admissions and deaths. Vaccinations by all vaccines approved in the EU were included in this study. Anonymous, individual-level data including dates of vaccination, infection, hospital admission and death were provided by the the Institute of Health Information and Statistics of the Czech Republic. The risks of reinfection, breakthrough infection after vaccination, hospital admission and death were calculated using hazard ratios from a Cox regression adjusted for sex, age, vaccine type and vaccination status.FindingsThe vaccine effectiveness against any PCR-confirmed infection declined from 87% (95% CI 86-87) at 0-2 months after the second dose to 53% (95% CI 52-54) at 7-8 months for Comirnaty, from 90% (95% CI 89-91) at 0-2 monthsto 65% (95% CI 63-67) at 7-8 months for Spikevax, and from 83% (95% CI 80-85) at 0-2 months to 55% at (95% CI 54-56) 5-6 months for the Vaxzevria. For Janssen Covid-19 Vaccine we found no significant decline but the estimates are less certain. The vaccine effectiveness against hospital admissions and deaths decayed at a significantly lower rate with about 15%, resp. 10% decline during the first 6-8 months. The administration of a booster dose returns the protection to or above the estimates in the first two months after dose 2. In unvaccinated but previously SARS-CoV-2-positive individuals the protection against PCR-confirmed SARS-CoV-2 infection declined from close to 97% (95% CI 97-97) after 2 months through 90% at 6 months down to 72% (95% CI 65-78) at 18 months.InterpretationOur results confirm the waning of vaccination-induced immunity against infection and a smaller decline in the protection against hospital admission and death. A booster dose is shown to restore the vaccine effectiveness back to the levels seen soon after the completion of the basic vaccination schedule. The post-infection immunity decreases over time, too.FundingNo external funding was used to conduct this study.Research in contextEvidence before this studyAccumulating evidence from several countries indicates that the effectiveness of covid-19 vaccines against infection declines in time, from about 80-90% shortly after completing the vaccination to about 50-60% and even less after 6 months. Published studies also suggest a significant boosting in vaccine effectiveness against infection about one week after the third vaccine dose. However, these observations come from different and often limited data sets. Moreover, the existing studies do not compare the decline in vaccine effectiveness with a decline in infection-based immunity in unvaccinated individuals.Added value of this studyIn our study, we bring together data on infections, vaccinations (including booster doses), hospital admissions and deaths to estimate how the protection due to vaccination or previous SARS-CoV-2 infection declines with time, for the whole population of the Czech Republic. Our findings show an overall decrease in vaccine effectiveness over time and a large increase after the administration of a booster dose. At the same time we show a fairly stable and high post-infection immunity over the study period. We hope this evidence will contribute to a better understanding of the changing impact of vaccines and previous infection in complex, real-world environments, which is crucial for the development of more effective and more easily communicated public health policies.Implications of all the available evidenceOur results strongly support a timely and widespread application of booster vaccine doses since their application appears to restore the vaccine-induced protection to the levels attained soon after completing the original vaccination scheme, including the high protection against mild disease or asymptomatic infection.

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“…A case-control study was conducted in the population of Qatar to assess the real-world effectiveness of the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines against the Delta (B.1.617.2) variant. At ≥14 days after the second dose, effectiveness against the Delta variant was 89.7% for BNT162b2 and 100.0% for mRNA-1273 [223].…”

Section: Efficiency Of Vaccines Observed After Phase 3 Trialmentioning

confidence: 99%

A Systematic Review on COVID-19 Vaccine Strategies, Their Effectiveness, and Issues

Khandker¹,

Godman

Jawad

et al. 2021

Vaccines

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COVID-19 vaccines are indispensable, with the number of cases and mortality still rising, and currently no medicines are routinely available for reducing morbidity and mortality, apart from dexamethasone, although others are being trialed and launched. To date, only a limited number of vaccines have been given emergency use authorization by the US Food and Drug Administration and the European Medicines Agency. There is a need to systematically review the existing vaccine candidates and investigate their safety, efficacy, immunogenicity, unwanted events, and limitations. The review was undertaken by searching online databases, i.e., Google Scholar, PubMed, and ScienceDirect, with finally 59 studies selected. Our findings showed several types of vaccine candidates with different strategies against SARS-CoV-2, including inactivated, mRNA-based, recombinant, and nanoparticle-based vaccines, are being developed and launched. We have compared these vaccines in terms of their efficacy, side effects, and seroconversion based on data reported in the literature. We found mRNA vaccines appeared to have better efficacy, and inactivated ones had fewer side effects and similar seroconversion in all types of vaccines. Overall, global variant surveillance and systematic tweaking of vaccines, coupled with the evaluation and administering vaccines with the same or different technology in successive doses along with homologous and heterologous prime-booster strategy, have become essential to impede the pandemic. Their effectiveness appreciably outweighs any concerns with any adverse events.

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BNT162b2 and mRNA-1273 COVID-19 vaccine effectiveness against the SARS-CoV-2 Delta variant in Qatar

Cited by 398 publications

References 42 publications

Effectiveness of mRNA-1273 against delta, mu, and other emerging variants of SARS-CoV-2: test negative case-control study

Effectiveness of mRNA-1273 against delta, mu, and other emerging variants of SARS-CoV-2: test negative case-control study

Real-life protection provided by vaccination, booster doses and previous infection against covid-19 infection, hospitalisation or death over time in the Czech Republic: a whole country retrospective view

A Systematic Review on COVID-19 Vaccine Strategies, Their Effectiveness, and Issues

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