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BNT162b2 Vaccine Booster and Mortality Due to Covid-19.
N Engl J Med. 2021 12 23; 385(26):2413-2420.NEJM

Abstract

BACKGROUND

The emergence of the B.1.617.2 (delta) variant of severe acute respiratory syndrome coronavirus 2 and the reduced effectiveness over time of the BNT162b2 vaccine (Pfizer-BioNTech) led to a resurgence of coronavirus disease 2019 (Covid-19) cases in populations that had been vaccinated early. On July 30, 2021, the Israeli Ministry of Health approved the use of a third dose of BNT162b2 (booster) to cope with this resurgence. Evidence regarding the effectiveness of the booster in lowering mortality due to Covid-19 is still needed.

METHODS

We obtained data for all members of Clalit Health Services who were 50 years of age or older at the start of the study and had received two doses of BNT162b2 at least 5 months earlier. The mortality due to Covid-19 among participants who received the booster during the study period (booster group) was compared with that among participants who did not receive the booster (nonbooster group). A Cox proportional-hazards regression model with time-dependent covariates was used to estimate the association of booster status with death due to Covid-19, with adjustment for sociodemographic factors and coexisting conditions.

RESULTS

A total of 843,208 participants met the eligibility criteria, of whom 758,118 (90%) received the booster during the 54-day study period. Death due to Covid-19 occurred in 65 participants in the booster group (0.16 per 100,000 persons per day) and in 137 participants in the nonbooster group (2.98 per 100,000 persons per day). The adjusted hazard ratio for death due to Covid-19 in the booster group, as compared with the nonbooster group, was 0.10 (95% confidence interval, 0.07 to 0.14; P<0.001).

CONCLUSIONS

Participants who received a booster at least 5 months after a second dose of BNT162b2 had 90% lower mortality due to Covid-19 than participants who did not receive a booster.

Authors+Show Affiliations

From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel.From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel.From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel.From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel.From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel.From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel.From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34879190

Citation

Arbel, Ronen, et al. "BNT162b2 Vaccine Booster and Mortality Due to Covid-19." The New England Journal of Medicine, vol. 385, no. 26, 2021, pp. 2413-2420.
Arbel R, Hammerman A, Sergienko R, et al. BNT162b2 Vaccine Booster and Mortality Due to Covid-19. N Engl J Med. 2021;385(26):2413-2420.
Arbel, R., Hammerman, A., Sergienko, R., Friger, M., Peretz, A., Netzer, D., & Yaron, S. (2021). BNT162b2 Vaccine Booster and Mortality Due to Covid-19. The New England Journal of Medicine, 385(26), 2413-2420. https://doi.org/10.1056/NEJMoa2115624
Arbel R, et al. BNT162b2 Vaccine Booster and Mortality Due to Covid-19. N Engl J Med. 2021 12 23;385(26):2413-2420. PubMed PMID: 34879190.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - BNT162b2 Vaccine Booster and Mortality Due to Covid-19. AU - Arbel,Ronen, AU - Hammerman,Ariel, AU - Sergienko,Ruslan, AU - Friger,Michael, AU - Peretz,Alon, AU - Netzer,Doron, AU - Yaron,Shlomit, Y1 - 2021/12/08/ PY - 2021/12/9/pubmed PY - 2022/1/6/medline PY - 2021/12/8/entrez SP - 2413 EP - 2420 JF - The New England journal of medicine JO - N Engl J Med VL - 385 IS - 26 N2 - BACKGROUND: The emergence of the B.1.617.2 (delta) variant of severe acute respiratory syndrome coronavirus 2 and the reduced effectiveness over time of the BNT162b2 vaccine (Pfizer-BioNTech) led to a resurgence of coronavirus disease 2019 (Covid-19) cases in populations that had been vaccinated early. On July 30, 2021, the Israeli Ministry of Health approved the use of a third dose of BNT162b2 (booster) to cope with this resurgence. Evidence regarding the effectiveness of the booster in lowering mortality due to Covid-19 is still needed. METHODS: We obtained data for all members of Clalit Health Services who were 50 years of age or older at the start of the study and had received two doses of BNT162b2 at least 5 months earlier. The mortality due to Covid-19 among participants who received the booster during the study period (booster group) was compared with that among participants who did not receive the booster (nonbooster group). A Cox proportional-hazards regression model with time-dependent covariates was used to estimate the association of booster status with death due to Covid-19, with adjustment for sociodemographic factors and coexisting conditions. RESULTS: A total of 843,208 participants met the eligibility criteria, of whom 758,118 (90%) received the booster during the 54-day study period. Death due to Covid-19 occurred in 65 participants in the booster group (0.16 per 100,000 persons per day) and in 137 participants in the nonbooster group (2.98 per 100,000 persons per day). The adjusted hazard ratio for death due to Covid-19 in the booster group, as compared with the nonbooster group, was 0.10 (95% confidence interval, 0.07 to 0.14; P<0.001). CONCLUSIONS: Participants who received a booster at least 5 months after a second dose of BNT162b2 had 90% lower mortality due to Covid-19 than participants who did not receive a booster. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/34879190/full_citation L2 - https://www.nejm.org/doi/10.1056/NEJMoa2115624?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -