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Comparative Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Against the Delta Variant.
Clin Infect Dis. 2022 08 24; 75(1):e623-e629.CI

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] = 0.37; 95% confidence interval [CI]: [.14-.98]; P = .05) and mRNA-1273 recipients (HR = 0.21; 95% CI: [.07-.64]; P = .006). Recipients of the mRNA-1273 vaccine had a lower risk of SARS-CoV-2 infection than Ad26.COV2.S recipients (HR = 0.6; 95% CI: [.43-.83]; P = .003) and BNT162b2 recipients (HR = 0.64; 95% CI: [.54-.76]; P < .001). After 1 July, efficacy against SARS-CoV-2 infection declined for Ad26.COV2.S recipients (VE = 76% before; VE = 49% after; P = .02), BNT162b2 recipients (VE = 87% before; VE = 52% after; P < .001), and mRNA-1273 recipients (VE = 92% before; VE = 70% after; P < .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.

Links

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Authors+Show Affiliations

Risk M
Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA.
Shen C
Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA.
Hayek SS
Division of Cardiology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Holevinski L
Data Office for Clinical and Translation Research, Office of Research, Ann Arbor, Michigan, USA.
Schiopu E
Rheumatology, Internal Medicine, Ann Arbor, Michigan, USA.
Freed G
Department of Pediatrics and Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan, USAand.
Akin C
Division of Allergy, University of Michigan, Ann Arbor, Michigan, USA.
Zhao L
Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA.

MeSH

2019-nCoV Vaccine mRNA-1273Ad26COVS1BNT162 VaccineCOVID-19COVID-19 VaccinesHumansSARS-CoV-2

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

35137006

Citation

Risk, Malcolm, et al. "Comparative Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Against the Delta Variant." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 75, no. 1, 2022, pp. e623-e629.
Risk M, Shen C, Hayek SS, et al. Comparative Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Against the Delta Variant. Clin Infect Dis. 2022;75(1):e623-e629.
Risk, M., Shen, C., Hayek, S. S., Holevinski, L., Schiopu, E., Freed, G., Akin, C., & Zhao, L. (2022). Comparative Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Against the Delta Variant. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 75(1), e623-e629. https://doi.org/10.1093/cid/ciac106
Risk M, et al. Comparative Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Against the Delta Variant. Clin Infect Dis. 2022 08 24;75(1):e623-e629. PubMed PMID: 35137006.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Against the Delta Variant. AU - Risk,Malcolm, AU - Shen,Chen, AU - Hayek,Salim S, AU - Holevinski,Lynn, AU - Schiopu,Elena, AU - Freed,Gary, AU - Akin,Cem, AU - Zhao,Lili, PY - 2021/11/21/received PY - 2022/2/10/pubmed PY - 2022/8/30/medline PY - 2022/2/9/entrez KW - COVID-19 KW - COVID-19 vaccines KW - Delta variant KW - comparative effectiveness KW - waning immunity SP - e623 EP - e629 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 75 IS - 1 N2 - 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] = 0.37; 95% confidence interval [CI]: [.14-.98]; P = .05) and mRNA-1273 recipients (HR = 0.21; 95% CI: [.07-.64]; P = .006). Recipients of the mRNA-1273 vaccine had a lower risk of SARS-CoV-2 infection than Ad26.COV2.S recipients (HR = 0.6; 95% CI: [.43-.83]; P = .003) and BNT162b2 recipients (HR = 0.64; 95% CI: [.54-.76]; P < .001). After 1 July, efficacy against SARS-CoV-2 infection declined for Ad26.COV2.S recipients (VE = 76% before; VE = 49% after; P = .02), BNT162b2 recipients (VE = 87% before; VE = 52% after; P < .001), and mRNA-1273 recipients (VE = 92% before; VE = 70% after; P < .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. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/35137006/Comparative_Effectiveness_of_Coronavirus_Disease_2019__COVID_19__Vaccines_Against_the_Delta_Variant_ DB - PRIME DP - Unbound Medicine ER -