Effectiveness of mRNA Covid-19 Vaccine among U.S. Health Care Personnel.
2019-nCoV Vaccine mRNA-1273
/ administration & dosage
Adolescent
Adult
Aged
BNT162 Vaccine
/ administration & dosage
COVID-19
/ diagnosis
COVID-19 Serological Testing
Case-Control Studies
Female
Health Personnel
Humans
Immunization, Secondary
Male
Middle Aged
Polymerase Chain Reaction
United States
Vaccine Efficacy
Journal
The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562
Informations de publication
Date de publication:
16 12 2021
16 12 2021
Historique:
pubmed:
23
9
2021
medline:
29
12
2021
entrez:
22
9
2021
Statut:
ppublish
Résumé
The prioritization of U.S. health care personnel for early receipt of messenger RNA (mRNA) vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19), allowed for the evaluation of the effectiveness of these new vaccines in a real-world setting. We conducted a test-negative case-control study involving health care personnel across 25 U.S. states. Cases were defined on the basis of a positive polymerase-chain-reaction (PCR) or antigen-based test for SARS-CoV-2 and at least one Covid-19-like symptom. Controls were defined on the basis of a negative PCR test for SARS-CoV-2, regardless of symptoms, and were matched to cases according to the week of the test date and site. Using conditional logistic regression with adjustment for age, race and ethnic group, underlying conditions, and exposures to persons with Covid-19, we estimated vaccine effectiveness for partial vaccination (assessed 14 days after receipt of the first dose through 6 days after receipt of the second dose) and complete vaccination (assessed ≥7 days after receipt of the second dose). The study included 1482 case participants and 3449 control participants. Vaccine effectiveness for partial vaccination was 77.6% (95% confidence interval [CI], 70.9 to 82.7) with the BNT162b2 vaccine (Pfizer-BioNTech) and 88.9% (95% CI, 78.7 to 94.2) with the mRNA-1273 vaccine (Moderna); for complete vaccination, vaccine effectiveness was 88.8% (95% CI, 84.6 to 91.8) and 96.3% (95% CI, 91.3 to 98.4), respectively. Vaccine effectiveness was similar in subgroups defined according to age (<50 years or ≥50 years), race and ethnic group, presence of underlying conditions, and level of patient contact. Estimates of vaccine effectiveness were lower during weeks 9 through 14 than during weeks 3 through 8 after receipt of the second dose, but confidence intervals overlapped widely. The BNT162b2 and mRNA-1273 vaccines were highly effective under real-world conditions in preventing symptomatic Covid-19 in health care personnel, including those at risk for severe Covid-19 and those in racial and ethnic groups that have been disproportionately affected by the pandemic. (Funded by the Centers for Disease Control and Prevention.).
Sections du résumé
BACKGROUND
The prioritization of U.S. health care personnel for early receipt of messenger RNA (mRNA) vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19), allowed for the evaluation of the effectiveness of these new vaccines in a real-world setting.
METHODS
We conducted a test-negative case-control study involving health care personnel across 25 U.S. states. Cases were defined on the basis of a positive polymerase-chain-reaction (PCR) or antigen-based test for SARS-CoV-2 and at least one Covid-19-like symptom. Controls were defined on the basis of a negative PCR test for SARS-CoV-2, regardless of symptoms, and were matched to cases according to the week of the test date and site. Using conditional logistic regression with adjustment for age, race and ethnic group, underlying conditions, and exposures to persons with Covid-19, we estimated vaccine effectiveness for partial vaccination (assessed 14 days after receipt of the first dose through 6 days after receipt of the second dose) and complete vaccination (assessed ≥7 days after receipt of the second dose).
RESULTS
The study included 1482 case participants and 3449 control participants. Vaccine effectiveness for partial vaccination was 77.6% (95% confidence interval [CI], 70.9 to 82.7) with the BNT162b2 vaccine (Pfizer-BioNTech) and 88.9% (95% CI, 78.7 to 94.2) with the mRNA-1273 vaccine (Moderna); for complete vaccination, vaccine effectiveness was 88.8% (95% CI, 84.6 to 91.8) and 96.3% (95% CI, 91.3 to 98.4), respectively. Vaccine effectiveness was similar in subgroups defined according to age (<50 years or ≥50 years), race and ethnic group, presence of underlying conditions, and level of patient contact. Estimates of vaccine effectiveness were lower during weeks 9 through 14 than during weeks 3 through 8 after receipt of the second dose, but confidence intervals overlapped widely.
CONCLUSIONS
The BNT162b2 and mRNA-1273 vaccines were highly effective under real-world conditions in preventing symptomatic Covid-19 in health care personnel, including those at risk for severe Covid-19 and those in racial and ethnic groups that have been disproportionately affected by the pandemic. (Funded by the Centers for Disease Control and Prevention.).
Identifiants
pubmed: 34551224
doi: 10.1056/NEJMoa2106599
pmc: PMC8482809
doi:
Substances chimiques
2019-nCoV Vaccine mRNA-1273
EPK39PL4R4
BNT162 Vaccine
N38TVC63NU
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e90Subventions
Organisme : NCEZID CDC HHS
ID : U01 CK000480
Pays : United States
Organisme : NCEZID CDC HHS
ID : U54 CK000481
Pays : United States
Investigateurs
Wei Xing
(W)
Yunmi Chung
(Y)
Anna Yousaf
(A)
Jennifer Onukwube
(J)
Bradley Clinansmith
(B)
Alysia Horcher
(A)
Kelli Wallace
(K)
Karin Hoth
(K)
Lisandra Uribe
(L)
Kavitha Pathmarajah
(K)
Kye E Poronsky
(KE)
Dean M Hashimoto
(DM)
Monica Bahamon
(M)
Michelle St Romain
(MS)
Efrat Kean
(E)
Amy Stubbs
(A)
Sara Roy
(S)
Gregory Volturo
(G)
Amanda Higgins
(A)
James Galbraith
(J)
James C Crosby
(JC)
Christine D Crider
(CD)
Mary Mulrow
(M)
Joelle Nadle
(J)
Helen Johnston
(H)
Christopher A Czaja
(CA)
Catherine Emanuel
(C)
Melissa Kellogg
(M)
AmberJean Hansen
(A)
James Meek
(J)
Sara Niesobecki
(S)
Anisa Linton
(A)
Amber Britton
(A)
Lucy E Wilson
(LE)
Sara Lovett
(S)
Ruth Lynfield
(R)
Melissa Christian
(M)
Yadira Salazar-Sanchez
(Y)
Lezah Brown
(L)
Kristina G Flores
(KG)
Caroline Habrun
(C)
Savannah Pierson
(S)
Helga Gonzales
(H)
Christopher Myers
(C)
Valerie L S Ocampo
(VLS)
Gabriela Escutia
(G)
Judith A Guzman-Cottrill
(JA)
H Keipp Talbot
(HK)
Jessica Seidelman
(J)
Aaron M Milstone
(AM)
Shaun Truelove
(S)
Mary K Hayden
(MK)
Matthew Samore
(M)
Hilary M Babcock
(HM)
Daniel Shirley
(D)
Aurora Pop-Vicas
(A)
Joseph A McBride
(JA)
Denise Dillard
(D)
Jennifer Dobson
(J)
Informations de copyright
Copyright © 2021 Massachusetts Medical Society.
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