Real-World Effectiveness of a Third Dose of mRNA-1273 Versus BNT162b2 on Inpatient and Medically Attended COVID-19 Among Immunocompromised US Adults.

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES Infectious Diseases and Therapy Pub Date : 2024-08-01 Epub Date: 2024-06-25 DOI:10.1007/s40121-024-01005-1

Tianyu Sun, Linwei Li, Katherine E Mues, Mihaela V Georgieva, Brenna Kirk, James A Mansi, Nicolas Van de Velde, Ekkehard C Beck

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Abstract

Introduction: Recent data have shown elevated infection rates in several subpopulations at risk of SARS-CoV-2 infection and COVID-19, including immunocompromised (IC) individuals. Previous research suggests that IC persons have reduced risks of hospitalization and medically attended COVID-19 with two doses of mRNA-1273 (SpikeVax; Moderna) compared to two doses of BNT162b2 (Comirnaty; Pfizer/BioNTech). The main objective of this retrospective cohort study was to compare real-world effectiveness of third doses of mRNA-1273 versus BNT162b2 at multiple time points on occurrence of COVID-19 hospitalization and medically attended COVID-19 among IC adults in the United States (US).

Methods: This retrospective, observational comparative effectiveness study identified patients from the US HealthVerity database from December 11, 2020, through August 31, 2022. Medically attended SARS-CoV-2 infections and hospitalizations were assessed following a three-dose mRNA-1273 versus BNT162b2 regimen. Inverse probability weighting was applied to balance baseline confounders between vaccine groups. Relative risk (RR) and risk difference were calculated for subgroup and sensitivity analyses using a non-parametric method.

Results: In propensity score-adjusted analyses, receiving mRNA-1273 vs. BNT162b2 as third dose was associated with 32.4% (relative risk 0.676; 95% confidence interval 0.506-0.887), 29.3% (0.707; 0.573-0.858), and 23.4% (0.766; 0.626-0.927) lower risk of COVID-19 hospitalization after 90, 180, and 270 days, respectively. Corresponding reductions in medically attended COVID-19 were 8.4% (0.916; 0.860-0.976), 6.4% (0.936; 0.895-0.978), and 2.4% (0.976; 0.935-1.017), respectively.

Conclusions: Our findings suggest a third dose of mRNA-1273 is more effective than a third dose of BNT162b2 in preventing COVID-19 hospitalization and breakthrough medically attended COVID-19 among IC adults in the US.

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mRNA-1273 第三剂量与 BNT162b2 第三剂量对美国免疫力低下的成人住院病人和就医者 COVID-19 的实际效果。

导言：最近的数据显示，包括免疫力低下者（IC）在内的一些有感染 SARS-CoV-2 和 COVID-19 风险的亚人群的感染率升高。以前的研究表明，与两剂 BNT162b2（Comirnaty；Pfizer/BioNTech）相比，IC 患者使用两剂 mRNA-1273 （SpikeVax；Moderna）可降低住院和就医 COVID-19 的风险。这项回顾性队列研究的主要目的是比较第三剂 mRNA-1273 与 BNT162b2 在多个时间点对美国 IC 成人 COVID-19 住院率和就医率的实际效果：这项回顾性、观察性比较效果研究从美国 HealthVerity 数据库中筛选出 2020 年 12 月 11 日至 2022 年 8 月 31 日期间的患者。在使用三剂 mRNA-1273 与 BNT162b2 方案后，对医疗护理的 SARS-CoV-2 感染和住院情况进行了评估。采用反概率加权法平衡疫苗组之间的基线混杂因素。采用非参数方法计算了亚组和敏感性分析的相对风险（RR）和风险差异：在倾向评分调整分析中，接种 mRNA-1273 与 BNT162b2 作为第三剂疫苗，90、180 和 270 天后 COVID-19 住院风险分别降低 32.4%（相对风险 0.676；95% 置信区间 0.506-0.887）、29.3%（0.707；0.573-0.858）和 23.4%（0.766；0.626-0.927）。相应的COVID-19就诊率分别降低了8.4% (0.916; 0.860-0.976)、6.4% (0.936; 0.895-0.978)和2.4% (0.976; 0.935-1.017)：我们的研究结果表明，在预防美国IC成人COVID-19住院和突破COVID-19医疗护理方面，第三剂mRNA-1273比第三剂BNT162b2更有效。

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来源期刊

Infectious Diseases and Therapy Medicine-Microbiology (medical)

CiteScore

8.60

自引率

1.90%

发文量

136

审稿时长

6 weeks

期刊介绍： Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.