Aetion, Inc., 5 Pennsylvania Plaza, New York, NY 10001, USA.
Moderna, Inc., 325 Binney Street, Cambridge, MA 02142, USA.
Vaccine. 2024 Nov 14;42(25):126113. doi: 10.1016/j.vaccine.2024.07.014. Epub 2024 Jul 18.
To compare the real-world effectiveness of a third dose of mRNA-1273 versus a third dose of BNT162b2 against breakthrough COVID-19 hospitalizations among adults aged ≥ 65 years who completed a primary series of an mRNA-based COVID-19 vaccine (regardless of which primary series was received).
This observational comparative vaccine effectiveness (VE) study was conducted using administrative claims data from the US HealthVerity database (September 22, 2021, to August 31, 2022). A third dose of mRNA-1273 versus BNT162b2 was assessed for preventing COVID-19 hospitalizations and medically attended COVID-19 among adults aged ≥ 65 years. Inverse probability of treatment weighting was applied to balance baseline characteristics between vaccine groups. Incidence rates from patient-level data and hazard ratios (HRs) with 95 % confidence intervals (CIs) using weighted Cox proportional hazards models were calculated to estimate relative VE for each outcome.
Overall, 94,587 and 92,377 individuals received a third dose of mRNA-1273 and BNT162b2, respectively. Among the weighted population, the median age was 69 years (interquartile range, 66-74), 53 % were female, and 46 % were commercially insured. COVID-19 hospitalization rates per 1000 person-years (PYs) were 5.61 (95 % CI, 5.13-6.09) for mRNA-1273 and 7.06 (95 % CI, 6.54-7.57) for BNT162b2 (HR, 0.82; 0.69-0.98). Medically attended COVID-19 rates per 1000 PYs (95 % CI) were 95.05 (95 % CI, 93.03-97.06) for mRNA-1273 and 106.55 (95 % CI, 104.53-108.57) for BNT162b2 (HR, 0.93; 0.89-0.98).
Results from this observational comparative VE database study provide evidence that among older adults, a third dose of mRNA-1273 was more effective in preventing breakthrough COVID-19 hospitalization and medically attended COVID-19 infection compared with a third dose of BNT162b2.
本研究旨在比较接种第三剂 mRNA-1273 与接种第三剂 BNT162b2 对已完成基于 mRNA 的 COVID-19 疫苗基础系列接种（无论接种了哪种基础系列）的≥65 岁成年人突破性 COVID-19 住院的真实世界疗效。
本观察性疫苗有效性（VE）比较研究使用了美国 HealthVerity 数据库的行政索赔数据（2021 年 9 月 22 日至 2022 年 8 月 31 日）。评估了第三剂 mRNA-1273 与 BNT162b2 对预防≥65 岁成年人 COVID-19 住院和有医疗记录的 COVID-19 的疗效。通过逆概率治疗加权法平衡疫苗组之间的基线特征。从患者水平数据计算发病率和使用加权 Cox 比例风险模型计算的风险比（HR）及其 95%置信区间（CI），以估计每种结局的相对 VE。
总体而言，分别有 94587 人和 92377 人接种了第三剂 mRNA-1273 和 BNT162b2。在加权人群中，中位年龄为 69 岁（四分位距，66-74），53%为女性，46%为商业保险。每 1000 人年（PY）的 COVID-19 住院率分别为 5.61（95%CI，5.13-6.09）mRNA-1273 和 7.06（95%CI，6.54-7.57）BNT162b2（HR，0.82；0.69-0.98）。每 1000 PY 的有医疗记录的 COVID-19 发病率（95%CI）分别为 95.05（95%CI，93.03-97.06）mRNA-1273 和 106.55（95%CI，104.53-108.57）BNT162b2（HR，0.93；0.89-0.98）。
这项来自观察性比较 VE 数据库研究的结果提供了证据，表明在老年人中，与接种第三剂 BNT162b2 相比，接种第三剂 mRNA-1273 可更有效地预防突破性 COVID-19 住院和有医疗记录的 COVID-19 感染。
