Comparative effectiveness of BNT162b2 versus mRNA-1273 boosting in England: a cohort study in OpenSAFELY-TPP
Comparative effectiveness of BNT162b2 versus mRNA-1273 boosting in England: a cohort study in OpenSAFELY-TPP
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英国 BNT162b2 与 mRNA-1273 加强的有效性比较：OpenSAFELY-TPP 中的一项队列研究
DOI：
10.1101/2022.07.29.22278186
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Hulme W
中科院分区：
文献类型：
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作者：
Hulme W
英格兰的COVID-19加强疫苗接种计划使用了BNT 162 b2和mRNA-1273疫苗。这两种疫苗对严重COVID-19的有效性的直接比较尚未在试验或观察data.MethodsOn代表NHS英格兰，我们使用OpenSAFELY-TPP数据库来匹配每种疫苗类型的成年接种者的接种日期，主要疫苗疗程，年龄和其他特征。受试者如在2021年10月29日至2022年1月31日期间接受加强注射，并接受12周的随访，则符合资格。结果是SARS-CoV-2检测呈阳性、COVID-19住院和COVID-19死亡。我们估计了每种结局的累积发生率，并使用风险差异（RD）和风险比（HRs）量化了比较有效性。结果每组匹配1，528，431人，共进行了23，150，504人周的随访。每1,000例SARS-CoV-2检测阳性者中，BNT 162 b2和mRNA-1273的12周风险分别为103.2（95%CI 102.4至104.0）和96.0（95.2至96.8）：mRNA-1273与BNT 162 b2相比的HR为0.92（95%CI 0.91至0.92）。对于COVID-19住院治疗，每1,000人的12周风险为0.65（95%CI 0.56至0.75）和0.44（0.36至0.54）：HR 0.67（95%CI 0.58至0.78）。COVID-19死亡病例罕见：每1,000人的12周风险为0.03（95%CI 0.02至0.06）和0.01（0.01至0.02）：HR 1.23（95%CI 0.59至2.56）。比较有效性在由初级疗程疫苗品牌、年龄、先前的SARS-CoV-2感染和临床易损性定义的亚组内基本相似。结论在接种后的前12周内，使用mRNA-1273 COVID-19疫苗的加强接种在预防SARS-CoV-2感染和COVID-19住院方面比BNT 162 b2更有效，在德尔塔和奥米克戎变体占优势的时期。
IntroductionThe COVID-19 booster vaccination programme in England used both BNT162b2 and mRNA-1273 vaccines. Direct comparisons of the effectiveness against severe COVID-19 of these two vaccines for boosting have not been made in trials or observational data.MethodsOn behalf of NHS England, we used the OpenSAFELY-TPP database to match adult recipients of each vaccine type on date of vaccination, primary vaccine course, age, and other characteristics. Recipients were eligible if boosted between 29 October 2021 and 31 January 2022, and followed up for 12 weeks. Outcomes were positive SARS-CoV-2 test, COVID-19 hospitalisation, and COVID-19 death. We estimated the cumulative incidence of each outcome, and quantified comparative effectiveness using risk differences (RD) and hazard ratios (HRs).Results1,528,431 people were matched in each group, contributing a total 23,150,504 person-weeks of follow-up. The 12-week risks per 1,000 people of positive SARS-CoV-2 test were 103.2 (95%CI 102.4 to 104.0) for BNT162b2 and 96.0 (95.2 to 96.8) for mRNA-1273: the HR comparing mRNA-1273 with BNT162b2 was 0.92 (95%CI 0.91 to 0.92). For COVID-19 hospitalisations the 12-week risks per 1,000 were 0.65 (95%CI 0.56 to 0.75) and 0.44 (0.36 to 0.54): HR 0.67 (95%CI 0.58 to 0.78). COVID-19 deaths were rare: the 12-week risks per 1,000 were 0.03 (95%CI 0.02 to 0.06) and 0.01 (0.01 to 0.02): HR 1.23 (95%CI 0.59 to 2.56). Comparative effectiveness was generally similar within subgroups defined by the primary course vaccine brand, age, prior SARS-CoV-2 infection and clinical vulnerability.ConclusionBooster vaccination with mRNA-1273 COVID-19 vaccine was more effective than BNT162b2 in preventing SARS-CoV-2 infection and COVID-19 hospitalisation during the first 12 weeks after vaccination, during a period of Delta followed by Omicron variant dominance.