The effectiveness of mRNA vaccines to prevent SARS-CoV-2 infection and hospitalisation for COVID-19 according to the time elapsed since their administration in health professionals in the Valencian Autonomous Community (Spain)

Chico-Sánchez, Pablo; Gras-Valentí, Paula; Algado-Sellés, Natividad; Jiménez-Sepúlveda, Natali Juliet; Vanaclocha, Hermelinda; Peiró, Salvador; Berenguer, Ana; Navarro, David; Sánchez‐Paya, José

doi:10.1016/j.ypmed.2022.107237

Cited by 8 publications

(15 citation statements)

References 19 publications

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“…Overall, the studies included >3.9 million older adults (aged ≥50 years) vaccinated with mRNA-1273 and >5.2 million vaccinated with BNT162b2. Most studies involved North American (Canada, n=2 (40, 41); United States, n=11 (42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52)) or European (Belgium, n=1 (53); Greece, n=1 (54); Hungary, n=2 (55, 56); Norway, n=1 (57); Netherlands, n=1 (58); Spain, n=2 (59, 60); multiple countries, n=1 (61)) populations. Although most studies included general population samples, two were restricted to nursing home or retirement home residents (40, 43) and two were restricted to Veteran’s Affairs populations in the United States (42, 44).…”

Section: Resultsmentioning

confidence: 99%

“…Based on the risk of bias assessment for nonrandomized studies, most of the studies included in the meta-analysis had no serious risk of bias; however there was serious risk of bias in four studies (40, 45, 54, 59), and risk of bias was not estimable for one study (50) ( Supplemental Table S4 ).…”

Section: Resultsmentioning

confidence: 99%

“…Risk of bias in Breznik 2023(40) and Chico-Sanchez 2022(59). In Butt 2022(42) and Kissling 2022 (61), wide 95% CI due to low number of events.…”

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confidence: 99%

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Comparative Effectiveness of mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Older Adults: Systematic Literature Review and Meta-Analysis Using the GRADE Framework

Kavikondala,

Haeussler,

Wang

et al. 2023

Preprint

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BackgroundThe mRNA vaccines mRNA-1273 and BNT162b2 demonstrated high efficacy against SARS-CoV-2 infection in phase 3 clinical trials, including among older adults. To inform COVID-19 vaccine selection, this systematic literature review (SLR) and meta-analysis assessed the comparative effectiveness of mRNA-1273 versus BNT162b2 in older adults.MethodsWe systematically searched for relevant studies reporting COVID-19 outcomes with mRNA vaccines in older adults aged ≥50 years by first cross-checking relevant published SLRs. Based on the cutoff date from a previous similar SLR, we then searched the WHO COVID-19 Research Database for relevant articles published between April 9, 2022 and June 2, 2023. Outcomes of interest were SARS-CoV-2 infection, symptomatic SARS-CoV-2 infection, severe SARS-CoV-2 infection, COVID-19‒related hospitalization, and COVID-19‒related death following ≥2 vaccine doses. Random-effects meta-analysis models were used to pool risk ratios (RRs) across studies. Heterogeneity was evaluated using chi-squared testing. Evidence certainty was assessed per GRADE framework.Results24 non-randomized real-world studies reporting clinical outcomes with mRNA vaccines in individuals aged ≥50 years were included in the meta-analysis. Vaccination with mRNA-1273 was associated with significantly lower risk of SARS-CoV-2 infection (RR 0.72 [95% confidence interval (CI) 0.64‒0.80]), symptomatic SARS-CoV-2 infection (RR 0.72 [95% CI 0.62‒0.83]), severe SARS-CoV-2 infection (RR 0.67 [95% CI 0.57‒0.78]), COVID-19‒related hospitalization (RR 0.65 [95% CI 0.53‒0.79]) and COVID-19‒related death (RR 0.80 [95% CI 0.64‒0.99]) compared with BNT162b2. There was considerable heterogeneity between studies for all outcomes (I2>75%) except death (I2=0%). Multiple subgroup and sensitivity analyses excluding specific studies generally demonstrated consistent results. Certainty of evidence across outcomes was rated as low (type 3) or very low (type 4), reflecting the lack of randomized-controlled trial data.ConclusionMeta-analysis of 24 observational studies demonstrated significantly lower risk of asymptomatic, symptomatic, and severe infections; hospitalizations; and deaths with the mRNA-1273 versus BNT162b2 vaccine in older adults aged ≥50 years.SUMMARY POINTSThe COVID-19 pandemic has disproportionately affected older adults, as this population is generally more susceptible to infection and severe outcomes due to immune senescence and underlying comorbidities.The 2 available mRNA vaccines mRNA-1273 and BNT162b2 demonstrated high efficacy against SARS-CoV-2 infection in phase 3 clinical trials, including among older adults.To inform COVID-19 vaccine selection, this systematic literature review and meta-analysis assessed the comparative effectiveness of mRNA-1273 versus BNT162b2 among older adults in real-world settings.Vaccination with homologous primary or booster mRNA-1273 was associated with significantly lower risk of infection (including asymptomatic, symptomatic, and severe infections), hospitalization, and death due to COVID-19 than vaccination with BNT162b2 in older adults aged ≥50 years.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Comparative Effectiveness of mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Older Adults: Systematic Literature Review and Meta-Analysis Using the GRADE Framework

Kavikondala,

Haeussler,

Wang

et al. 2023

Preprint

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“…Nevertheless, as discussed above, during the period analyzed, the delta variant prevailed, representing more than 50% of the diagnosed cases. Additionally, an unpublished study under editorial evaluation [ 30 ] conducted in HCWs from the European region of the Valencian community between EW 4 and 28 showed a drop in VE during the periods from 12 to 120 days and more than 120 days after the second dose administration from 91.6% to 71.5%. During the period analyzed in this study, the alpha variant was the prevailing one, a fact that highlights that VE decline occurred in a period that preceded the predominance of the delta variant.…”

Section: Discussionmentioning

confidence: 99%

The Waning of BNT162b2 Vaccine Effectiveness for SARS-CoV-2 Infection Prevention over Time: A Test-Negative Study in Health Care Professionals of a Health Department from January 2021 to December 2021

Jiménez-Sepúlveda¹,

Chico-Sánchez²,

Castro-García³

et al. 2022

IJERPH

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The duration of protection of vaccines against SARS-CoV-2 infection has been evaluated in previous studies, but uncertainty remains about the persistence of effectiveness over time and the ideal timing for booster doses. Therefore, the aim of this study was to evaluate BNT162b2 vaccine effectiveness against SARS-CoV-2 infection in health care workers (HCWs) at a tertiary hospital depending on time elapsed since the completion of a two-dose vaccination regimen. We conducted a case–control with negative test study between 25 January and 12 December 2021 that included 1,404 HCWs who underwent an active infection diagnostic test (AIDT) to rule out SARS-CoV-2 infection due to COVID-19 suspicion or prior close contact with patients diagnosed with COVID-19. The adjusted vaccine effectiveness (aVE) for the prevention of SARS-CoV-2 infection 12 to 120 days after completing the full two-dose vaccination regimen was 91.9%. Then, aVE decreased to 63.7% between 121 to 240 days after completing the full two-dose regimen and to 37.2% after 241 days since the second dose. Vaccination against SARS-CoV-2 infection in HCWs remains highly effective after 12 to 120 days have elapsed since the administration of two doses of the BNT162b2 vaccine; however, effectiveness decreases as time elapses since its administration.

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“…This issue is also relevant to currently licensed COVID-19 vaccines, all designed for intramuscular administration [6][7][8]. These vaccines have indeed been very effective in reducing the incidence of severe disease and hospitalization [9,10] but have had less effects in the containment of asymptomatic or mild infections, and thus on viral circulation [3,11].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of mucosal vaccination using a protozoan parasite as a vehicle for antigen delivery: IgG and neutralizing response after rectal administration of LeCoVax-2, a candidate vaccine against COVID-19

Epis

Varotto-Boccazzi

Manenti

et al. 2022

Pharmacological Research

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The effectiveness of mRNA vaccines to prevent SARS-CoV-2 infection and hospitalisation for COVID-19 according to the time elapsed since their administration in health professionals in the Valencian Autonomous Community (Spain)

Cited by 8 publications

References 19 publications

Comparative Effectiveness of mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Older Adults: Systematic Literature Review and Meta-Analysis Using the GRADE Framework

Comparative Effectiveness of mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Older Adults: Systematic Literature Review and Meta-Analysis Using the GRADE Framework

The Waning of BNT162b2 Vaccine Effectiveness for SARS-CoV-2 Infection Prevention over Time: A Test-Negative Study in Health Care Professionals of a Health Department from January 2021 to December 2021

Efficacy of mucosal vaccination using a protozoan parasite as a vehicle for antigen delivery: IgG and neutralizing response after rectal administration of LeCoVax-2, a candidate vaccine against COVID-19

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