Vaccine effectiveness of the BNT162b2 mRNA COVID-19 vaccine against RT-PCR confirmed SARS-CoV-2 infections, hospitalisations and mortality in prioritised risk groups

Abstract

Objective: To estimate in a real life setting, the vaccine effectiveness of the BNT162b2 mRNA vaccine against confirmed SARS-CoV-2 infection, hospital admission, and death among five priority groups for vaccination Design: Cohort study Setting: Roll-out of the BNT162b2 mRNA vaccine in Denmark Participants: 864,096 individuals who were first inline to receive the BNT162b2 mRNA vaccine: 46,101 long-term care facility (LTCF) residents, 61,805 individuals 65 years and older living at home but requiring practical help and personal care (65PHC), 98,533 individuals ≥85 years of age (+85), 425,799 health-care workers (HCWs), and 231,858 individuals with comorbidities that predispose for severe COVID-19 disease (SCD). Intervention: vaccination with BNT162b2 mRNA vaccine Main outcome measures: RT-PCR confirmed SARS-CoV-2 infections, COVID-19 related admissions within 14 days after a confirmed SARS-CoV-2 infection, all-cause admission, COVID-19 related death within 30 days after confirmed SARS-CoV-2 infection, and all-cause death. Results: Beyond 7 days after the second dose, the VE against SARS-CoV-2 infection in all groups ranged from 53-86%. In 65PHC, HCW and SCD, we observed a substantial reduction in risk of infection 0-7 days after the second dose ranging from 46-71%. The VE against COVID-19 related admissions ranged from 75-87% in all groups except +85 and HCWs where no events occurred. For COVID-19 related deaths, a significant VE was observed in LTCF residents (VE of 89%) and 65PHC (VE of 97%), whereas no events were observed in the three remaining groups. VE against all-cause death ranged from 26-73% in all groups except HCW where an insignificant VE was estimated. For all-cause admission, the VE ranged from 37-50% in all groups except in SCD where a negative VE was observed. Conclusion: In a real-life setting and more than 7 days after the second dose of BNT162b2 mRNA was administered to the most vulnerable individuals, the vaccine was associated with a reduction of SARS-CoV-2 infection (53-86%) and COVID-19 related admissions (≥75%) or deaths (≥89%).

Effectiveness of the WHO-Authorized COVID-19 Vaccines: A Rapid Review of Global Reports till 30 June 2021

“…The only exception was a low VE noted for CoronaVac (42%, 95% CI, 26.9-53.3%) in a Brazilian study of subjects aged ≥70, with an 83% P.1 variant prevalence during the study time (Table 1) [43]. The VE among fully vaccinated healthcare workers was 80% or higher (80-97% by BNT162b2 [11,19,22,30,34,39,47,48] and 82-99% by mRNA-1273 [47,48]) (Table 1). Comparatively, VE estimates among residents of long-term care facilities were low (partially vaccinated: 21-65% by BNT162b2 [39,45], 68% [95% CI, 34-85%] by ChAdOx1 [45]; fully vaccinated: 53-64% by BNT162b2 [11,39]).…”

“…Among the partially vaccinated general population, the VE varied among studies (42-78% by BNT162b2 [23,28,31,32,40,42,46], 67-93% by mRNA-1273 [26,31,40], and 61-95% by ChAdOx1 [31,32,42]). After full vaccination, the VE was all higher than 75% (77-98% by BNT162b2 [11,23,28,31,33,40,42], 93-99% by mRNA-1273 [31,40], 79% by ChAdOx1 [42], and 78% by Ad26.COV2.S with a single dose as full vaccination [27]). The only exception was a low VE noted for CoronaVac (42%, 95% CI, 26.9-53.3%) in a Brazilian study of subjects aged ≥70, with an 83% P.1 variant prevalence during the study time (Table 1) [43].…”

“…After a full-text review of the remaining 57 articles for eligibility, 18 were removed due to not completely meeting the criteria. Therefore, 39 studies [9,11,12, that met the inclusion criteria were included in this rapid review (Figure 1, Supplementary Table S1). The results of the quality assessment of all the included studies are shown in Supplementary Table S2.…”

“…The results of the quality assessment of all the included studies are shown in Supplementary Table S2. Before 1 July 2021, 24 of 39 studies were published in peer-reviewed journals [9,12,[15][16][17]19,22,24,25,[28][29][30][31]33,34,36,37,[40][41][42]45,47,48,50] while the remaining 15 studies were posted online as preprint articles [11,18,20,21,23,26,27,32,35,38,39,43,44,46,49]. The characteristics of the studies are shown in Supplementary Table S1, including the country, study design, types of vaccines, outcomes, and SARS-CoV-2 variants involved in the studies.…”

“…Given a different efficacy was shown for vaccines developed with different platforms [1][2][3][4], their effectiveness in the real world for different populations needs to be confirmed. A Denmark study showed different VE in different age groups (77% for people ≥ 85 years of age vs. 86% for people ≥ 65 years), and different living/working environments (53% for long-term care facilities dwellers vs. 80% for healthcare workers) [11]. Similarly, the VE may also be different among different countries or races.…”