Real-World Effectiveness of a Third Dose of mRNA-1273 versus BNT162b2 on Inpatient and Medically Attended COVID-19 among Immunocompromised Adults in the United States

Tianyu Sun, Linwei Li, Katherine Mues, Mihaela Georgieva, Brenna Kirk, James Mansi, Nicolas Van de Velde, Ekkehard Beck
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Abstract

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 2 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 US. The HealthVerity (HV) medical and pharmacy claims database, which contains data from >330 million patients, was the data source. Both subgroup and sensitivity analyses were conducted in addition to the core comparisons noted. In propensity score-adjusted analyses, receiving mRNA-1273 vs BNT162b2 as third dose was associated with 32% (relative risk [RR] 0.68; 95% confidence interval [CI] 0.51-0.89) , 29% (0.71; 0.57-0.86), and 23% (0.77; 0.62-0.93) lower risk of COVID-19 hospitalization after 90, 180, and 270 days, respectively. Corresponding reductions in medically-attended COVID-19 were 8% (0.92; 0.86-0.98), 6% (0.94; 0.90-0.98), and 2% (0.98; 0.94-1.02), respectively. 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.
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 的实际疗效对比
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,与使用两剂 BNT162b2(Comirnaty;辉瑞/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 住院率和就诊率的实际效果。数据来源是HealthVerity(HV)医疗和药房索赔数据库,该数据库包含3.3亿患者的数据。除上述核心比较外,还进行了亚组分析和敏感性分析。在倾向评分调整分析中,接受 mRNA-1273 与 BNT162b2 作为第三剂分别与 90 天、180 天和 270 天后 COVID-19 住院风险降低 32%(相对风险 [RR] 0.68;95% 置信区间 [CI] 0.51-0.89)、29%(0.71;0.57-0.86)和 23%(0.77;0.62-0.93)有关。相应地,COVID-19医疗就诊率分别降低了8% (0.92; 0.86-0.98)、6% (0.94; 0.90-0.98)和2% (0.98; 0.94-1.02)。我们的研究结果表明,在美国的 IC 成人中,在预防 COVID-19 住院治疗和突破药物治疗的 COVID-19 方面,第三剂 mRNA-1273 比第三剂 BNT162b2 更有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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