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Cited by 31SARS-CoV-2 and COVID-19 ResearchVaccine Coverage and HesitancyCOVID-19 Clinical Research Studies

Effectiveness of BNT162b2, mRNA-1273, and ChAdOx1-S vaccines against severe covid-19 outcomes in a nationwide mass vaccination setting: cohort study

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Bouillon, Kim, Baricault, Bérangère, Botton, Jérémie, Jabagi, Marie-Joëlle, Bertrand, Marion, Semenzato, Laura, Le Vu, Stéphane, Drouin, Jérôme +3 more·2022·BMJ Medicine
DOI 10.1136/bmjmed-2021-000104PMC PMC9978755
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Abstract

Objective: To estimate the effectiveness of the three covid-19 vaccines by Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273), and Oxford-AstraZeneca (ChAdOx1-S) in people after receiving two doses. Design: Cohort study. Setting: Nationwide, population based data in France, from the French National Health Data System (Système National des Données de Santé), between 27 December 2020 and 30 April 2021. Participants: Adults aged ≥50 years receiving a first dose of BNT162b2, mRNA-1273, or ChAdOx1-S were randomly selected (1:1) and matched on the date of vaccination with one unvaccinated control. Individuals were matched on year of birth, sex, region of residence, and residence in a nursing home (for individuals aged ≥75 years). All individuals were followed up until 20 August 2021. Main outcome measures: Primary outcome measure was vaccine effectiveness estimated at least 14 days after the second dose against covid-19 related hospital admission using Cox proportional hazards models adjusted for baseline characteristics and comorbidities. Vaccine effectiveness against covid-19 related death in hospital was also investigated. Results: 11 256 832 vaccinated individuals were included in the study (63.6% (n=7 161 658) with the BNT162b2 vaccine, 7.6% (n=856 599) with the mRNA-1273 vaccine, and 28.8% (n=3 238 575) with the ChAdOx1-S vaccine), along with 11 256 832 matched unvaccinated controls. During follow-up (up to 20 August 2021), 43 158 covid-19 related hospital admissions and 7957 covid-19 related deaths in hospital were registered. Compared with unvaccinated controls, vaccine effectiveness of two doses against covid-19 related hospital admission was 91% (95% confidence interval 91% to 92%), 95% (93% to 96%), and 91% (89% to 94%) for the BNT162b2, mRNA-1273, and ChAdOx1-S vaccines, respectively. Similar results were observed for vaccine effectiveness of two doses against covid-19 related deaths in hospital (BNT162b2, 91% (90% to 93%); mRNA-1273, 96% (92% to 98%); and ChAdOx1 nCoV-19, 88% (68% to 95%)). At 5-6 months after receiving the second dose of vaccine, effectiveness remained high at 94% (92% to 95%) for the BNT162b2 vaccine and 98% (93% to 100%) for the mRNA-1273 vaccine. Vaccine effectiveness of ChAdOx1-S estimated at 3-4 months was 90% (63% to 97%). All three vaccines remained effective at the time of circulation of the delta variant of SARS-CoV-2 between 1 July and 20 August 2021 (effectiveness between 89% and 95%). Conclusions: These findings provide evidence indicating that two doses of ChAdOx1-S is as effective as two doses of mRNA vaccines in France against the alpha and delta variants of SARS-CoV-2. The effectiveness of ChAdOx1-S should be further examined with a longer follow-up and in the light of the circulation of new SARS-CoV-2 variants of concern.

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Authors
Bouillon, K., Baricault, B., Botton, J., Jabagi, M.-J., Bertrand, M., Semenzato, L., Le Vu, S., Drouin, J., Dray-Spira, R., Weill, A., & Zureik, M.
Affiliations
  • Epi-Phare (FR)
  • Université Paris-Saclay (FR)
  • EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, Saint-Denis, France
  • Inserm (FR)
Corresponding author
Zureik, Mahmoud
ORCID
Venue
BMJ Medicine
Publisher
BMJ
Published
2022-06
Volume
1
Issue
1
Pages
e000104
ISSN
2754-0413 (ISSN-L)
DOI
10.1136/bmjmed-2021-000104
PMC
PMC9978755
OpenAlex
W4312857378
Cited by
31
References
11
Citations by year
2026: 4 · 2025: 8 · 2024: 7 · 2023: 12
FWCI
3.30
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Medicine (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Keywords
COVID-19 vaccines, BNT162b2, mRNA-1273, ChAdOx1 nCoV-19 vaccine, vaccine effectiveness, hospitalization, in-hospital mortality, severe COVID-19 outcomes, mass vaccination, older adults, SARS-CoV-2, France, nursing homes, comorbidities

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