Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions — United States, March–August 2021
Open accessAbstract
Three COVID-19 vaccines are authorized or approved for use among adults in the United States (1,2). Two 2-dose mRNA vaccines, mRNA-1273 from Moderna and BNT162b2 from Pfizer-BioNTech, received Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA) in December 2020 for persons aged ≥18 years and aged ≥16 years, respectively. A 1-dose viral vector vaccine (Ad26.COV2 from Janssen [Johnson & Johnson]) received EUA in February 2021 for persons aged ≥18 years (3). The Pfizer-BioNTech vaccine received FDA approval for persons aged ≥16 years on August 23, 2021 (4). Current guidelines from FDA and CDC recommend vaccination of eligible persons with one of these three products, without preference for any specific vaccine (4,5). To assess vaccine effectiveness (VE) of these three products in preventing COVID-19 hospitalization, CDC and collaborators conducted a case-control analysis among 3,689 adults aged ≥18 years who were hospitalized at 21 U.S. hospitals across 18 states during March 11-August 15, 2021. An additional analysis compared serum antibody levels (anti-spike immunoglobulin G [IgG] and anti-receptor binding domain [RBD] IgG) to SARS-CoV-2, the virus that causes COVID-19, among 100 healthy volunteers enrolled at three hospitals 2-6 weeks after full vaccination with the Moderna, Pfizer-BioNTech, or Janssen COVID-19 vaccine. Patients with immunocompromising conditions were excluded. VE against COVID-19 hospitalizations was higher for the Moderna vaccine (93%; 95% confidence interval [CI] = 91%-95%) than for the Pfizer-BioNTech vaccine (88%; 95% CI = 85%-91%) (p = 0.011); VE for both mRNA vaccines was higher than that for the Janssen vaccine (71%; 95% CI = 56%-81%) (all p<0.001). Protection for the Pfizer-BioNTech vaccine declined 4 months after vaccination. Postvaccination anti-spike IgG and anti-RBD IgG levels were significantly lower in persons vaccinated with the Janssen vaccine than the Moderna or Pfizer-BioNTech vaccines. Although these real-world data suggest some variation in levels of protection by vaccine, all FDA-approved or authorized COVID-19 vaccines provide substantial protection against COVID-19 hospitalization.
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Real-world studies performed a few months into COVID-19 vaccination campaigns showed high effectiveness of these vaccines.
“Real-world setting studies performed, few months into vaccination campaigns, showed high effectiveness of these vaccines [1-8].”
Recent immunologic studies have shown higher antibody responses after vaccination with mRNA-1273 compared with BNT162b2.
“Furthermore, recent immunologic studies have shown higher antibody responses after vaccination with mRNA-1273 compared with BNT162b2.16,35”
From Association Between mRNA Vaccination and COVID-19 Hospitalization and Disease Severity (2021) · cites this paper as [16]
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References 5 · Cited by 406
Research works printed but not linked: 1
- [7]Tenforde MW, Patel MM, Ginde AA,; Influenza and Other Viruses in the Acutely Ill (IVY) Network. Effectiveness of SARS-CoV-2 mRNA vaccines for preventing Covid-19 hospitalizations in the United States. Clin Infect Dis 2021. Epub August 6, 2021. 10.1093/cid/ciab687 34358310 PMC8436392 · DOI
- Authors
- Self, W. H., Tenforde, M. W., Rhoads, J. P., Gaglani, M., Ginde, A. A., Douin, D. J., Olson, S. M., Talbot, H. K., Casey, J. D., Mohr, N. M., Zepeski, A., McNeal, T., Ghamande, S., Gibbs, K. W., Files, D. C., Hager, D. N., Shehu, A., Prekker, M. E., Erickson, H. L., Gong, M. N., Mohamed, A., Henning, D. J., Steingrub, J. S., Peltan, I. D., Brown, S. M., Martin, E. T., Monto, A. S., Khan, A., Hough, C. L., Busse, L. W., ten Lohuis, C. C., Duggal, A., Wilson, J. G., Gordon, A. J., Qadir, N., Chang, S. Y., Mallow, C., Rivas, C., Babcock, H. M., Kwon, J. H., Exline, M. C., Halasa, N., Chappell, J. D., Lauring, A. S., Grijalva, C. G., Rice, T. W., Jones, I. D., Stubblefield, W. B., Baughman, A., Womack, K. N., Lindsell, C. J., Hart, K. W., Zhu, Y., Mills, L., Lester, S. N., Stumpf, M. M., Naioti, E. A., Kobayashi, M., Verani, J. R., Thornburg, N. J., Patel, M. M., IVY Network, IVY Network, Calhoun, N., Murthy, K., Herrick, J., McKillop, A., Hoffman, E., Zayed, M., Smith, M., Seattle, N., Ettlinger, J., Priest, E., Thomas, J., Arroliga, A., Beeram, M., Kindle, R., Kozikowski, L.-A., De Souza, L., Ouellette, S., Thornton-Thompson, S., Mehkri, O., Ashok, K., Gole, S., King, A., Poynter, B., Stanley, N., Hendrickson, A., Maruggi, E., Scharber, T., Jorgensen, J., Bowers, R., King, J., Aston, V., Armbruster, B., Rothman, R. E., Nair, R., Chen, J.-T. T., Karow, S., Robart, E., Maldonado, P. N., Khan, M., So, P., Levitt, J., Perez, C., Visweswaran, A., Roque, J., Rivera, A., Angeles, L., Frankel, T., Angeles, L., Goff, J., Huynh, D., Howell, M., Friedel, J., Tozier, M., Driver, C., Carricato, M., Foster, A., Nassar, P., Stout, L., Sibenaller, Z., Walter, A., Mares, J., Olson, L., Clinansmith, B., Rivas, C., Gershengorn, H., McSpadden, E., Truscon, R., Kaniclides, A., Thomas, L., Bielak, R., Valvano, W. D., Fong, R., Fitzsimmons, W. J., Blair, C., Valesano, A. L., Gilbert, J., Crider, C. D., Steinbock, K. A., Paulson, T. C., Anderson, L. A., Kampe, C., Johnson, J., McHenry, R., Blair, M., Conway, D., LaRose, M., Landreth, L., Hicks, M., Parks, L., Bongu, J., McDonald, D., Cass, C., Seiler, S., Park, D., Hink, T., Wallace, M., Burnham, C.-A., & Arter, O. G.
- Affiliations
- University of Iowa (US)
- Baylor Scott & White Health (US)
- Baystate Medical Center (US)
- Cleveland Clinic (US)
- Emory University (US)
- Hennepin County Medical Center (US)
- Intermountain Medical Center (US)
- Johns Hopkins University (US)
- Montefiore Medical Center (US)
- The Ohio State University (US)
- Stanford University (US)
- University of California System (US)
- University of Colorado Hospital (US)
- University of Miami (US)
- University of Michigan (US)
- University of Washington (US)
- Vanderbilt University Medical Center (US)
- Wake Forest University (US)
- Washington University in St. Louis (US)
- Corresponding author
- Self, Wesley H.
- ORCID
- Self, Wesley H.
- Tenforde, Mark W.
- Rhoads, Jillian P.
- Gaglani, Manjusha
- Ginde, Adit A.
- Douin, David J.
- Olson, Samantha M.
- Talbot, H. Keipp
- Casey, Jonathan D.
- Mohr, Nicholas M.
- Zepeski, Anne
- McNeal, Tresa
- Ghamande, Shekhar
- Gibbs, Kevin W.
- Files, D. Clark
- Hager, David N.
- Shehu, Arber
- Prekker, Matthew E.
- Erickson, Heidi L.
- Gong, Michelle N.
- Mohamed, Amira
- Steingrub, Jay S.
- Peltan, Ithan D.
- Brown, Samuel M.
- Martin, Emily T.
- Monto, Arnold S.
- Khan, Akram
- Hough, Catherine L.
- Busse, Laurence W.
- Duggal, Abhijit
- Wilson, Jennifer G.
- Gordon, Alexandra June
- Qadir, Nida
- Chang, Steven Y.
- Mallow, Christopher
- Babcock, Hilary M.
- Kwon, Jennie H.
- Exline, Matthew C.
- Halasa, Natasha
- Chappell, James D.
- Lauring, Adam S.
- Grijalva, Carlos G.
- Rice, Todd W.
- Stubblefield, William B.
- Womack, Kelsey N.
- Lindsell, Christopher J.
- Hart, Kimberly W.
- Zhu, Yuwei
- Mills, Lisa
- Lester, Sandra N.
- Stumpf, Megan M.
- Kobayashi, Miwako
- Verani, Jennifer R.
- Thornburg, Natalie J.
- Patel, Manish M.
- Murthy, Kempapura
- Smith, Michael
- Ettlinger, Jason
- Priest, Elisa
- Thomas, Jennifer
- Arroliga, Alejandro
- Kozikowski, Lori-Ann
- Ouellette, Scott
- Mehkri, Omar
- King, Jennifer
- Rothman, Richard E.
- Huynh, David
- Sibenaller, Zita
- Gershengorn, Hayley
- Truscon, Rachel
- Thomas, Lara
- Valvano, Weronika Damek
- Fitzsimmons, William J.
- Valesano, Andrew L.
- Blair, Marcia
- Wallace, Meghan
- Burnham, Carey-Ann
- Venue
- MMWR. Morbidity and Mortality Weekly Report
- Published
- 2021-09-24
- Volume
- 70
- Issue
- 38
- Pages
- 1337-1343
- ISSN
- 0149-2195 (ISSN-L)
- 1545-861X
- PMC
- PMC8459899
- OpenAlex
- W3199384045
- Cited by
- 406
- References
- 5
- Citations by year
- 2026: 10 · 2025: 19 · 2024: 52 · 2023: 83 · 2022: 202 · 2021: 40
- FWCI
- 29.93
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- MMWR Morbidity and Mortality Weekly Report (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- U.S. Department of Defense
- U.S. Department of Health and Human Services
- Pfizer
- Sanofi
- Brigham Young University
- Medpace
- United Therapeutics Corporation
- Cincinnati Children's Hospital Medical Center
- Cumberland Pharmaceuticals
- Regeneron Pharmaceuticals
- Incyte
- Marcus Foundation
- York University
- Seqirus
- National Institutes of Health
- Centers for Disease Control and Prevention
- Agency for Healthcare Research and Quality
- National Heart, Lung, and Blood Institute (T32HL087738)
- National Institute of General Medical Sciences (K23GM129661, T32GM135169)
- National Center for Advancing Translational Sciences
- Janssen Pharmaceuticals
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- COVID-19 vaccines, vaccine effectiveness, COVID-19 hospitalization, Moderna mRNA-1273, BNT162b2, viral vector vaccines, mRNA vaccines, anti-spike IgG, anti-RBD IgG, SARS-CoV-2, waning vaccine protection
- MeSH terms
- COVID-19, COVID-19 Vaccines, mRNA Vaccines, Adolescent, Adult, Aged, Female, Hospitalization, Humans, Male, Middle Aged, United States, Vaccines, Synthetic, Immunocompromised Host, Young Adult
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