Duration of mRNA vaccine protection against SARS-CoV-2 Omicron BA.1 and BA.2 subvariants in Qatar

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Abstract

SARS-CoV-2 Omicron BA.1 and BA.2 subvariants are genetically divergent. We conducted a matched, test-negative, case-control study to estimate duration of protection of the second and third/booster doses of mRNA COVID-19 vaccines against BA.1 and BA.2 infections in Qatar. BNT162b2 effectiveness was highest at 46.6% (95% CI: 33.4–57.2%) against symptomatic BA.1 and at 51.7% (95% CI: 43.2–58.9%) against symptomatic BA.2 infections in the first three months after the second dose, but declined to ~10% or below thereafter. Effectiveness rebounded to 59.9% (95% CI: 51.2–67.0%) and 43.7% (95% CI: 36.5–50.0%), respectively, in the first month after the booster dose, before declining again. Effectiveness against COVID-19 hospitalization and death was 70–80% after the second dose and >90% after the booster dose. mRNA-1273 vaccine protection showed similar patterns. mRNA vaccines provide comparable, moderate, and short-lived protection against symptomatic BA.1 and BA.2 Omicron infections, but strong and durable protection against COVID-19 hospitalization and death.

Abstract

The SARS-CoV-2 Omicron variant has subvariants with divergent properties but relative vaccine effectiveness has not been characterized. Here, the authors show that mRNA vaccine effectiveness is similar for the subvariants BA.1 and BA.2, with a decline three months after the second dose and increase after the booster.

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Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine

Fernando P Polack, Stephen J. Thomas, Nicholas R.E. Kitchin … (2023)

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (Covid-19) have afflicted tens of millions of people in a worldwide pandemic. Safe and effective vaccines are needed urgently. Methods In an ongoing multinational, placebo-controlled, observer-blinded, pivotal efficacy trial, we randomly assigned persons 16 years of age or older in a 1:1 ratio to receive two doses, 21 days apart, of either placebo or the BNT162b2 vaccine candidate (30 μg per dose). BNT162b2 is a lipid nanoparticle–formulated, nucleoside-modified RNA vaccine that encodes a prefusion stabilized, membrane-anchored SARS-CoV-2 full-length spike protein. The primary end points were efficacy of the vaccine against laboratory-confirmed Covid-19 and safety. Results A total of 43,548 participants underwent randomization, of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo; BNT162b2 was 95% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6). Similar vaccine efficacy (generally 90 to 100%) was observed across subgroups defined by age, sex, race, ethnicity, baseline body-mass index, and the presence of coexisting conditions. Among 10 cases of severe Covid-19 with onset after the first dose, 9 occurred in placebo recipients and 1 in a BNT162b2 recipient. The safety profile of BNT162b2 was characterized by short-term, mild-to-moderate pain at the injection site, fatigue, and headache. The incidence of serious adverse events was low and was similar in the vaccine and placebo groups. Conclusions A two-dose regimen of BNT162b2 conferred 95% protection against Covid-19 in persons 16 years of age or older. Safety over a median of 2 months was similar to that of other viral vaccines. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04368728.)

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Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine

Lindsey Baden, Hana El Sahly, Brandon Essink … (2020)

Abstract Background Vaccines are needed to prevent coronavirus disease 2019 (Covid-19) and to protect persons who are at high risk for complications. The mRNA-1273 vaccine is a lipid nanoparticle–encapsulated mRNA-based vaccine that encodes the prefusion stabilized full-length spike protein of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes Covid-19. Methods This phase 3 randomized, observer-blinded, placebo-controlled trial was conducted at 99 centers across the United States. Persons at high risk for SARS-CoV-2 infection or its complications were randomly assigned in a 1:1 ratio to receive two intramuscular injections of mRNA-1273 (100 μg) or placebo 28 days apart. The primary end point was prevention of Covid-19 illness with onset at least 14 days after the second injection in participants who had not previously been infected with SARS-CoV-2. Results The trial enrolled 30,420 volunteers who were randomly assigned in a 1:1 ratio to receive either vaccine or placebo (15,210 participants in each group). More than 96% of participants received both injections, and 2.2% had evidence (serologic, virologic, or both) of SARS-CoV-2 infection at baseline. Symptomatic Covid-19 illness was confirmed in 185 participants in the placebo group (56.5 per 1000 person-years; 95% confidence interval [CI], 48.7 to 65.3) and in 11 participants in the mRNA-1273 group (3.3 per 1000 person-years; 95% CI, 1.7 to 6.0); vaccine efficacy was 94.1% (95% CI, 89.3 to 96.8%; P<0.001). Efficacy was similar across key secondary analyses, including assessment 14 days after the first dose, analyses that included participants who had evidence of SARS-CoV-2 infection at baseline, and analyses in participants 65 years of age or older. Severe Covid-19 occurred in 30 participants, with one fatality; all 30 were in the placebo group. Moderate, transient reactogenicity after vaccination occurred more frequently in the mRNA-1273 group. Serious adverse events were rare, and the incidence was similar in the two groups. Conclusions The mRNA-1273 vaccine showed 94.1% efficacy at preventing Covid-19 illness, including severe disease. Aside from transient local and systemic reactions, no safety concerns were identified. (Funded by the Biomedical Advanced Research and Development Authority and the National Institute of Allergy and Infectious Diseases; COVE ClinicalTrials.gov number, NCT04470427.)

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Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant

Jamie Lopez Bernal, Nick Andrews, Charlotte Gower … (2021)

Background The B.1.617.2 (delta) variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19), has contributed to a surge in cases in India and has now been detected across the globe, including a notable increase in cases in the United Kingdom. The effectiveness of the BNT162b2 and ChAdOx1 nCoV-19 vaccines against this variant has been unclear. Methods We used a test-negative case–control design to estimate the effectiveness of vaccination against symptomatic disease caused by the delta variant or the predominant strain (B.1.1.7, or alpha variant) over the period that the delta variant began circulating. Variants were identified with the use of sequencing and on the basis of the spike ( S ) gene status. Data on all symptomatic sequenced cases of Covid-19 in England were used to estimate the proportion of cases with either variant according to the patients’ vaccination status. Results Effectiveness after one dose of vaccine (BNT162b2 or ChAdOx1 nCoV-19) was notably lower among persons with the delta variant (30.7%; 95% confidence interval [CI], 25.2 to 35.7) than among those with the alpha variant (48.7%; 95% CI, 45.5 to 51.7); the results were similar for both vaccines. With the BNT162b2 vaccine, the effectiveness of two doses was 93.7% (95% CI, 91.6 to 95.3) among persons with the alpha variant and 88.0% (95% CI, 85.3 to 90.1) among those with the delta variant. With the ChAdOx1 nCoV-19 vaccine, the effectiveness of two doses was 74.5% (95% CI, 68.4 to 79.4) among persons with the alpha variant and 67.0% (95% CI, 61.3 to 71.8) among those with the delta variant. Conclusions Only modest differences in vaccine effectiveness were noted with the delta variant as compared with the alpha variant after the receipt of two vaccine doses. Absolute differences in vaccine effectiveness were more marked after the receipt of the first dose. This finding would support efforts to maximize vaccine uptake with two doses among vulnerable populations. (Funded by Public Health England.)

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Author and article information

Contributors

Hiam Chemaitelly:

ORCID: http://orcid.org/0000-0002-8756-6968

hsc2001@qatar-med.cornell.edu

Laith J. Abu-Raddad:

ORCID: http://orcid.org/0000-0003-0790-0506

lja2002@qatar-med.cornell.edu

Journal

Journal ID (nlm-ta): Nat Commun

Journal ID (iso-abbrev): Nat Commun

Title: Nature Communications

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2041-1723

Publication date (Electronic): 2 June 2022

Publication date PMC-release: 2 June 2022

Publication date Collection: 2022

Volume: 13

Electronic Location Identifier: 3082

Affiliations

[1 ]GRID grid.416973.e, ISNI 0000 0004 0582 4340, Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, , Cornell University, ; Doha, Qatar

[2 ]GRID grid.416973.e, ISNI 0000 0004 0582 4340, World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine—Qatar, Qatar Foundation—Education City, , Cornell University, ; Doha, Qatar

[3 ]GRID grid.5386.8, ISNI 000000041936877X, Department of Population Health Sciences, Weill Cornell Medicine, , Cornell University, ; New York, NY USA

[4 ]GRID grid.412603.2, ISNI 0000 0004 0634 1084, Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, , Qatar University, ; Doha, Qatar

[5 ]GRID grid.413548.f, ISNI 0000 0004 0571 546X, Hamad Medical Corporation, ; Doha, Qatar

[6 ]GRID grid.412603.2, ISNI 0000 0004 0634 1084, Biomedical Research Center, Member of QU Health, , Qatar University, ; Doha, Qatar

[7 ]GRID grid.4777.3, ISNI 0000 0004 0374 7521, Wellcome-Wolfson Institute for Experimental Medicine, , Queens University, ; Belfast, UK

[8 ]GRID grid.467063.0, ISNI 0000 0004 0397 4222, Department of Pathology, , Sidra Medicine, ; Doha, Qatar

[9 ]GRID grid.412603.2, ISNI 0000 0004 0634 1084, Department of Biomedical Science, College of Health Sciences, Member of QU Health, , Qatar University, ; Doha, Qatar

[10 ]GRID grid.412603.2, ISNI 0000 0004 0634 1084, Department of Public Health, College of Health Sciences, QU Health, , Qatar University, ; Doha, Qatar

[11 ]GRID grid.498624.5, ISNI 0000 0004 4676 5308, Primary Health Care Corporation, ; Doha, Qatar

[12 ]GRID grid.5386.8, ISNI 000000041936877X, Department of Medicine, Weill Cornell Medicine, , Cornell University, ; New York, NY USA

[13 ]GRID grid.498619.b, Ministry of Public Health, ; Doha, Qatar

Author information

Hiam Chemaitelly http://orcid.org/0000-0002-8756-6968

Houssein H. Ayoub http://orcid.org/0000-0003-2512-6657

Peter Coyle http://orcid.org/0000-0002-0819-6103

Patrick Tang http://orcid.org/0000-0003-1583-5484

Hadi M. Yassine http://orcid.org/0000-0001-7592-2788

Andrew Jeremijenko http://orcid.org/0000-0002-0375-2713

Gheyath K. Nasrallah http://orcid.org/0000-0001-9252-1038

Adeel A. Butt http://orcid.org/0000-0002-1118-1826

Abdullatif Al-Khal http://orcid.org/0000-0003-3737-8253

Laith J. Abu-Raddad http://orcid.org/0000-0003-0790-0506

Article

Publisher ID: 30895

DOI: 10.1038/s41467-022-30895-3

PMC ID: 9163167

PubMed ID: 35654888

SO-VID: 2c7c6978-555d-4a3e-9bcd-50cc725b6fb1

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 18 March 2022

Date accepted : 24 May 2022

Funding

Funded by: Biomedical Research Program and the Biostatistics, Epidemiology, and Biomathematics Research Core, both at Weill Cornell Medicine-Qatar

Funded by: FundRef https://doi.org/10.13039/100007833, Hamad Medical Corporation (HMC);

Funded by: Ministry of Public Health, Hamad Medical Corporation, and Sidra Medicine

Funded by: Qatar Genome Programme and Qatar University Biomedical Research Center

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ScienceOpen disciplines: Uncategorized

Keywords: viral infection,epidemiology

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ScienceOpen disciplines: Uncategorized

Keywords: viral infection, epidemiology

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Duration of mRNA vaccine protection against SARS-CoV-2 Omicron BA.1 and BA.2 subvariants in Qatar

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Most cited references 49

Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine

Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine

Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant

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