tetano
Editor, Senior Moderator
Adv Ther
. 2025 Mar 10.
doi: 10.1007/s12325-025-03117-7. Online ahead of print. Comparative Effectiveness of mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Adults with Underlying Medical Conditions: Systematic Literature Review and Pairwise Meta-Analysis Using GRADE
Xuan Wang[SUP] 1 [/SUP], Ankit Pahwa[SUP] 2 [/SUP], Mary T Bausch-Jurken[SUP] 3 [/SUP], Anushri Chitkara[SUP] 2 [/SUP], Pawana Sharma[SUP] 4 [/SUP], Mia Malmenäs[SUP] 1 [/SUP], Sonam Vats[SUP] 2 [/SUP], Michael Gordon Whitfield[SUP] 4 [/SUP], Kira Zhi Hua Lai[SUP] 5 [/SUP], Priyadarsini Dasari[SUP] 6 [/SUP], Ritu Gupta[SUP] 2 [/SUP], Maria Nassim[SUP] 7 [/SUP], Nicolas Van de Velde[SUP] 3 [/SUP], Nathan Green[SUP] 8 [/SUP], Ekkehard Beck[SUP] 9 [/SUP]
Affiliations
Introduction: This systematic literature review and pairwise meta-analysis evaluated the comparative effectiveness of mRNA-1273 versus BNT162b2 in patients with at least one underlying medical condition at high risk for severe COVID-19.
Methods: MEDLINE, Embase, and Cochrane databases were searched for relevant articles from January 1, 2019 to February 9, 2024. Studies reporting effectiveness data from at least two doses of mRNA-1273 and BNT162b2 vaccination in adults with medical conditions at high risk of developing severe COVID-19 according to the US Centers for Disease Control and Prevention were included. Outcomes of interest were SARS-CoV-2 infection (overall, symptomatic, and severe), hospitalization due to COVID-19, and death due to COVID-19. Risk ratios (RRs) were calculated with random effects models. Subgroup analyses by specific medical conditions, number of vaccinations, age, and SARS-CoV-2 variant were conducted. Heterogeneity between studies was estimated with chi-square testing. The certainty of evidence was assessed using the Grading of Recommendations, Assessments, Development, and Evaluations framework.
Results: Sixty-five observational studies capturing the original/ancestral-containing primary series to Omicron-containing bivalent original-BA4-5 vaccinations were included in the meta-analysis. mRNA-1273 was associated with significantly lower risk of SARS-CoV-2 infection (RR, 0.85 [95% CI, 0.79-0.92]; I[SUP]2[/SUP] = 92.5%), symptomatic SARS-CoV-2 infection (RR, 0.75 [95% CI, 0.65-0.86]; I[SUP]2[/SUP] = 62.3%), severe SARS-CoV-2 infection (RR, 0.83 [95% CI, 0.78-0.89]; I[SUP]2[/SUP] = 38.0%), hospitalization due to COVID-19 (RR, 0.88 [95% CI, 0.82-0.94]; I[SUP]2[/SUP] = 38.7%), and death due to COVID-19 (RR, 0.84 [95% CI, 0.76-0.93]; I[SUP]2[/SUP] = 1.3%) than BNT162b2. Findings were generally consistent across subgroups. Evidence certainty was low or very low because sufficiently powered randomized controlled trials are impractical in this heterogeneous population.
Conclusion: Meta-analysis of 65 observational studies showed that vaccination with mRNA-1273 was associated with a significantly lower risk of SARS-CoV-2 infection and COVID-19-related hospitalization and death than BNT162b2 in patients with medical conditions at high risk of severe COVID-19.
Keywords: BNT162b2; COVID-19; Comorbidity; Effectiveness; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; mRNA vaccine; mRNA-1273.
. 2025 Mar 10.
doi: 10.1007/s12325-025-03117-7. Online ahead of print. Comparative Effectiveness of mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Adults with Underlying Medical Conditions: Systematic Literature Review and Pairwise Meta-Analysis Using GRADE
Xuan Wang[SUP] 1 [/SUP], Ankit Pahwa[SUP] 2 [/SUP], Mary T Bausch-Jurken[SUP] 3 [/SUP], Anushri Chitkara[SUP] 2 [/SUP], Pawana Sharma[SUP] 4 [/SUP], Mia Malmenäs[SUP] 1 [/SUP], Sonam Vats[SUP] 2 [/SUP], Michael Gordon Whitfield[SUP] 4 [/SUP], Kira Zhi Hua Lai[SUP] 5 [/SUP], Priyadarsini Dasari[SUP] 6 [/SUP], Ritu Gupta[SUP] 2 [/SUP], Maria Nassim[SUP] 7 [/SUP], Nicolas Van de Velde[SUP] 3 [/SUP], Nathan Green[SUP] 8 [/SUP], Ekkehard Beck[SUP] 9 [/SUP]
Affiliations
- PMID: 40063213
- DOI: 10.1007/s12325-025-03117-7
Introduction: This systematic literature review and pairwise meta-analysis evaluated the comparative effectiveness of mRNA-1273 versus BNT162b2 in patients with at least one underlying medical condition at high risk for severe COVID-19.
Methods: MEDLINE, Embase, and Cochrane databases were searched for relevant articles from January 1, 2019 to February 9, 2024. Studies reporting effectiveness data from at least two doses of mRNA-1273 and BNT162b2 vaccination in adults with medical conditions at high risk of developing severe COVID-19 according to the US Centers for Disease Control and Prevention were included. Outcomes of interest were SARS-CoV-2 infection (overall, symptomatic, and severe), hospitalization due to COVID-19, and death due to COVID-19. Risk ratios (RRs) were calculated with random effects models. Subgroup analyses by specific medical conditions, number of vaccinations, age, and SARS-CoV-2 variant were conducted. Heterogeneity between studies was estimated with chi-square testing. The certainty of evidence was assessed using the Grading of Recommendations, Assessments, Development, and Evaluations framework.
Results: Sixty-five observational studies capturing the original/ancestral-containing primary series to Omicron-containing bivalent original-BA4-5 vaccinations were included in the meta-analysis. mRNA-1273 was associated with significantly lower risk of SARS-CoV-2 infection (RR, 0.85 [95% CI, 0.79-0.92]; I[SUP]2[/SUP] = 92.5%), symptomatic SARS-CoV-2 infection (RR, 0.75 [95% CI, 0.65-0.86]; I[SUP]2[/SUP] = 62.3%), severe SARS-CoV-2 infection (RR, 0.83 [95% CI, 0.78-0.89]; I[SUP]2[/SUP] = 38.0%), hospitalization due to COVID-19 (RR, 0.88 [95% CI, 0.82-0.94]; I[SUP]2[/SUP] = 38.7%), and death due to COVID-19 (RR, 0.84 [95% CI, 0.76-0.93]; I[SUP]2[/SUP] = 1.3%) than BNT162b2. Findings were generally consistent across subgroups. Evidence certainty was low or very low because sufficiently powered randomized controlled trials are impractical in this heterogeneous population.
Conclusion: Meta-analysis of 65 observational studies showed that vaccination with mRNA-1273 was associated with a significantly lower risk of SARS-CoV-2 infection and COVID-19-related hospitalization and death than BNT162b2 in patients with medical conditions at high risk of severe COVID-19.
Keywords: BNT162b2; COVID-19; Comorbidity; Effectiveness; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; mRNA vaccine; mRNA-1273.