key: cord-0711743-x7aczryz
authors: Drawz, Paul E; DeSilva, Malini; Bodurtha, Peter; Benitez, Gabriela Vazquez; Murray, Anne; Chamberlain, Alanna M; Dudley, R Adams; Waring, Stephen; Kharbanda, Anupam B; Murphy, Daniel; Muscoplat, Miriam Halstead; Melendez, Victor; Margolis, Karen L; McFarling, Lynn; Lupu, Roxana; Winkelman, Tyler N A; Johnson, Steven G
title: Effectiveness of BNT162b2 and mRNA-1273 Second Doses and Boosters for SARS-CoV-2 infection and SARS-CoV-2 Related Hospitalizations: A Statewide Report from the Minnesota Electronic Health Record Consortium
date: 2022-02-07
journal: Clin Infect Dis
DOI: 10.1093/cid/ciac110
sha: b73d45659386bff9aa76d8c54448ef8b9cefd7c0
doc_id: 711743
cord_uid: x7aczryz

Using vaccine data combined with electronic health records, we report that mRNA boosters provide greater protection than a two-dose regimen against SARS-CoV-2 infection and related hospitalizations. The benefit of a booster was more evident in the elderly and those with comorbidities. These results support the case for COVID-19 boosters.

M a n u s c r i p t vaccines are effective at reducing SARS-CoV-2 infections and related hospitalizations but there is concern for waning immunity. 1 COVID-19 vaccine booster doses increase antibodies and cellular responses. 2 However, data on the effectiveness of boosters are limited. [3] [4] [5] We report on vaccine effectiveness (VE) in individuals who received a second dose of a BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) COVID-19 vaccine and in those who received a booster dose of either vaccine. We used statewide COVID-19 vaccination data from the Minnesota Immunization Information Connection (MIIC) linked via a privacypreserving record linkage process with distributed electronic health record (EHR) data from the 11 largest health systems in Minnesota. 6 Health systems reported data aggregated by categories defined by race/ethnicity, age, sex, and comorbidities. The project was reviewed by the Institutional Review Board at 10 of the data-contributing sites and was either approved or deemed exempt as non-human subject research or public health surveillance. Investigators and the legal office at the 11 th site deemed this work to be public health surveillance. Table 1 Table 3 ). VE for SARS-CoV-2 related hospitalizations for boosters was 88% (95% CI 86 to 90) for Pfizer and 86% (95% CI 82 to 89) for Moderna. The benefit of a booster was more evident in the elderly and those with comorbidities.

Using statewide vaccine data combined with EHR data in Minnesota, we report that mRNA booster doses provide greater protection against medically attended SARS-CoV-2 infection and SARS-CoV-2 related hospitalizations. Our results are consistent with prior studies from Israel that only reported on the VE of Pfizer booster doses. [3] [4] [5] There are some limitations to consider. First, it is possible that our definition of a SARS-CoV-2 related hospitalization may include admissions unrelated to the infection. Second, while results are consistent across subgroups, because health systems aggregated results by categories of single variables, we cannot provide multi-variable adjusted analyses. Third, the analyses assume that patients without a matching record in MIIC are unvaccinated. However, since the health systems in our consortium account for 93% of all vaccinated patients in the state, there could not be many patients who appear to be unvaccinated but have, in fact, received a vaccination. Finally, while the Minnesota EHR Consortium data includes most of the large health systems in Minnesota, the analyses do not include complete statewide data.

In conclusion, we demonstrate that individuals who have received a booster have a greater 

Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study

Safety and immunogenicity of seven COVID-19 vaccines as a third dose (booster) following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK (COV-BOOST): a blinded, multicentre, randomised, controlled, phase 2 trial

Protection of BNT162b2 Vaccine Booster against Covid-19 in Israel

Odds of Testing Positive for SARS-CoV-2 Following Receipt of 3 vs 2 Doses of the BNT162b2 mRNA Vaccine

Effectiveness of a third dose of the BNT162b2 mRNA COVID-19 vaccine for preventing severe outcomes in Israel: an observational study

Minnesota Electronic Health Record Consortium COVID-19 Project: Informing Pandemic Response Through Statewide Collaboration Using Observational Data

Office for Human Research Protections

Code of Federal Regulations, Title 45, National Archives and Records Administration

A c c e p t e d M a n u s c r i p t M a n u s c r i p t