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. 2024 Jun 13;12(6):657.
doi: 10.3390/vaccines12060657.

Effectiveness of BNT162b2 Vaccine for Preventing COVID-19-Related Hospitalizations: A Test-Negative Case-Control Study

Amy Keane  1 , Ashley Tippett  1 , Elizabeth Grace Taylor  1 , Olivia Reese  1 , Luis Salazar  1 , Khalel De Castro  1 , Chris Choi  1 , Caroline Ciric  1 , Meg Taylor  1 , Anna Mitchell  1 , Theda Gibson  1 , Laura Puzniak  2 , Robin Hubler  2 , Srinivas Rao Valluri  2 , Timothy L Wiemken  2 , Ben A Lopman  3 , Satoshi Kamidani  1   4 , Larry J Anderson  1   4 , John M McLaughlin  2 , Christina A Rostad  1   4 , Evan J Anderson  1   4   5
Affiliations

Effectiveness of BNT162b2 Vaccine for Preventing COVID-19-Related Hospitalizations: A Test-Negative Case-Control Study

Amy Keane et al. Vaccines (Basel). .

Abstract

It is important to understand real-world BNT162b2 COVID-19 vaccine effectiveness (VE), especially among racial and ethnic minority groups. We performed a test-negative case-control study to measure BNT162b2 COVID-19 VE in the prevention of COVID-19-associated acute respiratory illness (ARI) hospitalizations at two Atlanta hospitals from May 2021-January 2023 and adjusted for potential confounders by multivariate analysis. Among 5139 eligible adults with ARI, 2763 (53.8%) were enrolled, and 1571 (64.5%) were included in the BNT162b2 analysis. The median age was 58 years (IQR, 44-68), 889 (56.6%) were female, 1034 (65.8%) were African American, 359 (22.9%) were White, 56 (3.6%) were Hispanic ethnicity, 645 (41.1%) were SARS-CoV-2-positive, 412 (26.2%) were vaccinated with a primary series, and 273 (17.4%) had received ≥1 booster of BNT162b2. The overall adjusted VE of the BNT162b2 primary series was 58.5% (95% CI 46.0, 68.1), while the adjusted VE of ≥1 booster was 78.9% (95% CI 70.0, 85.1). The adjusted overall VE of primary series for African American/Black individuals was 64.0% (95% CI 49.9, 74.1) and 82.7% (95% CI 71.9, 89.4) in those who received ≥1 booster. When analysis was limited to the period of Omicron predominance, overall VE of the primary series decreased with widened confidence intervals (24.5%, 95% CI -4.5, 45.4%), while VE of ≥1 booster was maintained at 60.9% (95% CI 42.0, 73.6). BNT162b2 primary series and booster vaccination provided protection against COVID-19-associated ARI hospitalization among a predominantly African American population.

Keywords: Delta; Omicron; SARS-CoV-2; hospital; vaccine; vaccine effectiveness; variant.

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Conflict of interest statement

L.P., R.H., S.R.V., T.L.W., and J.M.M. are employees of Pfizer, Inc. The funder did participate in the design of the study, in the collection, analysis, or interpretation of data, in the writing of the manuscript, and in the decision to publish the results. B.A.L. has received institutional research support from Pfizer, Inc. S.K. has received institutional research support from Pfizer, Inc., Meissa, Emergent BioSolutions, Sanofi, the Centers for Disease Control and Prevention, and the National Institutes of Health. L.J.A. has received institutional research support from Pfizer, Inc. C.A.R. has received institutional research support from Pfizer Inc., BioFire Inc., GSK plc, Janssen Pharmaceuticals, MedImmune, Micron Technology Inc., ModernaTX, Inc., Merck & Co., Inc., Novavax, PaxVax, Regeneron, Sanofi Pasteur, and from the Centers for Disease Control and Prevention and the National Institutes of Health. She is a co-inventor of patented RSV vaccine technology, which has been licensed to Meissa Vaccines, Inc. E.J.A. has consulted for Pfizer, Sanofi Pasteur, GSK, Janssen, Moderna, and Medscape, and his institution has received funds to conduct clinical research unrelated to this manuscript from MedImmune, Regeneron, PaxVax, Pfizer, GSK, Merck, Sanofi-Pasteur, Janssen, and Micron. He has also served on a safety monitoring board for Kentucky BioProcessing, Inc., and Sanofi Pasteur. He has served on a data adjudication board for WCG and ACI Clinical. His institution has also received funding from the NIH to conduct clinical trials of COVID-19 vaccines. He is currently an employee of Moderna, Inc. The other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study enrollment.
See this image and copyright information in PMC

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