BNT162b2 Vaccine Booster and Mortality Due to Covid-19.

Publisher: Massachusetts Medical Society Country of Publication: United States NLM ID: 0255562 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1533-4406 (Electronic) Linking ISSN: 00284793 NLM ISO Abbreviation: N Engl J Med Subsets: MEDLINE

Original Publication: Boston, Massachusetts Medical Society.

BNT162 Vaccine*/immunology ; Immunization, Secondary*; COVID-19/*mortality ; Vaccine Efficacy/*statistics & numerical data; Aged ; COVID-19/prevention & control ; Female ; Humans ; Israel/epidemiology ; Male ; Middle Aged ; Proportional Hazards Models

Background: The emergence of the B.1.617.2 (delta) variant of severe acute respiratory syndrome coronavirus 2 and the reduced effectiveness over time of the BNT162b2 vaccine (Pfizer-BioNTech) led to a resurgence of coronavirus disease 2019 (Covid-19) cases in populations that had been vaccinated early. On July 30, 2021, the Israeli Ministry of Health approved the use of a third dose of BNT162b2 (booster) to cope with this resurgence. Evidence regarding the effectiveness of the booster in lowering mortality due to Covid-19 is still needed.
Methods: We obtained data for all members of Clalit Health Services who were 50 years of age or older at the start of the study and had received two doses of BNT162b2 at least 5 months earlier. The mortality due to Covid-19 among participants who received the booster during the study period (booster group) was compared with that among participants who did not receive the booster (nonbooster group). A Cox proportional-hazards regression model with time-dependent covariates was used to estimate the association of booster status with death due to Covid-19, with adjustment for sociodemographic factors and coexisting conditions.
Results: A total of 843,208 participants met the eligibility criteria, of whom 758,118 (90%) received the booster during the 54-day study period. Death due to Covid-19 occurred in 65 participants in the booster group (0.16 per 100,000 persons per day) and in 137 participants in the nonbooster group (2.98 per 100,000 persons per day). The adjusted hazard ratio for death due to Covid-19 in the booster group, as compared with the nonbooster group, was 0.10 (95% confidence interval, 0.07 to 0.14; P<0.001).
Conclusions: Participants who received a booster at least 5 months after a second dose of BNT162b2 had 90% lower mortality due to Covid-19 than participants who did not receive a booster.
(Copyright © 2021 Massachusetts Medical Society.)

Comment in: N Engl J Med. 2021 Dec 23;385(26):2476-2477. (PMID: 34879192)
Comment in: N Engl J Med. 2022 Mar 10;386(10):1000. (PMID: 35139266)
Comment in: N Engl J Med. 2022 Mar 10;386(10):1000. (PMID: 35139267)
Comment in: N Engl J Med. 2023 Jul 20;389(3):284-285. (PMID: 37470285)
Comment in: N Engl J Med. 2023 Jul 20;389(3):285-286. (PMID: 37470347)

N Engl J Med. 2021 Apr 15;384(15):1412-1423. (PMID: 33626250)
Ann Transl Med. 2018 Apr;6(7):121. (PMID: 29955581)
N Engl J Med. 2021 Nov 4;385(19):1761-1773. (PMID: 34525277)
BMJ. 2021 Apr 13;373:n971. (PMID: 33849903)
N Engl J Med. 2021 Sep 16;385(12):1078-1090. (PMID: 34432976)
MMWR Morb Mortal Wkly Rep. 2021 Sep 24;70(38):1337-1343. (PMID: 34555004)
N Engl J Med. 2021 Oct 7;385(15):1393-1400. (PMID: 34525275)
Lancet. 2021 Oct 9;398(10308):1377-1380. (PMID: 34534516)
PLoS One. 2021 Mar 4;16(3):e0247461. (PMID: 33661992)
N Engl J Med. 2021 Dec 9;385(24):e85. (PMID: 34706170)
Lancet. 2021 Jun 26;397(10293):2461-2462. (PMID: 34139198)
N Engl J Med. 2021 Dec 9;385(24):e83. (PMID: 34614327)
N Engl J Med. 2021 Dec 9;385(24):e84. (PMID: 34614326)
N Engl J Med. 2021 Sep 30;385(14):1330-1332. (PMID: 34469645)
N Engl J Med. 2020 Dec 31;383(27):2603-2615. (PMID: 33301246)
N Engl J Med. 2021 Aug 12;385(7):650-651. (PMID: 34289269)

N38TVC63NU (BNT162 Vaccine)

Date Created: 20211208 Date Completed: 20220105 Latest Revision: 20231123

20231123

PMC8728797

10.1056/NEJMoa2115624

34879190