Duration of protection of BNT162b2 and mRNA-1273 COVID-19 vaccines against symptomatic SARS-CoV-2 Omicron infection in Qatar

  1. Hiam Chemaitelly
  2. Houssein H. Ayoub
  3. Sawsan AlMukdad
  4. Patrick Tang
  5. Mohammad R. Hasan
  6. Hadi M. Yassine
  7. Hebah A. Al Khatib
  8. Maria K. Smatti
  9. Peter Coyle
  10. Zaina Al Kanaani
  11. Einas Al Kuwari
  12. Andrew Jeremijenko
  13. Anvar Hassan Kaleeckal
  14. Ali Nizar Latif
  15. Riyazuddin Mohammad Shaik
  16. Hanan F. Abdul Rahim
  17. Gheyath K. Nasrallah
  18. Mohamed Ghaith Al Kuwari
  19. Adeel A. Butt
  20. Hamad Eid Al Romaihi
  21. Mohamed H. Al-Thani
  22. Abdullatif Al Khal
  23. Roberto Bertollini
  24. Laith J. Abu-Raddad
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Abstract

BACKGROUND

Qatar has been experiencing a large SARS-CoV-2 Omicron (B.1.1.529) wave that started on December 19, 2021. We assessed duration of protection of BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) COVID-19 vaccines after second dose and after third/booster dose against symptomatic Omicron infection and against COVID-19 hospitalization and death, between December 23, 2021 and February 2, 2022.

METHODS

Vaccine effectiveness was estimated using the test-negative, case-control study design, applying the same methodology used earlier to assess waning of BNT162b2 and mRNA-1273 effectiveness in the same population during earlier infection waves.

RESULTS

BNT162b2 effectiveness against symptomatic Omicron infection was highest at 61.9% (95% CI: 49.9-71.1%) in the first month after the second dose, but then gradually declined and was at 10% or less starting from the 5 th month after the second dose. After the booster, effectiveness rapidly rebounded to peak at about 55% between 2-5 weeks after the booster, but then started to decline again thereafter. Effectiveness against severe, critical, or fatal COVID-19 was maintained at >70% after the second dose and at >90% after the booster with no evidence for declining effectiveness over time. mRNA-1273 effectiveness against symptomatic Omicron infection was highest at 44.8% (95% CI: 16.0-63.8%) in the first three months after the second dose, before gradually declining to negligible levels thereafter. After the booster, effectiveness rapidly rebounded to peak at about 55% between 2-5 weeks after the booster, but then declined again thereafter. Effectiveness against severe, critical, or fatal COVID-19 was high at >60% after the second dose and at >80% after the booster, but the confidence intervals were wide owing to the small number of cases.

CONCLUSIONS

BNT162b2 and mRNA-1273 vaccines show a similar level and pattern of protection against symptomatic Omicron infection. Protection against Omicron is lower than that against Alpha, Beta, and Delta variants, and wanes more rapidly than against earlier variants after the second and booster doses. Meanwhile, protection against hospitalization and death appears robust and durable after both the second and booster doses.

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