Pfizer vs Moderna vs J&J

Study in Science of more than 780,000 veterans is the first to compare declining protection rates among all three vaccine types available to most Americans and directly report death rates after breakthrough infection.

A new study in the leading journal Science assessed COVID-19 breakthrough infections among 780,225 veterans, finding that vaccine protection fell from 87.9% to 48.1% during the 2021 Delta wave in the US. Researchers from PHI, the Veterans Affairs Medical Center and the University of the Texas Health Science Center found a dramatic decline in effectiveness for the Janssen (Johnson and Johnson) vaccine, from 86.4% in March to 13%.1 in September. They also found that any form of vaccination was protective against death in infected individuals.

As breakthrough COVID-19 infections continue to affect some vaccine recipients and health authorities develop policies around booster vaccinations, national data on breakthrough infections from COVID-19 vaccines are insufficient but urgently needed. Now, a study from the Public Health Institute, the Veterans Affairs Medical Center and the University of Texas Health Science Center, published today in the journal Science, analyzed COVID infection by vaccination status among 780,225 veterans.

Researchers found that protection against each COVID-19 infection declined for all vaccine types, with overall vaccine protection falling from 87.9% in February to 48.1% in October 2021.

The decline was largest for the Janssen (Johnson & Johnson) vaccine, with protection against infection falling from 86.4% in March to 13%.1 in September Decreases for PfizerBioNTech were from 86.9% to 43.3% Declines for Moderna were 89.2% to 58%.

Credit: Institute of Public Health

While most previous studies have focused on the PfizerBioNTech or Moderna vaccines, the Science study is the first to compare the decline in protection between the three major vaccine types, and the first to compare the similarly dramatic decline in effectiveness of the Janssen vaccine. vaccine shows. Declines were assessed from February 1, 2021 to October 1, 2021, reflecting the rise and dominance of the Delta variant in the US. Patterns of breakthrough infection over time were consistent by age despite advancing vaccine eligibility, implying that the Delta variant was the primary determinant of infection.

Importantly, any form of vaccination was protective against death in those who had become infected. The relative benefit of vaccination for protection against death was greater for those under 65, but was also very strong for those over 65.

The study found that the risk of death from COVID infection was highest among unvaccinated veterans, regardless of age and comorbidity. While some breakthrough infections resulted in death, vaccination remained protective against death in those infected during the Delta Wave.

For those under the age of 65, vaccines were a total of 81.7% effective against death.

Protection against death was greatest for the Pfizer vaccine at 84.3%. Moderna was the next most effective, with 81.5%. Jansen was 73% effective.

For people over 65, the overall vaccine efficacy against death was 71.6%.

Moderna was 75.5% effective. Pfizer was 70.1% effective. Jansen was 52.2% effective.

“Our study gives researchers, policymakers and others a strong foundation for comparing the long-term effectiveness of COVID vaccines, and a lens for making informed decisions about primary vaccination, booster shots, and other multiple layers of protection, including masking mandates, social distancing, testing and other public health interventions to reduce the risk of spreading,” said Dr Barbara Cohn of PHI, the study’s lead author. “For example, the CDC recommendation for boosters for all Janssen recipients over the age of 18 is supported by our results. And given the declining vaccine protection and the dominance of the more infectious Delta variant, we are pushing for swift action to advance primary vaccination, boosters and also to encourage masking, social distancing and other layers of protection against infection. This is supported by our finding that breakthrough infections are not benign, but also by the strong evidence that vaccination still protects against death, even for individuals with breakthrough infections, compared to individuals who become infected and are not vaccinated.”

The FDA approved Pfizer boosters for some groups in September and Moderna and Janssen boosters in October, and the CDC has made similar recommendations, including supporting a “mix and match” approach that allows people to create a ​​of the three vaccine boosters, regardless of which they are. were initially given.

Reference: “SARS-CoV-2 Vaccine Protection and Deaths Among U.S. Veterans in 2021” by Barbara A. Cohn, Piera M. Cirillo, Caitlin C. Murphy, Nickilou Y. Krigbaum, and Arthur W. Wallace, Nov. 4, 2021, Science.
DOI: 10.1126/science.abm0620