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

Area of Science:

• Vaccinology
• Infectious Diseases
• Public Health

Background:

• Understanding real-world vaccine effectiveness (VE) of BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine is crucial, especially for minority groups.
• COVID-19-associated acute respiratory illness (ARI) hospitalizations pose a significant public health burden.
• Previous studies may not fully capture VE in diverse, real-world settings.

Purpose of the Study:

• To measure the real-world effectiveness of the BNT162b2 COVID-19 vaccine in preventing COVID-19-associated ARI hospitalizations.
• To assess VE specifically within racial and ethnic minority groups, particularly African Americans.
• To evaluate the impact of primary series and booster doses on vaccine effectiveness.

Main Methods:

• A test-negative case-control study was conducted at two Atlanta hospitals from May 2021 to January 2023.
• Eligible adults presenting with ARI were analyzed, with adjustments for potential confounders using multivariate analysis.
• Vaccine effectiveness was calculated for primary series and booster doses of the BNT162b2 vaccine.

Main Results:

• The overall adjusted VE for the BNT162b2 primary series was 58.5%, and for ≥1 booster, it was 78.9%.
• For African American/Black individuals, adjusted VE was 64.0% for the primary series and 82.7% for ≥1 booster.
• During Omicron predominance, primary series VE decreased to 24.5%, while booster VE remained substantial at 60.9%.

Conclusions:

• BNT162b2 primary series and booster vaccinations provide significant protection against COVID-19-associated ARI hospitalizations.
• Booster doses enhance protection, maintaining effectiveness even during periods of variant predominance like Omicron.
• The findings underscore the importance of vaccination, including boosters, for vulnerable and minority populations.