The 24-week risk for COVID-19 outcomes is slightly lower after vaccination with mRNA-1273 versus BNT162b2, according to a study published in the New England Journal of Medicine. Barbra A. Dickerman, Ph.D., and colleagues emulated a target trial using EHR data from US veterans who received the first dose of either vaccine between January 4 and May 14, 2021, and a second target trial of veterans vaccinated between July 1 and September 20, 2021. The estimated risk for infection was 5.75 (95% CI, 5.39-6.23) and 4.52 (95% CI, 4.17- 4.84) events per 1,000 persons in the BNT162b2 and mRNA-1273 groups, respectively, in a period marked by alpha variant predominance. For BNT162b2 compared with mRNA-1273, the excess number of events per 1,000 persons was 1.23 (95% CI, 0.72-1.81) for documented infection, 0.44 (95% CI, 0.25-0.70) for symptomatic COVID-19, 0.55 (95% CI, 0.36-0.83) for hospitalization, 0.10 (95% CI, 0.00-0.26) for ICU admission, and 0.02 (95% CI, −0.06-0.12) for death. For infection over 12 weeks during delta variant predominance, the corresponding excess risk for BNT162b2 versus mRNA-1273 was 6.54 events per 1,000 persons (95% CI, −2.58-11.82).

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