{"doi":"10.1056/nejmoa2115463","title":"Comparative Effectiveness of BNT162b2 and mRNA-1273 Vaccines in U.S. Veterans","abstract":"BACKGROUND: The messenger RNA (mRNA)-based vaccines BNT162b2 and mRNA-1273 are more than 90% effective against coronavirus disease 2019 (Covid-19). However, their comparative effectiveness for a range of outcomes across diverse populations is unknown. METHODS: We emulated a target trial using the electronic health records of U.S. veterans who received a first dose of the BNT162b2 or mRNA-1273 vaccine between January 4 and May 14, 2021, during a period marked by predominance of the SARS-CoV-2 B.1.1.7 (alpha) variant. We matched recipients of each vaccine in a 1:1 ratio according to their risk factors. Outcomes included documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, symptomatic Covid-19, hospitalization for Covid-19, admission to an intensive care unit (ICU) for Covid-19, and death from Covid-19. We estimated risks using the Kaplan-Meier estimator. To assess the influence of the B.1.617.2 (delta) variant, we emulated a second target trial that involved veterans vaccinated between July 1 and September 20, 2021. RESULTS: Each vaccine group included 219,842 persons. Over 24 weeks of follow-up in a period marked by alpha-variant predominance, the estimated risk of documented infection was 5.75 events per 1000 persons (95% confidence interval [CI], 5.39 to 6.23) in the BNT162b2 group and 4.52 events per 1000 persons (95% CI, 4.17 to 4.84) in the mRNA-1273 group. The excess number of events per 1000 persons for BNT162b2 as compared with mRNA-1273 was 1.23 (95% CI, 0.72 to 1.81) for documented infection, 0.44 (95% CI, 0.25 to 0.70) for symptomatic Covid-19, 0.55 (95% CI, 0.36 to 0.83) for hospitalization for Covid-19, 0.10 (95% CI, 0.00 to 0.26) for ICU admission for Covid-19, and 0.02 (95% CI, -0.06 to 0.12) for death from Covid-19. The corresponding excess risk (BNT162b2 vs. mRNA-1273) of documented infection over 12 weeks of follow-up in a period marked by delta-variant predominance was 6.54 events per 1000 persons (95% CI, -2.58 to 11.82). CONCLUSIONS: The 24-week risk of Covid-19 outcomes was low after vaccination with mRNA-1273 or BNT162b2, although risks were lower with mRNA-1273 than with BNT162b2. This pattern was consistent across periods marked by alpha- and delta-variant predominance. (Funded by the Department of Veterans Affairs and others.).","journal":"New England Journal of Medicine","year":2021,"id":146027,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":272,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8758,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":424321,"name":"Hanna Gerlovin","orcid":"0000-0002-6700-2129","position":1,"is_corresponding":false},{"id":388729,"name":"Arin L. Madenci","orcid":"0000-0003-1258-7278","position":2,"is_corresponding":false},{"id":620453,"name":"Katherine E. Kurgansky","orcid":"0000-0001-9357-0034","position":3,"is_corresponding":false},{"id":620454,"name":"Brian R. Ferolito","orcid":"0000-0003-3208-6446","position":4,"is_corresponding":false},{"id":620455,"name":"Michael J. Figueroa Muñiz","orcid":"0000-0001-5747-8767","position":5,"is_corresponding":false},{"id":525249,"name":"David Gagnon","orcid":"0000-0002-6367-3179","position":6,"is_corresponding":false},{"id":11341,"name":"J. Michael Gaziano","orcid":"0000-0002-5384-9767","position":7,"is_corresponding":false},{"id":11349,"name":"Kelly Cho","orcid":"0000-0003-1727-7076","position":8,"is_corresponding":false},{"id":42600,"name":"Juan P. Casas","orcid":"0000-0002-1898-6862","position":9,"is_corresponding":false},{"id":80984,"name":"Miguel A. Hernán","orcid":"0000-0003-1619-8456","position":10,"is_corresponding":false},{"id":324240,"name":"Barbra A. Dickerman","orcid":"0000-0003-2843-687X","position":0,"is_corresponding":true}],"reference_count":15,"raw_metadata":null,"created_at":"2026-07-18T23:42:18.947086Z","pmid":"34942066","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}