Top 5 Takeaways

1. Higher VE for Moderna: The Moderna vaccine showed a higher vaccine effectiveness (VE) of 93% against COVID-19 hospitalizations compared to Pfizer-BioNTech’s 88% and Janssen’s 71%.
2. Decline in Pfizer-BioNTech VE: Protection from the Pfizer-BioNTech vaccine declined significantly after 120 days, dropping from 91% to 77%.
3. Lower Antibody Levels for Janssen: Postvaccination antibody levels were significantly lower for Janssen vaccine recipients compared to those who received Moderna or Pfizer-BioNTech vaccines.
4. Consistent VE for Moderna: The Moderna vaccine maintained a consistent VE of around 93% even after 120 days post-vaccination.
5. Substantial Protection from All Vaccines: Despite variations in VE, all three FDA-approved or authorized vaccines provided substantial protection against COVID-19 hospitalizations.

Original Article Author and Citation

Corresponding Author

Wesley H. Self, welsey.self@vumc.org

Suggested Citation

Self WH, Tenforde MW, Rhoads JP, et al. Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions — United States, March–August 2021. MMWR Morb Mortal Wkly Rep 2021;70:1337–1343. DOI: http://dx.doi.org/10.15585/mmwr.mm7038e1

Summary

This study assessed the effectiveness of Moderna, Pfizer-BioNTech, and Janssen COVID-19 vaccines in preventing hospitalizations among adults without immunocompromising conditions. The analysis included 3,689 adults hospitalized at 21 U.S. hospitals from March 11 to August 15, 2021. The Moderna vaccine had the highest VE at 93%, followed by Pfizer-BioNTech at 88%, and Janssen at 71%. Antibody levels post-vaccination were also higher for Moderna and Pfizer-BioNTech compared to Janssen.

Methods

A case-control analysis was conducted among adults aged ≥18 years hospitalized with COVID-19-like illness across 21 hospitals. VE was estimated using logistic regression, adjusting for various factors. Additionally, an antibody analysis was performed on 100 healthy volunteers to compare post-vaccination antibody levels among the three vaccines.

Discussion

The study found that the two-dose mRNA vaccines (Moderna and Pfizer-BioNTech) provided higher protection against COVID-19 hospitalizations compared to the single-dose Janssen vaccine. The decline in VE for Pfizer-BioNTech after 120 days highlights the potential need for booster doses. The findings suggest that while all vaccines offer substantial protection, the mRNA vaccines may offer more durable immunity.

Conclusion

The Moderna and Pfizer-BioNTech vaccines provided higher and more consistent protection against COVID-19 hospitalizations compared to the Janssen vaccine. Understanding these differences can inform vaccine recommendations and booster policies. All three vaccines, however, significantly reduce the risk of severe COVID-19 outcomes.

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