Efficacy of the mRNA-1273 SARS-CoV-2 Vaccine at Completion of Blinded Phase

Copyright © 2021 Massachusetts Medical Society..

BACKGROUND: At interim analysis in a phase 3, observer-blinded, placebo-controlled clinical trial, the mRNA-1273 vaccine showed 94.1% efficacy in preventing coronavirus disease 2019 (Covid-19). After emergency use of the vaccine was authorized, the protocol was amended to include an open-label phase. Final analyses of efficacy and safety data from the blinded phase of the trial are reported.

METHODS: We enrolled volunteers who were at high risk for Covid-19 or its complications; participants were randomly assigned in a 1:1 ratio to receive two intramuscular injections of mRNA-1273 (100 μg) or placebo, 28 days apart, at 99 centers across the United States. The primary end point was prevention of Covid-19 illness with onset at least 14 days after the second injection in participants who had not previously been infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The data cutoff date was March 26, 2021.

RESULTS: The trial enrolled 30,415 participants; 15,209 were assigned to receive the mRNA-1273 vaccine, and 15,206 to receive placebo. More than 96% of participants received both injections, 2.3% had evidence of SARS-CoV-2 infection at baseline, and the median follow-up was 5.3 months in the blinded phase. Vaccine efficacy in preventing Covid-19 illness was 93.2% (95% confidence interval [CI], 91.0 to 94.8), with 55 confirmed cases in the mRNA-1273 group (9.6 per 1000 person-years; 95% CI, 7.2 to 12.5) and 744 in the placebo group (136.6 per 1000 person-years; 95% CI, 127.0 to 146.8). The efficacy in preventing severe disease was 98.2% (95% CI, 92.8 to 99.6), with 2 cases in the mRNA-1273 group and 106 in the placebo group, and the efficacy in preventing asymptomatic infection starting 14 days after the second injection was 63.0% (95% CI, 56.6 to 68.5), with 214 cases in the mRNA-1273 group and 498 in the placebo group. Vaccine efficacy was consistent across ethnic and racial groups, age groups, and participants with coexisting conditions. No safety concerns were identified.

CONCLUSIONS: The mRNA-1273 vaccine continued to be efficacious in preventing Covid-19 illness and severe disease at more than 5 months, with an acceptable safety profile, and protection against asymptomatic infection was observed. (Funded by the Biomedical Advanced Research and Development Authority and the National Institute of Allergy and Infectious Diseases; COVE ClinicalTrials.gov number, NCT04470427.).

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:385

Enthalten in:

The New England journal of medicine - 385(2021), 19 vom: 04. Nov., Seite 1774-1785

Sprache:

Englisch

Beteiligte Personen:

El Sahly, Hana M [VerfasserIn]
Baden, Lindsey R [VerfasserIn]
Essink, Brandon [VerfasserIn]
Doblecki-Lewis, Susanne [VerfasserIn]
Martin, Judith M [VerfasserIn]
Anderson, Evan J [VerfasserIn]
Campbell, Thomas B [VerfasserIn]
Clark, Jesse [VerfasserIn]
Jackson, Lisa A [VerfasserIn]
Fichtenbaum, Carl J [VerfasserIn]
Zervos, Marcus [VerfasserIn]
Rankin, Bruce [VerfasserIn]
Eder, Frank [VerfasserIn]
Feldman, Gregory [VerfasserIn]
Kennelly, Christina [VerfasserIn]
Han-Conrad, Laurie [VerfasserIn]
Levin, Michael [VerfasserIn]
Neuzil, Kathleen M [VerfasserIn]
Corey, Lawrence [VerfasserIn]
Gilbert, Peter [VerfasserIn]
Janes, Holly [VerfasserIn]
Follmann, Dean [VerfasserIn]
Marovich, Mary [VerfasserIn]
Polakowski, Laura [VerfasserIn]
Mascola, John R [VerfasserIn]
Ledgerwood, Julie E [VerfasserIn]
Graham, Barney S [VerfasserIn]
August, Allison [VerfasserIn]
Clouting, Heather [VerfasserIn]
Deng, Weiping [VerfasserIn]
Han, Shu [VerfasserIn]
Leav, Brett [VerfasserIn]
Manzo, Deb [VerfasserIn]
Pajon, Rolando [VerfasserIn]
Schödel, Florian [VerfasserIn]
Tomassini, Joanne E [VerfasserIn]
Zhou, Honghong [VerfasserIn]
Miller, Jacqueline [VerfasserIn]
COVE Study Group [VerfasserIn]
Adams, Atoya [Sonstige Person]
Miller, Eric [Sonstige Person]
Rankin, Bruce G [Sonstige Person]
Hill, John [Sonstige Person]
Shinn, Steven [Sonstige Person]
Nash, Marshall [Sonstige Person]
Green, Sinikka L [Sonstige Person]
Jacobsen, Colleen [Sonstige Person]
Krishnankutty, Jayasree [Sonstige Person]
Phungwayo, Sikhongi [Sonstige Person]
Glover, Richard M [Sonstige Person]
Slechta, Drs Stacy [Sonstige Person]
Holdeman, Troy [Sonstige Person]
Hartvickson, Robyn [Sonstige Person]
Grant, Amber [Sonstige Person]
Poling, Terry L [Sonstige Person]
Klein, Terry D [Sonstige Person]
Klein, Thomas C [Sonstige Person]
Klein, Tracy R [Sonstige Person]
Smith, William B [Sonstige Person]
Gibson, Richard L [Sonstige Person]
Winbigler, Jennifer [Sonstige Person]
Parker, Elizabeth [Sonstige Person]
Wijewardane, Priyantha N [Sonstige Person]
Bravo, Eric [Sonstige Person]
Thessing, Jeffrey [Sonstige Person]
Maxwell, Michelle [Sonstige Person]
Horn, Amanda [Sonstige Person]
Sahly, Hana El [Sonstige Person]
Whitaker, Jennifer [Sonstige Person]
Healy, Catherine Mary [Sonstige Person]
Akamine, Christine [Sonstige Person]
Chu, Laurence [Sonstige Person]
Chouteau, R Michelle [Sonstige Person]
Cotugno, Michael J [Sonstige Person]
Bauer, George H [Sonstige Person]
Hachigian, Greg [Sonstige Person]
Oshita, Masaru [Sonstige Person]
Cancilla, Michael [Sonstige Person]
Murray, Deborah [Sonstige Person]
Kiersey, Kristen [Sonstige Person]
Seger, William [Sonstige Person]
Antwi, Mohammed [Sonstige Person]
Green, Allison [Sonstige Person]
Kim, Anthony [Sonstige Person]
Baden, Lindsey R [Sonstige Person]
Desjardins, Michael [Sonstige Person]
Johnson, Jennifer A [Sonstige Person]
Sherman, Amy [Sonstige Person]
Walsh, Stephen R [Sonstige Person]
Borger, Judith [Sonstige Person]
Starr, Ryan [Sonstige Person]
Syndergaard, Scott [Sonstige Person]
Saleem, Nafisa [Sonstige Person]
Solis, Joel [Sonstige Person]
Medina, Martha Carmen [Sonstige Person]
Keating, Westly [Sonstige Person]
Garcia, Edgar [Sonstige Person]
Bueno, Cynthia [Sonstige Person]
Segall, Nathan [Sonstige Person]
Finley, Jon [Sonstige Person]
Stull, Mildred [Sonstige Person]
Denham, Douglas Scott [Sonstige Person]
Weiss, Thomas [Sonstige Person]
Avworo, Ayoade [Sonstige Person]
Hedges, Parke [Sonstige Person]
Becher Strout, Cynthia [Sonstige Person]
Santiago, Rica [Sonstige Person]
Davis, Yvonne [Sonstige Person]
Howenstine, Patty [Sonstige Person]
Bondell, Alison [Sonstige Person]
Marks, Kristin [Sonstige Person]
Ellsworth, Grant [Sonstige Person]
Wang, Tina [Sonstige Person]
Wilkin, Timothy [Sonstige Person]
Vogler, Mary [Sonstige Person]
Johnston, Carrie [Sonstige Person]
Andrasik, Michele P [Sonstige Person]
Andriesen, Jessica G [Sonstige Person]
Broder, Gail [Sonstige Person]
Corey, Lawrence [Sonstige Person]
Eaton, Niles [Sonstige Person]
Neuzil, Kathleen M [Sonstige Person]
Gelderblom, Huub G [Sonstige Person]
Kublin, James G [Sonstige Person]
McClennen, Rachael [Sonstige Person]
Michael, Nelson [Sonstige Person]
Robb, Merlin [Sonstige Person]
Sopher, Carrie [Sonstige Person]
Miller, Vicki E [Sonstige Person]
Santiago, Fredric [Sonstige Person]
Gomez, Blanca [Sonstige Person]
Valika, Insiya [Sonstige Person]
Starr, Amy [Sonstige Person]
Kelley, Colleen [Sonstige Person]
Cantos, Valeria D [Sonstige Person]
Kandiah, Sheetal [Sonstige Person]
Del Rio, Carlos A [Sonstige Person]
Rouphael, Nadine [Sonstige Person]
Rebolledo, Paulina [Sonstige Person]

Links:

Volltext

Themen:

2019-nCoV Vaccine mRNA-1273
COVID-19 Vaccines
Clinical Trial, Phase III
EPK39PL4R4
Journal Article
Multicenter Study
Randomized Controlled Trial

Anmerkungen:

Date Completed 16.11.2021

Date Revised 23.11.2023

published: Print-Electronic

ClinicalTrials.gov: NCT04470427

Citation Status MEDLINE

doi:

10.1056/NEJMoa2113017

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM330930834