Abstract: PO0132
Comparative Effectiveness of Ad26.COV2.S vs. BNT162b2 for the Prevention of SARS-CoV-2 Infection Among Dialysis Patients
Session Information
- COVID-19: Vaccines, Diagnosis, and Treatment
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Brunelli, Steven M., Davita Clinical Research, Minneapolis, Minnesota, United States
- Sibbel, Scott, Davita Clinical Research, Minneapolis, Minnesota, United States
- Marlowe, Gilbert, Davita Clinical Research, Minneapolis, Minnesota, United States
- Giullian, Jeffrey A., DaVita Inc, Denver, Colorado, United States
- Van Wyck, David B., DaVita Inc, Denver, Colorado, United States
- Tentori, Francesca, Davita Clinical Research, Minneapolis, Minnesota, United States
Background
Elsewhere, we have demonstrated that the BNT162b2 vaccine (Pfizer/BioNTech) is highly effective in reducing risk of COVID-19 among real-world dialysis patients. Because individual vaccines may be differentially available (and acceptable) to patients, it is important to understand the comparative effectiveness of other agents, such as Ad26.COV2.S (Janssen).
Methods
This was a retrospective real-world comparative effectiveness study comparing two vaccination strategies (“use Ad26.COV2.S” versus “use BNT162b”) among adult patients dialyzing at a large dialysis organization. Patients receiving Ad26.COV2.S were matched 1:1 to those initiating a BNT162b2 series based on age, race, US state of residence, calendar week of first vaccine receipt, and prior history of COVID-19. Follow-up time began the day after the first vaccine dose. The outcome of interest was the comparative rate of polymerase chain reaction-confirmed SARS-CoV-2 infections considered over 3 follow-up intervals: days 1-21, 22-42, and ≥ 43 post vaccination.
Results
There were 2683 matched pairs of patients who received a first dose of each vaccine. During days 1-21, the incidence rate was 1.26 infections per 1000 patient-weeks (pt-wks) among BNT162b2 recipients and 1.26 among Ad26.COV2.S recipients (incident rate difference [IRD]: 0.00; 95% confidence interval [CI]: -1.10, 1.10). During days 22-42, the incidence rate was 0.93 infections per 1000 pt-wks among BNT162b2 recipients and 0.40 among Ad26.COV2.S recipients (IRD: -0.50; 95% CI: -1.40, 0.30). After day 43, the incidence rate was 0.50 infections per 1000 pt-wks among BNT162b2 recipients and 0.50 among Ad26.COV2.S recipients (IRD: 0.00; 95% CI: -0.8, 0.8). Results were nearly identical when considering only patients without a prior history of COVID-19.
Conclusion
In a large contemporary cohort of dialysis patients, a “use Ad26.COV2.S” strategy versus a “use BNT162b2” strategy would be expected to yield no difference in additional cases of SARS-CoV-2 infections. Given similar effectiveness, vaccine allocation should be based on availability and logistical considerations.