Evidence map›Paper›PMID 34417165›Full record

ArticleBMJ (Clinical research ed.)2021

Effectiveness of BNT162b2 and mRNA-1273 covid-19 vaccines against symptomatic SARS-CoV-2 infection and severe covid-19 outcomes in Ontario, Canada: test negative design study.

Hannah Chung, Siyi He, Sharifa Nasreen, Maria E Sundaram, Sarah A Buchan, Sarah E Wilson, Branson Chen, Andrew Calzavara, Deshayne B Fell, Peter C Austin and 13 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 204 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
204citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

204 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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  11. Population-based evaluation of the effectiveness of nirmatrelvir-ritonavir for reducing hospital admissions and mortality from COVID-19.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023
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  18. Mucosal implications of oral Jak3-targeted drugs in COVID patients.Molecular medicine (Cambridge, Mass.) · 2025
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144 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Hannah ChungICES, Toronto, ON, Canada.
Siyi HeICES, Toronto, ON, Canada.
Sharifa NasreenICES, Toronto, ON, Canada.
Maria E SundaramICES, Toronto, ON, Canada.
Sarah A BuchanICES, Toronto, ON, Canada.
Sarah E WilsonICES, Toronto, ON, Canada.
Branson ChenICES, Toronto, ON, Canada.
Andrew CalzavaraICES, Toronto, ON, Canada.
Deshayne B FellICES, Toronto, ON, Canada.
Peter C AustinICES, Toronto, ON, Canada.
Kumanan WilsonSchool of Epidemiology and Public Health, University of Ottawa, ON, Canada.
Kevin L SchwartzICES, Toronto, ON, Canada.
Kevin A BrownICES, Toronto, ON, Canada.
Jonathan B GubbayPublic Health Ontario, ON, Canada.
Nicole E BastaDepartment of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montreal, QC, Canada.
Salaheddin M MahmudVaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Christiaan H RigholtVaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Lawrence W SvensonAnalytics and Performance Reporting Branch, Alberta Health, Edmonton, AB, Canada.
Shannon E MacDonaldSchool of Public Health, University of Alberta, Edmonton, AB, Canada.
Naveed Z JanjuaBritish Columbia Centre for Disease Control, Vancouver, BC, Canada.
Mina TadrousICES, Toronto, ON, Canada.
Jeffrey C KwongICES, Toronto, ON, Canada jeff.kwong@utoronto.ca.ORCID 0000-0002-7820-2046
Canadian Immunization Research Network (CIRN) Provincial Collaborative Network (PCN) Investigators

Funding

Quantifying the Breadth and Duration of Immunity Induced by Meningococcal B VaccinesR01AI132496 · NIAID · UNIVERSITY OF MINNESOTA · PI BASTA, NICOLE ELAINE · 2018 to 2023
$3.1M
NIAID NIH HHS R01 AI132496
6 · The paper itself

Abstract

objectiveTo estimate the effectiveness of mRNA covid-19 vaccines against symptomatic infection and severe outcomes (hospital admission or death).

designTest negative design study.

settingOntario, Canada between 14 December 2020 and 19 April 2021.

participants324 033 community dwelling people aged ≥16 years who had symptoms of covid-19 and were tested for SARS-CoV-2.

interventionsBNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine.

main outcome measuresLaboratory confirmed SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR) and hospital admissions and deaths associated with SARS-CoV-2 infection. Multivariable logistic regression was adjusted for personal and clinical characteristics associated with SARS-CoV-2 and vaccine receipt to estimate vaccine effectiveness against symptomatic infection and severe outcomes.

resultsOf 324 033 people with symptoms, 53 270 (16.4%) were positive for SARS-CoV-2 and 21 272 (6.6%) received at least one dose of vaccine. Among participants who tested positive, 2479 (4.7%) were admitted to hospital or died. Vaccine effectiveness against symptomatic infection observed ≥14 days after one dose was 60% (95% confidence interval 57% to 64%), increasing from 48% (41% to 54%) at 14-20 days after one dose to 71% (63% to 78%) at 35-41 days. Vaccine effectiveness observed ≥7 days after two doses was 91% (89% to 93%). Vaccine effectiveness against hospital admission or death observed ≥14 days after one dose was 70% (60% to 77%), increasing from 62% (44% to 75%) at 14-20 days to 91% (73% to 97%) at ≥35 days, whereas vaccine effectiveness observed ≥7 days after two doses was 98% (88% to 100%). For adults aged ≥70 years, vaccine effectiveness estimates were observed to be lower for intervals shortly after one dose but were comparable to those for younger people for all intervals after 28 days. After two doses, high vaccine effectiveness was observed against variants with the E484K mutation.

conclusionsTwo doses of mRNA covid-19 vaccines were observed to be highly effective against symptomatic infection and severe outcomes. Vaccine effectiveness of one dose was observed to be lower, particularly for older adults shortly after the first dose.

Indexed as

2019-nCoV Vaccine mRNA-1273AdolescentAdultAgedBNT162 VaccineCOVID-19COVID-19 Nucleic Acid TestingCOVID-19 VaccinesFemaleHumansMaleMiddle AgedOntarioPatient AdmissionSARS-CoV-2Treatment Outcome2019-nCoV Vaccine mRNA-1273BNT162 VaccineCOVID-19 Vaccines

Identifiers

PMID34417165
PMCPMC8377789

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.