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MG Thompson, JL Burgess, AL Naleway, HL Tyner, SK Yoon, J Meece, LEW Olsho, AJ Caban-Martinez, A Fowlkes, K Lutrick, JL Kuntz, K Dunnigan, MJ Odean, KT Hegmann, E Stefanski, LJ Edwards, N Schaefer-Solle, L Grant, K Ellingson, HC Groom, T Zunie, MS Thiese, L Ivacic, MG Wesley, JM Lamberte, X Sun, ME Smith, AL Phillips, KD Groover, YM Yoo, J Gerald, RT Brown, MK Herring, G Joseph, S Beitel, TC Morrill, J Mak, P Rivers, KM Harris, DR Hunt, ML Arvay, P Kutty, AM Fry and M Gaglani
Abstract
Messenger RNA (mRNA) BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) COVID-19 vaccines have been shown to be effective in preventing symptomatic COVID-19 in randomized placebo-controlled Phase III trials (1,2); however, the benefits of these vaccines for preventing asymptomatic and symptomatic SARS-CoV-2 (the virus that causes COVID-19) infection, particularly when administered in real-world conditions, is less well understood. Using prospective cohorts of health care personnel, first responders, and other essential and frontline workers* in eight U.S. locations during December 14, 2020-March 13, 2021, CDC routinely tested for SARS-CoV-2 infections every week regardless of symptom status and at the onset of symptoms consistent with COVID-19-associated illness. Among 3,950 participants with no previous laboratory documentation of SARS-CoV-2 infection, 2,479 (62.8%) received both recommended mRNA doses and 477 (12.1%) received only one dose of mRNA vaccine.† Among unvaccinated participants, 1.38 SARS-CoV-2 infections were confirmed by reverse transcription-polymerase chain reaction (RT-PCR) per 1,000 person-days.§ In contrast, among fully immunized (≥14 days after second dose) persons, 0.04 infections per 1,000 person-days were reported, and among partially immunized (≥14 days after first dose and before second dose) persons, 0.19 infections per 1,000 person-days were reported. Estimated mRNA vaccine effectiveness for prevention of infection, adjusted for study site, was 90% for full immunization and 80% for partial immunization. These findings indicate that authorized mRNA COVID-19 vaccines are effective for preventing SARS-CoV-2 infection, regardless of symptom status, among working-age adults in real-world conditions. COVID-19 vaccination is recommended for all eligible persons.
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