Infectious Diseases and Therapy (May 2024)

Immunogenicity of mRNA-1273 and BNT162b2 in Immunocompromised Patients: Systematic Review and Meta-analysis Using GRADE

  • Sushma Kavikondala,
  • Katrin Haeussler,
  • Xuan Wang,
  • Anne Spellman,
  • Mary T. Bausch-Jurken,
  • Pawana Sharma,
  • Mohammadreza Amiri,
  • Anna Krivelyova,
  • Sonam Vats,
  • Maria Nassim,
  • Nitendra Kumar,
  • Nicolas Van de Velde

DOI
https://doi.org/10.1007/s40121-024-00987-2
Journal volume & issue
Vol. 13, no. 7
pp. 1419 – 1438

Abstract

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Abstract Introduction Immunocompromised (IC) patients mount poor immune responses to vaccination. Higher-dose coronavirus disease 2019 (COVID-19) vaccines may offer increased immunogenicity. Methods A pairwise meta-analysis of 98 studies reporting comparisons of mRNA-1273 (50 or 100 mcg/dose) and BNT162b2 (30 mcg/dose) in IC adults was performed. Outcomes were seroconversion, total and neutralizing antibody titers, and cellular immune responses. Results mRNA-1273 was associated with a significantly higher seroconversion likelihood [relative risk, 1.11 (95% CI, 1.08, 1.14); P < 0.0001; I 2 = 66.8%] and higher total antibody titers [relative increase, 50.45% (95% CI, 34.63%, 66.28%); P < 0.0001; I 2 = 89.5%] versus BNT162b2. mRNA-1273 elicited higher but statistically nonsignificant relative increases in neutralizing antibody titers and cellular immune responses versus BNT162b2. Conclusion Higher-dose mRNA-1273 had increased immunogenicity versus BNT162b2 in IC patients.

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