mRNA-1283 and BNT162b2 COVID-19 vaccines show protective effectiveness in adults aged 65 and older.
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Key Takeaway
Consider that observational data show mRNA-1283 may have higher effectiveness than BNT162b2 for COVID-19 outcomes in adults aged >=65 years.
This observational cohort study used linked electronic health record and administrative claims data through Jan 31, 2026, to evaluate two 2025/2026 COVID-19 vaccines in U.S. adults aged >=65 years. The population included 233,072 mRNA-1283 recipients and 422,610 BNT162b2 recipients, with unvaccinated individuals matched as comparators.
For COVID-19 related hospitalization, the adjusted vaccine effectiveness (aVE) for mRNA-1283 was 59.3% among adults >=65 years (95% CI: 39.0% to 72.9%) and 66.9% among adults >=75 years (95% CI: 45.9% to 79.8%). For BNT162b2, aVE was 48.3% among adults >=65 years (95% CI: 32.4% to 60.5%) and 45.9% among adults >=75 years (95% CI: 26.0% to 60.4%).
For medically-attended COVID-19, aVE for mRNA-1283 was 42.0% among adults >=65 years (95% CI: 35.0% to 48.3%) and 50.2% among adults >=75 years (95% CI: 42.1% to 57.2%). For BNT162b2, aVE was 41.2% among adults >=65 years (95% CI: 36.2% to 45.8%) and 44.0% among adults >=75 years (95% CI: 37.8% to 49.6%). Safety data were not reported.
Key limitations include the observational design, which cannot prove causation, and the lack of reported follow-up duration. Findings support mRNA-1283 as a public health tool for reducing COVID-19 burden in older adults, but results should be interpreted with caution due to the study's design.
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View Original Abstract ↓
Background: The 2025/2026 COVID-19 vaccine season introduced updated formulations targeting the LP.8.1 lineage. This study assessed the absolute vaccine effectiveness (aVE) of mRNA-1283 and BNT162b2 on COVID-19 outcomes in adults aged [≥]65 years. Methods: Background: The 2025/2026 COVID-19 vaccine season introduced updated formulations targeting the LP.8.1 lineage. This study assessed the absolute vaccine effectiveness (aVE) of mRNA-1283 and BNT162b2 on COVID-19 outcomes in adults aged [≥]65 years. Methods: This retrospective study used linked electronic health record and administrative claims data through Jan 31, 2026. Adults [≥]65 years who received the mRNA-1283 or BNT162b2 2025/2026 COVID-19 vaccine were matched to unvaccinated individuals. Inverse probability of treatment weighting was applied to matched cohorts of each vaccine to balance covariates. Each vaccine was evaluated independently against its own unvaccinated comparator group. aVE against COVID-19 related hospitalization and medically-attended COVID-19 was estimated using Cox proportional hazards models; aVE = 100 x (1 - hazard ratio [HR]). Results: We identified 233,072 mRNA-1283 recipients and 422,610 BNT162b2 recipients [≥]65 years. The aVE (95% confidence interval) of mRNA-1283 against COVID-19 related hospitalization and medically-attended COVID-19 was 59.3% (39.0%, 72.9%) and 42.0% (35.0%, 48.3%) among adults [≥]65 years and 66.9% (45.9%, 79.8%) and 50.2% (42.1%, 57.2%) in [≥]75 years, respectively. The aVE of BNT162b2 against COVID-19 related hospitalization and medically-attended COVID-19 was 48.3% (32.4%, 60.5%) and 41.2% (36.2%, 45.8%) in [≥]65 years and 45.9% (26.0%, 60.4%) and 44.0% (37.8%, 49.6%) in [≥]75 years, respectively. Conclusions: This is the first real-world evidence showing that mRNA-1283 prevents COVID-19-related hospitalizations and medically attended events in vulnerable older adults at highest risk of severe disease. These findings support mRNA-1283 as an important public health tool for reducing the ongoing burden of COVID-19.Results: We identified 233,072 mRNA-1283 recipients and 422,610 BNT162b2 recipients [≥]65 years. The aVE (95% confidence interval) of mRNA-1283 against COVID-19 related hospitalization and medically-attended COVID-19 was 59.3% (39.0%, 72.9%) and 42.0% (35.0%, 48.3%) among adults [≥]65 years and 66.9% (45.9 %, 79.8%) and 50.2% (42.1%, 57.2%) in [≥]75 years, respectively. The aVE of BNT162b2 against COVID-19 related hospitalization and medically-attended COVID-19 was 48.3% (32.4%, 60.5%) and 41.2% (36.2%, 45.8%) in [≥]65 years and 45.9% (26.0%, 60.4%) and 44.0% (37.8%, 49.6%) in [≥]75 years, respectively. Conclusions: This is the first real-world evidence showing that mRNA-1283 prevents COVID-19-related hospitalizations and medically attended events in vulnerable older adults at highest risk of severe disease. These findings support mRNA-1283 as an important public health tool for reducing the ongoing burden of COVID-19.
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