Trial Outcomes & Findings for COVID-19 Vaccination and Breakthrough Infections Among Persons With Immunocompromising Conditions in the United States (NCT NCT05020145)

NCT ID: NCT05020145

Last Updated: 2024-02-12

Results Overview

The incidence rate of breakthrough cases of SARS-CoV-2 infection was calculated as the number of participants who experienced the event divided by the observed time at risk and reported as incidence rate per 100 person-years. Rate of breakthrough SARS-CoV-2 infection among fully vaccinated participants was reported in this outcome measure.

Recruitment status

COMPLETED

Target enrollment

1277747 participants

Primary outcome timeframe

From 14 days after Dose 2 of BNT162b2 vaccine up to COVID-19 vaccine breakthrough infection case or end of continuous enrollment, whichever occurred first (retrospective data was retrieved and observed during 4 months approximately)

Results posted on

2024-02-12

Participant Flow

Data of participants aged 12 years or more with at least 1 BNT162b2 vaccine claim between 10 Dec 2020 to 08 Jul 2021 examined for COVID-19 breakthrough infections (vaccination greater than equal to \[\>=\] 14 days after 2nd dose) in real-world practice, were retrieved from US HealthVerity database. Available data were extracted and evaluated during approximately 4 months of this retrospective observational study.

Participant milestones

Participant milestones
Measure
BNT162b2 (Tozinameran): IC Cohort
Participants with IC condition who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 were retrospectively observed in this cohort. Participants were considered immunocompromised if they had \>=1 hospitalization or \>=2 outpatient visits on separate dates on a healthcare claim indicated 1 or more IC condition or if they had usage of specific immunosuppressive (IS) medications during the 12-month baseline period (prior to index period). Index date was defined as the date of receipt of the 1st BNT162b2 dose.
BNT162b2 (Tozinameran): Non-IC Cohort
Participants who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 and without evidence of immunocompromising condition were included in this reporting arm.
Overall Study
STARTED
225796
1051951
Overall Study
Fully Vaccinated
212945
963962
Overall Study
COMPLETED
225796
1051951
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
BNT162b2 (Tozinameran): IC Cohort
n=225796 Participants
Participants with IC condition who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 were retrospectively observed in this cohort. Participants were considered immunocompromised if they had \>=1 hospitalization or \>=2 outpatient visits on separate dates on a healthcare claim indicated 1 or more IC condition or if they had usage of specific immunosuppressive (IS) medications during the 12-month baseline period (prior to index period). Index date was defined as the date of receipt of the 1st BNT162b2 dose.
BNT162b2 (Tozinameran): Non-IC Cohort
n=1051951 Participants
Participants who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 and without evidence of immunocompromising condition were included in this reporting arm.
Total
n=1277747 Participants
Total of all reporting groups
Age, Continuous
55.4 Years
STANDARD_DEVIATION 15.2 • n=225796 Participants
44.1 Years
STANDARD_DEVIATION 16.9 • n=1051951 Participants
46.1 Years
STANDARD_DEVIATION 17.1 • n=1277747 Participants
Sex/Gender, Customized
Female
127101 Participants
n=225796 Participants
558164 Participants
n=1051951 Participants
685265 Participants
n=1277747 Participants
Sex/Gender, Customized
Male
96835 Participants
n=225796 Participants
476804 Participants
n=1051951 Participants
573639 Participants
n=1277747 Participants
Sex/Gender, Customized
Unknown
1860 Participants
n=225796 Participants
16983 Participants
n=1051951 Participants
18843 Participants
n=1277747 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.

PRIMARY outcome

Timeframe: From 14 days after Dose 2 of BNT162b2 vaccine up to COVID-19 vaccine breakthrough infection case or end of continuous enrollment, whichever occurred first (retrospective data was retrieved and observed during 4 months approximately)

Population: Analysis population included fully vaccinated participants against COVID-19 in dataset during 10-Dec-2020 through 08-Jul-2021, at least 12 years old on index date, had continuous medical enrolment 12-month period prior to index date, with no prior COVID-19 diagnosis during baseline. Fully vaccinated was defined as \>=14 days of follow-up after Dose 2 of BNT162b2 vaccine. Here, N=participant who had at least 1 incidence of SARS-CoV-2 breakthrough infection were evaluable for this outcome measure.

The incidence rate of breakthrough cases of SARS-CoV-2 infection was calculated as the number of participants who experienced the event divided by the observed time at risk and reported as incidence rate per 100 person-years. Rate of breakthrough SARS-CoV-2 infection among fully vaccinated participants was reported in this outcome measure.

Outcome measures

Outcome measures
Measure
BNT162b2 (Tozinameran): IC Cohort
n=212945 Participants
Participants with IC condition who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 were retrospectively observed in this cohort. Participants were considered immunocompromised if they had \>=1 hospitalization or \>=2 outpatient visits on separate dates on a healthcare claim indicated 1 or more IC condition or if they had usage of specific immunosuppressive (IS) medications during the 12-month baseline period (prior to index period). Index date was defined as the date of receipt of the 1st BNT162b2 dose.
BNT162b2 (Tozinameran): Non-IC Cohort
n=963962 Participants
Participants who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 and without evidence of immunocompromising condition were included in this reporting arm.
Incidence Rate of Breakthrough Cases of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection
0.89 Events per 100 person-years
Interval 0.8 to 0.98
0.34 Events per 100 person-years
Interval 0.32 to 0.37

PRIMARY outcome

Timeframe: From 14 days after Dose 2 of BNT162b2 vaccine up to COVID-19 vaccine breakthrough infection case or end of continuous enrollment, whichever occurred first (retrospective data was retrieved and observed during 4 months approximately)

Population: Analysis population included fully vaccinated participants against COVID-19 in dataset during 10-Dec-2020 through 08-Jul-2021, at least 12 years old on index date, had continuous medical enrolment 12-month period prior to index date, with no prior COVID-19 diagnosis during baseline. Fully vaccinated was defined as \>=14 days of follow-up after Dose 2 of BNT162b2 vaccine. Here, N=participant who had at least 1 incidence of SARS-CoV-2 breakthrough infection were evaluable for this outcome measure.

Time to SARS-CoV-2 breakthrough infection was calculated as the number of days from Dose 2 of vaccination till first occurrence of a breakthrough SARS-CoV-2 infection.

Outcome measures

Outcome measures
Measure
BNT162b2 (Tozinameran): IC Cohort
n=374 Participants
Participants with IC condition who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 were retrospectively observed in this cohort. Participants were considered immunocompromised if they had \>=1 hospitalization or \>=2 outpatient visits on separate dates on a healthcare claim indicated 1 or more IC condition or if they had usage of specific immunosuppressive (IS) medications during the 12-month baseline period (prior to index period). Index date was defined as the date of receipt of the 1st BNT162b2 dose.
BNT162b2 (Tozinameran): Non-IC Cohort
n=604 Participants
Participants who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 and without evidence of immunocompromising condition were included in this reporting arm.
Time to SARS-CoV-2 Breakthrough Infection
34.5 Days
Interval 22.0 to 58.0
33 Days
Interval 20.5 to 58.0

SECONDARY outcome

Timeframe: From 14 days after Dose 2 of BNT162b2 vaccine up to COVID-19 vaccine breakthrough infection case or end of continuous enrollment, whichever occurred first (retrospective data was retrieved and observed during 4 months approximately)

Population: Analysis population included fully vaccinated participants against COVID-19 in dataset during 10-Dec-2020 through 08-Jul-2021, at least 12 years old on index date, had continuous medical enrolment 12-month period prior to index date, with no prior COVID-19 diagnosis during baseline. Fully vaccinated was defined as \>=14 days of follow-up after Dose 2 of BNT162b2 vaccine. Here, N=participant who had at least 1 incidence of SARS-CoV-2 breakthrough infection were evaluable for this outcome measure.

In this outcome measure, number of participants with emergency department visits who were fully vaccination and had SARS-CoV-2 breakthrough infection were analyzed. Emergency department visits included an outpatient claim that occurs after the breakthrough COVID-19 diagnosis date or at the same time or episode of care.

Outcome measures

Outcome measures
Measure
BNT162b2 (Tozinameran): IC Cohort
n=374 Participants
Participants with IC condition who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 were retrospectively observed in this cohort. Participants were considered immunocompromised if they had \>=1 hospitalization or \>=2 outpatient visits on separate dates on a healthcare claim indicated 1 or more IC condition or if they had usage of specific immunosuppressive (IS) medications during the 12-month baseline period (prior to index period). Index date was defined as the date of receipt of the 1st BNT162b2 dose.
BNT162b2 (Tozinameran): Non-IC Cohort
n=604 Participants
Participants who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 and without evidence of immunocompromising condition were included in this reporting arm.
Number of Participants With Emergency Department Visits After SARS-CoV-2 Infection
95 Participants
72 Participants

SECONDARY outcome

Timeframe: From 14 days after Dose 2 of BNT162b2 vaccine up to COVID-19 vaccine breakthrough infection case or end of continuous enrollment, whichever occurred first (retrospective data was retrieved and observed during 4 months approximately)

Population: Analysis population included fully vaccinated participants against COVID-19 in dataset during 10-Dec-2020 through 08-Jul-2021, at least 12 years old on index date, had continuous medical enrolment 12-month period prior to index date, with no prior COVID-19 diagnosis during baseline. Fully vaccinated was defined as \>=14 days of follow-up after Dose 2 of BNT162b2 vaccine. Here, N=participant who had at least 1 incidence of SARS-CoV-2 breakthrough infection were evaluable for this outcome measure.

In this outcome measure, number of participants with outpatient hospital visits who were fully vaccination and had SARS-CoV-2 breakthrough infection were analyzed. Outpatient hospital visits included an outpatient claim that occurs after the breakthrough COVID-19 diagnosis date or at the same time or episode of care other than emergency department visits.

Outcome measures

Outcome measures
Measure
BNT162b2 (Tozinameran): IC Cohort
n=374 Participants
Participants with IC condition who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 were retrospectively observed in this cohort. Participants were considered immunocompromised if they had \>=1 hospitalization or \>=2 outpatient visits on separate dates on a healthcare claim indicated 1 or more IC condition or if they had usage of specific immunosuppressive (IS) medications during the 12-month baseline period (prior to index period). Index date was defined as the date of receipt of the 1st BNT162b2 dose.
BNT162b2 (Tozinameran): Non-IC Cohort
n=604 Participants
Participants who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 and without evidence of immunocompromising condition were included in this reporting arm.
Number of Participants With Outpatient Hospital Visits After SARS-CoV-2 Infection
146 Participants
164 Participants

SECONDARY outcome

Timeframe: From 14 days after Dose 2 of BNT162b2 vaccine up to COVID-19 vaccine breakthrough infection case or end of continuous enrollment, whichever occurred first (retrospective data was retrieved and observed during 4 months approximately)

Population: Analysis population included fully vaccinated participants against COVID-19 in dataset during 10-Dec-2020 through 08-Jul-2021, at least 12 years old on index date, had continuous medical enrolment 12-month period prior to index date, with no prior COVID-19 diagnosis during baseline. Fully vaccinated was defined as \>=14 days of follow-up after Dose 2 of BNT162b2 vaccine. Here, N=participant who had at least 1 incidence of SARS-CoV-2 breakthrough infection were evaluable for this outcome measure.

In this outcome measure, number of participants with other outpatient visits (excluding emergency department visits and outpatient hospital visits) who were fully vaccination and had SARS-CoV-2 breakthrough infection were analyzed.

Outcome measures

Outcome measures
Measure
BNT162b2 (Tozinameran): IC Cohort
n=374 Participants
Participants with IC condition who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 were retrospectively observed in this cohort. Participants were considered immunocompromised if they had \>=1 hospitalization or \>=2 outpatient visits on separate dates on a healthcare claim indicated 1 or more IC condition or if they had usage of specific immunosuppressive (IS) medications during the 12-month baseline period (prior to index period). Index date was defined as the date of receipt of the 1st BNT162b2 dose.
BNT162b2 (Tozinameran): Non-IC Cohort
n=604 Participants
Participants who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 and without evidence of immunocompromising condition were included in this reporting arm.
Number of Participants With Other Outpatient Visits After SARS-CoV-2 Infection
309 Participants
527 Participants

SECONDARY outcome

Timeframe: From 14 days after Dose 2 of BNT162b2 vaccine up to COVID-19 vaccine breakthrough infection case or end of continuous enrollment, whichever occurred first (retrospective data was retrieved and observed during 4 months approximately)

Population: Analysis population included fully vaccinated participants against COVID-19 in dataset during 10-Dec-2020 through 08-Jul-2021, at least 12 years old on index date, had continuous medical enrolment 12-month period prior to index date, with no prior COVID-19 diagnosis during baseline. Fully vaccinated was defined as \>=14 days of follow-up after Dose 2 of BNT162b2 vaccine. Here, N=participant who had at least 1 incidence of SARS-CoV-2 breakthrough infection were evaluable for this outcome measure.

In this outcome measure, number of participants hospitalized who were fully vaccination and had SARS-CoV-2 breakthrough infection were analyzed.

Outcome measures

Outcome measures
Measure
BNT162b2 (Tozinameran): IC Cohort
n=374 Participants
Participants with IC condition who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 were retrospectively observed in this cohort. Participants were considered immunocompromised if they had \>=1 hospitalization or \>=2 outpatient visits on separate dates on a healthcare claim indicated 1 or more IC condition or if they had usage of specific immunosuppressive (IS) medications during the 12-month baseline period (prior to index period). Index date was defined as the date of receipt of the 1st BNT162b2 dose.
BNT162b2 (Tozinameran): Non-IC Cohort
n=604 Participants
Participants who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 and without evidence of immunocompromising condition were included in this reporting arm.
Number of Participants Hospitalized After SARS-CoV-2 Infection
74 Participants
50 Participants

SECONDARY outcome

Timeframe: From 14 days after Dose 2 of BNT162b2 vaccine up to COVID-19 vaccine breakthrough infection case or end of continuous enrollment, whichever occurred first (retrospective data was retrieved and observed during 4 months approximately)

Population: Analysis population included fully vaccinated participants against COVID-19 in dataset during 10-Dec-2020 through 08-Jul-2021, at least 12 years old on index date, had continuous medical enrolment 12-month period prior to index date, with no prior COVID-19 diagnosis during baseline. Fully vaccinated was defined as \>=14 days of follow-up after Dose 2 of BNT162b2 vaccine. Here, N=participant who had at least 1 incidence of SARS-CoV-2 breakthrough infection were evaluable for this outcome measure.

In this outcome measure, number of participants admitted to ICU with or without Invasive Mechanical Ventilation (IMV) during hospitalization who were fully vaccination and had SARS-CoV-2 breakthrough infection were analyzed.

Outcome measures

Outcome measures
Measure
BNT162b2 (Tozinameran): IC Cohort
n=74 Participants
Participants with IC condition who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 were retrospectively observed in this cohort. Participants were considered immunocompromised if they had \>=1 hospitalization or \>=2 outpatient visits on separate dates on a healthcare claim indicated 1 or more IC condition or if they had usage of specific immunosuppressive (IS) medications during the 12-month baseline period (prior to index period). Index date was defined as the date of receipt of the 1st BNT162b2 dose.
BNT162b2 (Tozinameran): Non-IC Cohort
n=50 Participants
Participants who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 and without evidence of immunocompromising condition were included in this reporting arm.
Number of Participants Admitted to Intensive Care Unit (ICU) During Hospitalization After SARS-CoV-2 Infection
With ICU admission and no IMV usage
15 Participants
9 Participants
Number of Participants Admitted to Intensive Care Unit (ICU) During Hospitalization After SARS-CoV-2 Infection
With ICU admission and IMV usage
8 Participants
1 Participants

SECONDARY outcome

Timeframe: From 14 days after Dose 2 of BNT162b2 vaccine up to COVID-19 vaccine breakthrough infection case or end of continuous enrollment, whichever occurred first (retrospective data was retrieved and observed during 4 months approximately)

Population: Analysis population included fully vaccinated participants against COVID-19 in dataset during 10-Dec-2020 through 08-Jul-2021, at least 12 years old on index date, had continuous medical enrolment 12-month period prior to index date, with no prior COVID-19 diagnosis during baseline. Fully vaccinated was defined as \>=14 days of follow-up after Dose 2 of BNT162b2 vaccine. Here, N=participant who had at least 1 incidence of SARS-CoV-2 breakthrough infection were evaluable for this outcome measure.

In this outcome measure, number of participants who received IMV with or without ICU admission during hospitalization who were fully vaccination and had SARS-CoV-2 breakthrough infection were analyzed.

Outcome measures

Outcome measures
Measure
BNT162b2 (Tozinameran): IC Cohort
n=74 Participants
Participants with IC condition who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 were retrospectively observed in this cohort. Participants were considered immunocompromised if they had \>=1 hospitalization or \>=2 outpatient visits on separate dates on a healthcare claim indicated 1 or more IC condition or if they had usage of specific immunosuppressive (IS) medications during the 12-month baseline period (prior to index period). Index date was defined as the date of receipt of the 1st BNT162b2 dose.
BNT162b2 (Tozinameran): Non-IC Cohort
n=50 Participants
Participants who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 and without evidence of immunocompromising condition were included in this reporting arm.
Number of Participants Who Received Invasive Mechanical Ventilation (IMV) During Hospitalization After SARS-CoV-2 Infection
With ICU admission and IMV usage
8 Participants
1 Participants
Number of Participants Who Received Invasive Mechanical Ventilation (IMV) During Hospitalization After SARS-CoV-2 Infection
No ICU admission with IMV usage
1 Participants
0 Participants

SECONDARY outcome

Timeframe: From 14 days after Dose 2 of BNT162b2 vaccine up to COVID-19 vaccine breakthrough infection case or end of continuous enrollment, whichever occurred first (retrospective data was retrieved and observed during 4 months approximately)

Population: Analysis population included fully vaccinated participants against COVID-19 in dataset during 10-Dec-2020 through 08-Jul-2021, at least 12 years old on index date, had continuous medical enrolment 12-month period prior to index date, with no prior COVID-19 diagnosis during baseline. Fully vaccinated was defined as \>=14 days of follow-up after Dose 2 of BNT162b2 vaccine. Here, N=participant who had at least 1 incidence of SARS-CoV-2 breakthrough infection were evaluable for this outcome measure.

In this outcome measure, number of participants who died during hospitalization who were fully vaccination and had SARS-CoV-2 breakthrough infection were analyzed.

Outcome measures

Outcome measures
Measure
BNT162b2 (Tozinameran): IC Cohort
n=74 Participants
Participants with IC condition who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 were retrospectively observed in this cohort. Participants were considered immunocompromised if they had \>=1 hospitalization or \>=2 outpatient visits on separate dates on a healthcare claim indicated 1 or more IC condition or if they had usage of specific immunosuppressive (IS) medications during the 12-month baseline period (prior to index period). Index date was defined as the date of receipt of the 1st BNT162b2 dose.
BNT162b2 (Tozinameran): Non-IC Cohort
n=50 Participants
Participants who had at least 1 BNT162b2 vaccine claim between 10 December 2020 to 08 July 2021 and without evidence of immunocompromising condition were included in this reporting arm.
Number of Participants Died During Hospitalization After SARS-CoV-2 Infection
2 Participants
0 Participants

SECONDARY outcome

Timeframe: From Dose 2 of COVID-19 vaccination till the end of study (retrospective data was retrieved and observed during 4 months of this study)

Population: Data was not collected and analyzed for this outcome measure as per Sponsor discretion.

Total duration of stay was total time spend by the participant for different types of hospitalization treatments, applicable for first hospitalization and/or readmissions.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: From Dose 2 of COVID-19 vaccination till the end of study (retrospective data was retrieved and observed during 4 months of this study)

Population: Data was not collected and analyzed for this outcome measure as per Sponsor discretion.

Total expenditure on HCRU was defined as total non-zero costs associated with any of the previously listed outpatient and inpatient encounters.

Outcome measures

Outcome data not reported

Adverse Events

BNT162b2 (Tozinameran): IC Cohort

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

BNT162b2 (Tozinameran): Non-IC Cohort

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Pfizer ClinicalTrials.gov Call Center

Pfizer Inc.

Phone: 1-800-718-1021

Results disclosure agreements

  • Principal investigator is a sponsor employee Pfizer has the right to review disclosures, requesting a delay of less than 60 days. Investigator will postpone single center publications until after disclosure of pooled data (all sites), less than 12 months from study completion/termination at all participating sites. Investigator may not disclose previously undisclosed confidential information other than study results.
  • Publication restrictions are in place

Restriction type: OTHER