Safety, Immunogenicity, and Efficacy of the BNT162b2 Covid-19 Vaccine in Adolescents
- PMID: 34043894
- PMCID: PMC8174030
- DOI: 10.1056/NEJMoa2107456
Safety, Immunogenicity, and Efficacy of the BNT162b2 Covid-19 Vaccine in Adolescents
Abstract
Background: Until very recently, vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had not been authorized for emergency use in persons younger than 16 years of age. Safe, effective vaccines are needed to protect this population, facilitate in-person learning and socialization, and contribute to herd immunity.
Methods: In this ongoing multinational, placebo-controlled, observer-blinded trial, we randomly assigned participants in a 1:1 ratio to receive two injections, 21 days apart, of 30 μg of BNT162b2 or placebo. Noninferiority of the immune response to BNT162b2 in 12-to-15-year-old participants as compared with that in 16-to-25-year-old participants was an immunogenicity objective. Safety (reactogenicity and adverse events) and efficacy against confirmed coronavirus disease 2019 (Covid-19; onset, ≥7 days after dose 2) in the 12-to-15-year-old cohort were assessed.
Results: Overall, 2260 adolescents 12 to 15 years of age received injections; 1131 received BNT162b2, and 1129 received placebo. As has been found in other age groups, BNT162b2 had a favorable safety and side-effect profile, with mainly transient mild-to-moderate reactogenicity (predominantly injection-site pain [in 79 to 86% of participants], fatigue [in 60 to 66%], and headache [in 55 to 65%]); there were no vaccine-related serious adverse events and few overall severe adverse events. The geometric mean ratio of SARS-CoV-2 50% neutralizing titers after dose 2 in 12-to-15-year-old participants relative to 16-to-25-year-old participants was 1.76 (95% confidence interval [CI], 1.47 to 2.10), which met the noninferiority criterion of a lower boundary of the two-sided 95% confidence interval greater than 0.67 and indicated a greater response in the 12-to-15-year-old cohort. Among participants without evidence of previous SARS-CoV-2 infection, no Covid-19 cases with an onset of 7 or more days after dose 2 were noted among BNT162b2 recipients, and 16 cases occurred among placebo recipients. The observed vaccine efficacy was 100% (95% CI, 75.3 to 100).
Conclusions: The BNT162b2 vaccine in 12-to-15-year-old recipients had a favorable safety profile, produced a greater immune response than in young adults, and was highly effective against Covid-19. (Funded by BioNTech and Pfizer; C4591001 ClinicalTrials.gov number, NCT04368728.).
Copyright © 2021 Massachusetts Medical Society.
Figures
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Comment in
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BNT162b2 Covid-19 Vaccine in Adolescents.N Engl J Med. 2021 Sep 30;385(14):1342-1343. doi: 10.1056/NEJMc2113394. Epub 2021 Sep 15. N Engl J Med. 2021. PMID: 34525283 No abstract available.
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BNT162b2 Covid-19 Vaccine in Adolescents. Reply.N Engl J Med. 2021 Sep 30;385(14):1343. doi: 10.1056/NEJMc2113394. Epub 2021 Sep 15. N Engl J Med. 2021. PMID: 34525284 No abstract available.
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The role of media messaging in COVID-19 vaccine hesitancy amongst the student population: Friend or foe.Pediatr Pulmonol. 2021 Dec;56(12):4066-4068. doi: 10.1002/ppul.25686. Epub 2021 Oct 1. Pediatr Pulmonol. 2021. PMID: 34597474 Free PMC article. No abstract available.
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References
-
- World Health Organization. Coronavirus disease (COVID-19) dashboard. 2021. (https://covid19.who.int/). - PubMed
-
- Pfizer Manufacturing Belgium NV. Pfizer-BioNTech COVID-19 vaccine: fact sheet for healthcare providers administering vaccine (vaccination providers). 2021. (http://labeling.pfizer.com/ShowLabeling.aspx?id=14471).
-
- Sahin U, Muik A, Vogler I, et al. BNT162b2 induces SARS-CoV-2-neutralising antibodies and T cells in humans. December 11, 2020. (https://www.medrxiv.org/content/10.1101/2020.12.09.20245175v1). preprint.
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