Comparative effectiveness of alternative intervals between first and second doses of the mRNA COVID-19 vaccines

Kayoko Shioda (), Alexander Breskin, Pravara Harati, Allison T. Chamberlain, Toshiaki Komura, Benjamin A. Lopman and Elizabeth T. Rogawski McQuade
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Kayoko Shioda: Boston University
Alexander Breskin: Regeneron Pharmaceuticals
Pravara Harati: Georgia Department of Public Health
Allison T. Chamberlain: Emory University
Toshiaki Komura: Boston University
Benjamin A. Lopman: Emory University
Elizabeth T. Rogawski McQuade: Emory University

Nature Communications, 2024, vol. 15, issue 1, 1-9

Abstract: Abstract The optimal interval between the first and second doses of COVID-19 mRNA vaccines has not been thoroughly evaluated. Employing a target trial emulation approach, we compared the effectiveness of different interdose intervals among >6 million mRNA vaccine recipients in Georgia, USA, from December 2020 to March 2022. We compared three protocols defined by interdose interval: recommended by the Food and Drug Administration (FDA) (17-25 days for Pfizer-BioNTech; 24-32 days for Moderna), late-but-allowable (26-42 days for Pfizer-BioNTech; 33-49 days for Moderna), and late ( ≥ 43 days for Pfizer-BioNTech; ≥50 days for Moderna). In the short-term, the risk of SARS-CoV-2 infection was lowest under the FDA-recommended protocol. Longer-term, the late-but-allowable protocol resulted in the lowest risk (risk ratio on Day 120 after the first dose administration compared to the FDA-recommended protocol: 0.83 [95% confidence interval: 0.82-0.84]). Here, we showed that delaying the second dose by 1-2 weeks may provide stronger long-term protection.

Date: 2024
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DOI: 10.1038/s41467-024-45334-8

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