Impact of original, B.1.1.7, and B.1.351/P.1 SARS-CoV-2 lineages on vaccine effectiveness of two doses of COVID-19 mRNA vaccines: Results from a nationwide case-control study in France

Tiffany Charmet; Laura Schaeffer; Rebecca Grant; Simon Galmiche; Olivia Chény; Cassandre Von Platen; Alexandra Maurizot; Alexandra Rogoff; Faïza Omar; Christophe David; Alexandra Septfons; Simon Cauchemez; Alexandre Gaymard; Bruno Lina; Louise H Lefrancois; Vincent Enouf; Sylvie van der Werf; Alexandra Mailles; Daniel Levy-Bruhl; Fabrice Carrat; Arnaud Fontanet

doi:10.1016/j.lanepe.2021.100171

Impact of original, B.1.1.7, and B.1.351/P.1 SARS-CoV-2 lineages on vaccine effectiveness of two doses of COVID-19 mRNA vaccines: Results from a nationwide case-control study in France

Lancet Reg Health Eur. 2021 Sep:8:100171. doi: 10.1016/j.lanepe.2021.100171. Epub 2021 Jul 13.

Authors

Tiffany Charmet¹, Laura Schaeffer¹, Rebecca Grant^{1

2}, Simon Galmiche¹, Olivia Chény³, Cassandre Von Platen³, Alexandra Maurizot⁴, Alexandra Rogoff⁴, Faïza Omar⁵, Christophe David⁵, Alexandra Septfons⁶, Simon Cauchemez⁷, Alexandre Gaymard^{8

9}, Bruno Lina^{8

9}, Louise H Lefrancois^{10

11}, Vincent Enouf^{10

11

12}, Sylvie van der Werf^{10

11}, Alexandra Mailles⁶, Daniel Levy-Bruhl⁶, Fabrice Carrat¹³, Arnaud Fontanet^{1

14}

Affiliations

¹ Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France.
² Sorbonne University, Paris, France.
³ Institut Pasteur, Centre for Translational Research, Paris, France.
⁴ Caisse Nationale d'Assurance Maladie, Paris, France.
⁵ Institut IPSOS, Paris, France.
⁶ Santé Publique France, Saint-Maurice, France.
⁷ Institut Pasteur, Mathematical Modelling of Infectious Diseases Unit; UMR2000; CNRS, Paris, France.
⁸ CNR des Virus des Infections Respiratoires, Institut des Agents Infectieux, Hospices Civils de Lyon.
⁹ Virpath, Centre International de Recherche En Infectiologie, Université de Lyon, Inserm U1111, CNRS UMR5308, École Normale Supérieure de Lyon, UCBL, Lyon, France.
¹⁰ Molecular Genetics of RNA Viruses, Department of Virology, Institut Pasteur CNRS UMR 3569; Université de Paris, Paris, France.
¹¹ National Reference Center for Respiratory Viruses, Institut Pasteur, Paris, France.
¹² Mutualized Platform of Microbiology, Pasteur International Bioresources Network, Institut Pasteur, Paris, France.
¹³ Sorbonne Université, Inserm, IPLESP, hôpital Saint-Antoine, APHP, 27 rue Chaligny, Paris F75571, France.
¹⁴ Conservatoire national des arts et métiers, Unité PACRI, Paris, France.

Abstract

Background: We aimed to assess the effectiveness of two doses of mRNA COVID-19 vaccines against COVID-19 with the original virus and other lineages circulating in France.

Methods: In this nationwide case-control study, cases were SARS-CoV-2 infected adults with onset of symptoms between 14 February and 3 May 2021. Controls were non-infected adults from a national representative panel matched to cases by age, sex, region, population density and calendar week. Participants completed an online questionnaire on recent activity-related exposures and vaccination history. Information about the infecting virus was based on a screening RT-PCR for either B.1.1.7 or B.1.351/P.1 variants.

Findings: Included in our analysis were 7 288 adults infected with the original SARS-CoV-2 virus, 31 313 with the B.1.1.7 lineage, 2 550 with B.1.351/P1 lineages, and 3 644 controls. In multivariable analysis, the vaccine effectiveness (95% confidence interval) seven days after the second dose of mRNA vaccine was estimated at 88% (81-92), 86% (81-90) and 77% (63-86) against COVID-19 with the original virus, the B.1.1.7 lineage, and the B.1.351/P.1 lineages, respectively. Recent (2 to 6 months) history of virologically confirmed SARS-CoV-2 infection was found to be 83% (76-88), 88% (85-91) and 83% (71-90) protective against COVID-19 with the original virus, the B.1.1.7 lineage, and the B.1.351/P.1 lineages, respectively; and more distant (> 6 months) infections were 76% (54-87), 84% (75-90), and 74% (41-89) protective against COVID-19 with the original virus, the B.1.1.7 lineage, and the B.1.351/P.1 lineages, respectively.

Interpretation: In real-life settings, two doses of mRNA vaccines proved to be effective against COVID-19 with the original virus, B.1.1.7 lineage and B.1.351/P.1 lineages.

Funding: Institut Pasteur, Research & Action Emerging Infectious Diseases (REACTing), Fondation de France (Alliance "Tous unis contre le virus").

Keywords: COVID-19; SARS-CoV-2 variants; Vaccine effectiveness; case-control study; epidemiology.