The comparative effectiveness study led by Pfizer, Inc. and Genesis Research, Inc. questioned whether the BNT162b2 BA.4/5 bivalent mRNA COVID-19 vaccine (BNT162b2-biv; Pfizer BioNTech) and seasonal influenza vaccine (SIV) have comparable effectiveness when coadministered versus being administered separately. The study involved 3.4 million commercially insured U.S. adults.
The researchers reported that after calibrating with negative control outcomes, coadministration of BNT162b2-biv and SIV were associated with similar effectiveness against COVID-19-related and influenza-related outcomes in the community setting compared with giving each vaccine alone. The results were published by the Journal of the American Medical Association Network Open.
“The data from this study suggest the outcomes observed following coadministration of SIV with COVID-19 boosters may be similar to those seen with separate administration; including this information during autumn or winter vaccination campaigns may improve uptake for both of these underused and potentially life-saving public health interventions,” the study pointed out.
Previous to the comparative effectiveness study, no data comparing the estimated effectiveness of coadministering COVID-19 vaccines with SIV in the community setting existed, according to the authors, who added, “These results add to the growing body of research suggesting that coadministration of COVID-19 and influenza vaccines has a similar safety, immunogenicity, and effectiveness profile in the community setting. These data support coadministration of SIV with COVID-19 boosters during future autumn or winter vaccination campaigns, which may improve uptake for both of these underutilized and potentially life-saving public health interventions.”
The researchers were focused on COVID-19-related and influenza-related hospitalization, emergency department (ED) or urgent care (UC) encounters, and outpatient visits.
Participants—who were 57.0% female with a mean age of 65 years—had either commercial health insurance or Medicare Advantage plans and were vaccinated with BNT162b2-biv only, SIV only, or both on the same day between August 31, 2022, and January 30, 2023. Individuals with monovalent or another brand of mRNA bivalent COVID-19 vaccine were excluded.
Of them, 627,735 individuals had BNT162b2-biv and SIV vaccine coadministered, 369,423 had BNT162b2-biv alone, and 2.4 million had SIV alone. The results indicated that those aged 65 years or older with a mean age of 75 years (the coadministration group) had a similar incidence of COVID-19-related hospitalization (adjusted hazard ratio [AHR], 1.04; 95% CI, 0.87-1.24) and slightly higher incidence of ED or UC encounters (AHR, 1.12; 95% CI, 1.02-1.23) and outpatient visits (AHR, 1.06; 95% CI, 1.01-1.11) compared with the BNT162b2-biv-only group.
For younger participants aged 18 to 64 years, the incidence of COVID-19-related outcomes was slightly higher among those who received both vaccines versus BNT162b2-biv alone (AHR point estimate range, 1.14-1.57); however, fewer events overall in this age group resulted in wider CIs.
“Overall, compared with those who received SIV alone, the coadministration group had a slightly lower incidence of most influenza-related endpoints (AHR point estimates 0.83-0.93 for those aged ≥65 years vs. 0.76-1.08 for those aged 18-64 years),” the study concluded.
“We believe the findings from our study are novel and have important public health implications for future autumn or winter vaccination campaigns,” the authors advised. “While the CDC recommended coadministration of COVID-19 vaccine and SIV in the 2022-2023 season, this was based primarily on safety data from clinical trial and community settings that suggested similar or only marginally higher rates of reactogenicity with coadministration. However, to our knowledge, no data describing the impact of coadministration of COVID-19 vaccines and SIV were available before our study.”
They noted that the new findings “provide contemporary data from routine clinical practice and may help reassure health care professionals that giving these vaccines together is not only safe but likely to yield similar effectiveness against COVID-19- and influenza-related outcomes.”
The researchers pointed out that coadministration of SIV with COVID-19 boosters during future autumn or winter vaccination campaigns might improve uptake for both of these “underutilized and potentially life-saving public health interventions.”
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