This study aims to use vaccination information from state vaccine registries linked withHealthVerity insurance claims for the following: - to measure how effective the Pfizer-BioNTech vaccine is at preventing post-COVID conditions. - to understand characteristics of patients who are receiving COVID-19 vaccines.All patients whose information is kept unidentified in the HealthVerity database areeligible to be included for both aims of this study.
The effectiveness of the COVID-19 vaccine in preventing post-COVID health conditions will
be assessed (Aim 1). To do this, a retrospective cohort time-to-event design will be
employed. Patients will be observed until an endpoint (post-COVID related condition) or a
censoring event (BNT162b2 vaccine, Other COVID-19 vaccinations formulated for 2023-2024
respiratory season, moderate/severe immunocompromised condition, or pregnancy). All
eligible patients are considered unvaccinated (unexposed) at cohort entry. Patients then
continue to contribute person-time to the time-to-event model as the study progresses.
Patient data will be gathered from HealthVerity, including those enrolled in the claims
database, and supplemented with information from the state's deidentified vaccine
registry. Only patients eligible to receive the vaccine during the study period will be
included in the analysis of post-COVID health conditions.
The second part of the study (Aim 2) will use a retrospective cohort design to examine
the uptake of the vaccine in specific groups over time. Subjects will be identified
through three different methods: 1) by analyzing all available dosing records in the
Immunization Registry, 2) by using HealthVerity claims data based on specific calendar
time periods when the vaccine was available, or 3) based on the start of pregnancy that
occurs after EUA date. Patients will be followed until experiencing the vaccination under
study, disenrollment, end of data or death. Vaccinations will be assessed overall and
also by specific type of prior dose (mRNA vs other).
Biological: Pfizer-BioNTech COVID-19 mRNA vaccine
Pfizer-BioNTech COVID-19 Vaccine, is FDA licensed or authorized under Emergency Use
Authorization (EUA) for active immunization to prevent coronavirus disease 2019
(COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in
individuals 6 months of age and older.
Other Name: Pfizer-BioNTech COVID-19 Vaccine
Aim 1:
Inclusion Criteria:
Patients must meet all of the following criteria to be eligible for inclusion in the
study:
1. Patients in HealthVerity database and residing in California or Louisiana as of 25
September 2023 AND
2. Have ≥1 year of pharmacy and medical enrollment in HealthVerity prior to cohort
entry date, allowing for up to a 30-day gap in enrollment AND
3. ≥18 years old as of 11 September 2023 AND
4. Have resided only in their respective state (California or Louisiana) for ≥1 year
prior to 11 September 2023
Exclusion Criteria:
Patients meeting any of the following criteria will not be included in the study:
1. Patients who were pregnant (using any pregnancy code) or immunocompromised from 1
year prior to cohort entry
2. Patients who received any 2023-2024 XBB-adapted formulation of the COVID-19 vaccine
prior to authorization (11 September 2023)
3. Patients who have discrepancies in sex and/or year of birth between HealthVerity
claims and state immunization registry datasets
4. Patients who had a prior diagnosis of COVID-19 ≤180 days preceding cohort entry
Aim 2:
By Age, Bivalent (older children, adults)
Patients must meet all of the following inclusion criteria to be eligible for inclusion
in the study:
1. Has medical and pharmacy enrollment in HealthVerity as of August 31, 2022
2. And is age ≥12 years
3. With 6 months of continuous medical and pharmacy enrollment before calendar index
date
4. And does not have evidence of moderate/severe immunocompromise as defined by CDC
5. And has evidence of ≥2 doses of COVID-19 original vaccine formulation before the
calendar index date
6. And does not have original vaccine formulation within 2 months before calendar index
date
7. And does not have a pregnancy start date within 9 months before or any point after
calendar entry
8. And does not have discrepancies in sex and/or year of birth between HealthVerity
claims and state Immunization registry datasets.
This analysis will be stratified by age: 12-17, 18-49. 50-64, 65-74, 75+, which will be
measured as of August 31, 2022.
By Age, Bivalent (younger children)
Patients must meet all of the following inclusion criteria to be eligible for inclusion
in the study:
1. Has medical and pharmacy enrollment in HealthVerity as of 12 October 2022
2. And is age 5-11 years
3. With 6 months of continuous medical and pharmacy enrollment before calendar index
date
4. And does not have evidence of moderate/severe immunocompromise as defined by CDC
5. And has evidence of ≥2 doses of COVID-19 original vaccine formulation before the
calendar index date
6. And does not have original vaccine formulation within 2 months before calendar index
date.
By Age, Bivalent (youngest children)
Patients must meet all of the following inclusion criteria to be eligible for inclusion
in the study:
1. Has medical and pharmacy enrollment in HealthVerity as of 08 December 2022
2. And is age 6 months-4 years
3. With 6 months of continuous medical and pharmacy enrollment before calendar index
date
4. And does not have evidence of moderate/severe immunocompromise as defined by CDC
5. And has evidence of ≥2 doses of COVID-19 original vaccine formulation before the
calendar index date
6. And does not have original vaccine formulation within 2 months before calendar index
date.
By Disease Status, Bivalent
Patients must meet all of the following inclusion criteria to be eligible for inclusion
in the study:
1. Has medical and pharmacy enrollment in HealthVerity as of 31 August 2022
2. And is age >=6 months
3. And has continuous medical and pharmacy enrollment for 6 months before the calendar
index date
4. And has evidence of 1) moderate/severe immunocompromising condition or separately 2)
COVID high-risk condition in a period before the calendar index period (lookback
times are dependent on the disease and are provided in variable table below)
5. And has evidence of ≥3 doses of COVID-19 original vaccine formulation before the
calendar index date.
For Pregnant Women, Bivalent
Patients must meet all of the following inclusion criteria to be eligible for inclusion
in the study:
1. Has at least 6 months of medical and pharmacy enrollment in HealthVerity as of 31
August 2022
2. And is female sex
3. Aged 12-49
4. And has estimated date of pregnancy start date within 9 months before or any point
after the calendar entry date (determined using gestational age algorithm)
5. And has evidence of ≥2 doses of COVID-19 original vaccine formulation before the
pregnancy start date or 31 August 2022, whichever is latest.
6. And did not receive the bivalent dose prior to pregnancy, if estimated pregnancy
start date is after 31 August 2022
Pfizer
New York, New York, United States
Pfizer CT.gov Call Center, Study Director
Pfizer