A target trial emulation study found that in an elderly population of U.S. veterans with high comorbidity burden, mRNA vaccine efficacy at preventing infection with COVID-19 was substantially lower than previously reported but effectiveness against death was very high. These finding suggest that complementary infection mitigation efforts remain important for pandemic control, even with vaccination. The study is published in Annals of Internal Medicine.

The real-world effectiveness of the Moderna or Pfizer-BioNTech COVID-19 mRNA vaccines in ethnically and racially diverse populations across the entire United States is not well characterized, especially in more vulnerable populations, such as elderly persons with high comorbidity burden. The U.S. Department of Veterans Affairs (VA) health care system is the largest national, comprehensive health care system in the United States. As such, it offers the opportunity to evaluate vaccines in this population.

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