BNT162b2 antigen dose and SARS-CoV-2 omicron infection in adolescents

Abstract

COVID-19 vaccine antigen dose might affect protection against SARS-CoV-2 infection,1, 2 but direct evidence to quantify this effect is absent. We conducted a matched, retrospective, cohort study using a regression discontinuity design3 to emulate a randomised controlled trial in Qatar between Feb 3, 2022, and Nov 8, 2022, to provide a head-to-head, controlled comparison of protection induced by two different antigen doses of the BNT162b2 (Pfizer–BioNTech) vaccine (appendix pp 4–10). The study compared incidence of infection with the omicron (B.1.1.529) variant in the national cohort of adolescents aged 12 years who received the two-dose 30 μg BNT162b2 primary series with that in the national cohort of adolescents aged 11 years who received the two-dose pediatric 10 μg BNT162b2 primary series.