The SARS-CoV-2 messenger RNA (mRNA) vaccines BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) have each shown more than 90% efficacy in preventing COVID-19 illness¹^,2 but, to our knowledge, humoral immune responses have not been compared directly.

Health care workers at a tertiary care center (Ziekenhuis Oost-Limburg, Belgium) who were scheduled for vaccination with 2 doses of either mRNA-1273 or BNT162b2 were invited to participate in this prospective cohort. Serologic testing was performed prior to vaccination as well as 6 to 10 weeks after the second dose (between April 27 and May 20, 2021). Total immunoglobulin levels to the receptor-binding domain of the SARS-CoV-2 spike protein were measured with an anti–SARS-CoV-2 S enzyme immunoassay (Elecsys, Roche Diagnostics International Ltd). After vaccination, antibodies against the SARS-CoV-2 nucleocapsid protein were determined. Previous infection was defined as anti-nucleocapsid positivity at any point, anti-spike positivity before vaccination, and/or a history of positive polymerase chain reaction results on nasopharyngeal swab.

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Article Information

Corresponding Author: Deborah Steensels, PharmD, PhD, Department of Laboratory Medicine, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium (Deborah.steensels@zol.be).

Accepted for Publication: August 19, 2021.

Published Online: August 30, 2021. doi:10.1001/jama.2021.15125

Author Contributions: Drs Steensels and Heylen had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Steensels, Penders, Mesotten, Heylen.

Acquisition, analysis, or interpretation of data: Steensels, Pierlet, Penders, Heylen.

Drafting of the manuscript: Steensels, Heylen.

Critical revision of the manuscript for important intellectual content: Pierlet, Penders, Mesotten, Heylen.

Statistical analysis: Steensels, Pierlet, Heylen.

Obtained funding: Steensels, Penders, Mesotten.

Administrative, technical, or material support: Steensels, Penders, Mesotten.

Supervision: Steensels, Penders.

Conflict of Interest Disclosures: None reported.

Funding/Support: Roche Diagnostics International Ltd provided test reagents and Interreg Euregio Meuse-Rhine provided financial support (grant EMR-187 CODAP).

Role of the Funder/Sponsor: Funders were not involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

Additional Contributions: We thank Maarten Coemans, MSc, PhD (Leuven Biostatistics Centre, KU Leuven), for his statistical advice. He was not compensated for his contribution.

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