mNEXSPIKE associated with lower COVID-19 hospitalisation risk than Comirnaty in older adults

Moderna has reported real-world data showing that mNEXSPIKE was associated with lower rates of medically attended COVID-19 and COVID-19-related hospitalisation than Comirnaty among adults aged 65 and older.

Results from the retrospective comparative effectiveness study were published in JAMA Network Open.

The analysis included 294,499 matched participants enrolled in the U.S. Veterans Health Administration during the 2025 to 2026 respiratory virus season.

The primary outcome was medically attended COVID-19, which included hospitalisations, emergency department visits, urgent care, outpatient visits and antiviral treatment.

Compared with Comirnaty, vaccination with mNEXSPIKE was associated with 35.9% relative vaccine effectiveness against medically attended COVID-19.

The 95% confidence interval ranged from 20.4% to 49.7%.

mNEXSPIKE was also associated with 47.0% relative vaccine effectiveness against COVID-19-associated hospitalisation compared with Comirnaty.

The 95% confidence interval for this outcome ranged from 5.4% to 74.8%.

Point estimates also favoured mNEXSPIKE across the individual components included within the medically attended COVID-19 endpoint.

An exploratory analysis assessed hospitalisations involving major adverse cardiovascular events, including myocardial infarction, stroke or heart failure.

mNEXSPIKE was associated with 39.3% relative vaccine effectiveness against hospitalisation involving these cardiovascular events compared with Comirnaty.

The confidence interval ranged from 11.8% to 57.0%.

Moderna said the exploratory findings may help inform further research into the broader health effects associated with preventing COVID-19 in older adults.

Francesca Ceddia, MD, Chief Medical Affairs Officer at Moderna, said the findings provide additional evidence on the real-world performance of mNEXSPIKE in an older population at increased risk of severe COVID-19.

The study included Veterans aged 65 and older who received an LP.8.1-formulated dose of either mNEXSPIKE or Comirnaty between August 27, 2025 and January 31, 2026.

Participants were followed for up to 150 days or through May 1, 2026.

Patients were matched according to home county and calendar week of vaccination, while inverse probability of treatment weighting was used to further address potential differences between the groups.

The authors noted several limitations associated with the observational design.

Residual confounding could remain because of factors including differences in COVID-19 testing behaviour, undocumented previous infections and vaccine availability.

The Veterans Health Administration population was also predominantly older and male, which may limit the generalisability of the results to other populations.

The findings therefore demonstrate associations and do not establish that mNEXSPIKE directly caused the differences in outcomes.

The study was supported by Moderna, which contributed to its design, interpretation of the findings and preparation and review of the manuscript.

The company did not conduct the study or collect, manage or analyse the underlying data.

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Related Topics and Keywords

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