Twelve-Month All-Cause Mortality after Initial COVID-19 Vaccination with Pfizer-BioNTech or mRNA-1273 among Adults Living in Florida

Comparative effects of the mRNA COVID-19 vaccines on mortality and other health outcomes are uncertain. Matched cohort analysis of 1,962,822 adults living in Florida who received a first dose of either BNT162b2 (Pfizer) or mRNA-1273 (Moderna) between December 18, 2020, and August 31, 2021, was used to examine 12-month risk of all-cause, cardiovascular, COVID-19, and non-COVID-19 mortality. Matching was performed on seven criteria, including census tract. Compared with mRNA-1273 recipients, BNT162b2 recipients had significantly higher risk for all-cause mortality (783.6 vs. 562.4 deaths per 100,000; odds ratio, OR [95% CI]: 1.407 [1.358, 1.457]), cardiovascular mortality, COVID-19 mortality and non-COVID-19 mortality. Negative control outcomes and robustness analyses did not show any indication of meaningful unobserved residual confounding that is likely to alter the results. The results of this study are consistent with cumulative evidence from prior literature showing worse outcomes in recipients of BNT162b2 compared to mRNA-1273.