原始毒株、B.1.1.7毒株以及B.1.351/P.1 新冠病毒谱系对两剂新冠mRNA疫苗有效性的影响：法国一项全国性病例对照研究的结果
Impact of original, B.1.1.7, and B.1.351/P.1 SARS-CoV-2 lineages on vaccine effectiveness of two doses of COVID-19 mRNA vaccines: Results from a nationwide case-control study in France.
作者信息
Charmet Tiffany, Schaeffer Laura, Grant Rebecca, Galmiche Simon, Chény Olivia, Von Platen Cassandre, Maurizot Alexandra, Rogoff Alexandra, Omar Faïza, David Christophe, Septfons Alexandra, Cauchemez Simon, Gaymard Alexandre, Lina Bruno, Lefrancois Louise H, Enouf Vincent, van der Werf Sylvie, Mailles Alexandra, Levy-Bruhl Daniel, Carrat Fabrice, Fontanet Arnaud
机构信息
Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France.
Sorbonne University, Paris, France.
出版信息
Lancet Reg Health Eur. 2021 Sep;8:100171. doi: 10.1016/j.lanepe.2021.100171. Epub 2021 Jul 13.
BACKGROUND
We aimed to assess the effectiveness of two doses of mRNA COVID-19 vaccines against COVID-19 with the original virus and other lineages circulating in France.
METHODS
In this nationwide case-control study, cases were SARS-CoV-2 infected adults with onset of symptoms between 14 February and 3 May 2021. Controls were non-infected adults from a national representative panel matched to cases by age, sex, region, population density and calendar week. Participants completed an online questionnaire on recent activity-related exposures and vaccination history. Information about the infecting virus was based on a screening RT-PCR for either B.1.1.7 or B.1.351/P.1 variants.
FINDINGS
Included in our analysis were 7 288 adults infected with the original SARS-CoV-2 virus, 31 313 with the B.1.1.7 lineage, 2 550 with B.1.351/P1 lineages, and 3 644 controls. In multivariable analysis, the vaccine effectiveness (95% confidence interval) seven days after the second dose of mRNA vaccine was estimated at 88% (81-92), 86% (81-90) and 77% (63-86) against COVID-19 with the original virus, the B.1.1.7 lineage, and the B.1.351/P.1 lineages, respectively. Recent (2 to 6 months) history of virologically confirmed SARS-CoV-2 infection was found to be 83% (76-88), 88% (85-91) and 83% (71-90) protective against COVID-19 with the original virus, the B.1.1.7 lineage, and the B.1.351/P.1 lineages, respectively; and more distant (> 6 months) infections were 76% (54-87), 84% (75-90), and 74% (41-89) protective against COVID-19 with the original virus, the B.1.1.7 lineage, and the B.1.351/P.1 lineages, respectively.
INTERPRETATION
In real-life settings, two doses of mRNA vaccines proved to be effective against COVID-19 with the original virus, B.1.1.7 lineage and B.1.351/P.1 lineages.
FUNDING
Institut Pasteur, Research & Action Emerging Infectious Diseases (REACTing), Fondation de France (Alliance "Tous unis contre le virus").
背景
我们旨在评估两剂mRNA新冠疫苗针对新冠原始病毒及在法国传播的其他谱系毒株预防新冠的有效性。
方法
在这项全国性病例对照研究中，病例为2021年2月14日至5月3日期间出现症状的SARS-CoV-2感染成年人。对照为来自全国代表性样本的未感染成年人，根据年龄、性别、地区、人口密度和日历周与病例匹配。参与者完成了一份关于近期与活动相关暴露和疫苗接种史的在线问卷。关于感染病毒的信息基于针对B.1.1.7或B.1.351/P.1变体的筛查逆转录聚合酶链反应。
研究结果
纳入我们分析的有7288名感染新冠原始病毒的成年人、31313名感染B.1.1.7谱系的成年人、2550名感染B.1.351/P1谱系的成年人以及3644名对照。在多变量分析中，第二剂mRNA疫苗接种七天后的疫苗有效性（95%置信区间）估计分别为：针对新冠原始病毒为88%（81-92），针对B.1.1.7谱系为86%（81-90），针对B.1.351/P.1谱系为77%（63-86）。病毒学确诊的SARS-CoV-2感染近期（2至6个月）病史被发现分别对新冠原始病毒、B.1.1.7谱系和B.1.351/P.1谱系预防新冠的保护率为83%（76-88）、88%（85-91）和83%（71-90）；而更久远（>6个月）的感染分别对新冠原始病毒、B.1.1.7谱系和B.1.351/P.1谱系预防新冠的保护率为76%（54-87）、84%（75-90）和74%（41-89）。
解读
在现实生活环境中，两剂mRNA疫苗被证明对新冠原始病毒、B.1.1.7谱系和B.1.351/P.1谱系预防新冠有效。
资金来源
巴斯德研究所、新兴传染病研究与行动组织（REACTing）、法国基金会（“团结抗疫联盟”）
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