CDC COVID-19 Response Team, Atlanta, Georgia, USA.
Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Clin Infect Dis. 2022 May 3;74(9):1515-1524. doi: 10.1093/cid/ciab687.
As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination coverage increases in the United States, there is a need to understand the real-world effectiveness against severe coronavirus disease 2019 (COVID-19) and among people at increased risk for poor outcomes.
In a multicenter case-control analysis of US adults hospitalized March 11-May 5, 2021, we evaluated vaccine effectiveness to prevent COVID-19 hospitalizations by comparing odds of prior vaccination with a messenger RNA (mRNA) vaccine (Pfizer-BioNTech or Moderna) between cases hospitalized with COVID-19 and hospital-based controls who tested negative for SARS-CoV-2.
Among 1212 participants, including 593 cases and 619 controls, median age was 58 years, 22.8% were Black, 13.9% were Hispanic, and 21.0% had immunosuppression. SARS-CoV-2 lineage B0.1.1.7 (Alpha) was the most common variant (67.9% of viruses with lineage determined). Full vaccination (receipt of 2 vaccine doses ≥14 days before illness onset) had been received by 8.2% of cases and 36.4% of controls. Overall vaccine effectiveness was 87.1% (95% confidence interval [CI], 80.7-91.3). Vaccine effectiveness was similar for Pfizer-BioNTech and Moderna vaccines, and highest in adults aged 18-49 years (97.4%; 95% CI, 79.3-9.7). Among 45 patients with vaccine-breakthrough COVID hospitalizations, 44 (97.8%) were ≥50 years old and 20 (44.4%) had immunosuppression. Vaccine effectiveness was lower among patients with immunosuppression (62.9%; 95% CI,20.8-82.6) than without immunosuppression (91.3%; 95% CI, 85.6-94.8).
During March-May 2021, SARS-CoV-2 mRNA vaccines were highly effective for preventing COVID-19 hospitalizations among US adults. SARS-CoV-2 vaccination was beneficial for patients with immunosuppression, but effectiveness was lower in the immunosuppressed population.
随着严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）在美国的疫苗接种覆盖率不断提高，有必要了解其在预防严重 2019 年冠状病毒病（COVID-19）方面的真实世界效果，以及在预后不良风险较高人群中的效果。
在对 2021 年 3 月 11 日至 5 月 5 日期间美国住院成人的多中心病例对照分析中，我们通过比较 COVID-19 住院病例与在医院进行 SARS-CoV-2 检测呈阴性的基于医院的对照者在接种信使 RNA（mRNA）疫苗（辉瑞-生物技术公司或 Moderna）之前的概率，评估了预防 COVID-19 住院的疫苗有效性。
在 1212 名参与者中，包括 593 例病例和 619 例对照者，中位年龄为 58 岁，22.8%为黑人，13.9%为西班牙裔，21.0%存在免疫抑制。SARS-CoV-2 谱系 B0.1.1.7（Alpha）是最常见的变体（67.9%的病毒具有谱系确定）。8.2%的病例和 36.4%的对照者已完全接种疫苗（在发病前至少 14 天接种了 2 剂疫苗）。总体疫苗有效性为 87.1%（95%置信区间[CI]，80.7-91.3）。辉瑞-生物技术公司和 Moderna 疫苗的疫苗有效性相似，在 18-49 岁成人中最高（97.4%；95%CI，79.3-9.7）。在 45 例疫苗突破性 COVID 住院患者中，44 例（97.8%）年龄≥50 岁，20 例（44.4%）存在免疫抑制。免疫抑制患者的疫苗有效性较低（62.9%；95%CI，20.8-82.6），而非免疫抑制患者的疫苗有效性较高（91.3%；95%CI，85.6-94.8）。
在 2021 年 3 月至 5 月期间，SARS-CoV-2 mRNA 疫苗对预防美国成年人 COVID-19 住院非常有效。SARS-CoV-2 疫苗对免疫抑制患者有益，但在免疫抑制人群中的有效性较低。
