Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA.
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
J Infect Dis. 2022 Jun 1;225(11):1915-1922. doi: 10.1093/infdis/jiab633.
Some vaccines elicit nonspecific immune responses that may protect against heterologous infections. We evaluated the association between recombinant adjuvanted zoster vaccine (RZV) and coronavirus disease 2019 (COVID-19) outcomes at Kaiser Permanente Southern California.
In a cohort design, adults aged ≥50 years who received ≥1 RZV dose before 1 March 2020 were matched 1:2 to unvaccinated individuals and followed until 31 December 2020. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for COVID-19 outcomes were estimated using Cox proportional hazards regression. In a test-negative design, cases had a positive severe acute respiratory syndrome coronavirus 2 test and controls had only negative tests, during 1 March-31 December 2020. Adjusted odds ratios (aORs) and 95% CIs for RZV receipt were estimated using logistic regression.
In the cohort design, 149 244 RZV recipients were matched to 298 488 unvaccinated individuals. The aHRs for COVID-19 diagnosis and hospitalization were 0.84 (95% CI, .81-.87) and 0.68 (95% CI, .64-.74), respectively. In the test-negative design, 8.4% of 75 726 test-positive cases and 13.1% of 340 898 test-negative controls had received ≥1 RZV dose (aOR, 0.84 [95% CI, .81-.86]).
RZV vaccination was associated with a 16% lower risk of COVID-19 diagnosis and 32% lower risk of hospitalization. Further study of vaccine-induced nonspecific immunity for potential attenuation of future pandemics is warranted.
一些疫苗会引发非特异性免疫反应，可能对异源感染起到保护作用。我们在 Kaiser Permanente Southern California 评估了重组佐剂带状疱疹疫苗（RZV）与 2019 年冠状病毒病（COVID-19）结局之间的关联。
采用队列设计，2020 年 3 月 1 日前≥50 岁且至少接受过 1 剂 RZV 的成年人与未接种疫苗的个体按 1:2 匹配，并随访至 2020 年 12 月 31 日。采用 Cox 比例风险回归估计 COVID-19 结局的调整后危害比（aHR）和 95%置信区间（CI）。在阴性检测设计中，2020 年 3 月 1 日至 12 月 31 日期间，病例的严重急性呼吸综合征冠状病毒 2 检测呈阳性，对照组仅检测呈阴性。采用 logistic 回归估计 RZV 接种的调整后比值比（aOR）和 95%CI。
在队列设计中，149244 名 RZV 接种者与 298488 名未接种者相匹配。COVID-19 诊断和住院的 aHR 分别为 0.84（95%CI，0.81-0.87）和 0.68（95%CI，0.64-0.74）。在阴性检测设计中，75726 例阳性病例中有 8.4%，340898 例阴性对照中有 13.1%接种了≥1 剂 RZV（aOR，0.84 [95%CI，0.81-0.86]）。
RZV 接种与 COVID-19 诊断风险降低 16%和住院风险降低 32%相关。需要进一步研究疫苗诱导的非特异性免疫，以评估其对未来大流行的潜在抑制作用。
