MMWR Morb Mortal Wkly Rep. 2022 Jan 28;71(4):118-124. doi: 10.15585/mmwr.mm7104a2.
COVID-19 mRNA vaccines (BNT162b2 [Pfizer-BioNTech] and mRNA-1273 [Moderna]) provide protection against infection with SARS-CoV-2, the virus that causes COVID-19, and are highly effective against COVID-19-associated hospitalization among eligible persons who receive 2 doses (1,2). However, vaccine effectiveness (VE) among persons with immunocompromising conditions* is lower than that among immunocompetent persons (2), and VE declines after several months among all persons (3). On August 12, 2021, the Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for a third mRNA vaccine dose as part of a primary series ≥28 days after dose 2 for persons aged ≥12 years with immunocompromising conditions, and, on November 19, 2021, as a booster dose for all adults aged ≥18 years at least 6 months after dose 2, changed to ≥5 months after dose 2 on January 3, 2022 (4,5,6). Among 2,952 adults (including 1,385 COVID-19 case-patients and 1,567 COVID-19-negative controls) hospitalized at 21 U.S. hospitals during August 19-December 15, 2021, effectiveness of mRNA vaccines against COVID-19-associated hospitalization was compared between adults eligible for but who had not received a third vaccine dose (1,251) and vaccine-eligible adults who received a third dose ≥7 days before illness onset (312). Among 1,875 adults without immunocompromising conditions (including 1,065 [57%] unvaccinated, 679 [36%] 2-dose recipients, and 131 [7%] 3-dose [booster] recipients), VE against COVID-19 hospitalization was higher among those who received a booster dose (97%; 95% CI = 95%-99%) compared with that among 2-dose recipients (82%; 95% CI = 77%-86%) (p <0.001). Among 1,077 adults with immunocompromising conditions (including 324 [30%] unvaccinated, 572 [53%] 2-dose recipients, and 181 [17%] 3-dose recipients), VE was higher among those who received a third dose to complete a primary series (88%; 95% CI = 81%-93%) compared with 2-dose recipients (69%; 95% CI = 57%-78%) (p <0.001). Administration of a third COVID-19 mRNA vaccine dose as part of a primary series among immunocompromised adults, or as a booster dose among immunocompetent adults, provides improved protection against COVID-19-associated hospitalization.
COVID-19 mRNA 疫苗（BNT162b2[辉瑞-生物科技]和 mRNA-1273[莫德纳]）可预防感染 SARS-CoV-2，该病毒是导致 COVID-19 的病原体，对于符合条件的接种两剂疫苗的人群，该疫苗对 COVID-19 相关住院具有高度有效性（1,2）。然而，在具有免疫功能低下条件*的人群中，疫苗有效性（VE）低于免疫功能正常的人群（2），并且所有人群的 VE 在几个月后都会下降（3）。2021 年 8 月 12 日，美国食品和药物管理局（FDA）发布了一项紧急使用授权（EUA），允许为免疫功能低下的 12 岁及以上人群在第二剂后至少 28 天内接种第三剂 mRNA 疫苗，以及在 2021 年 11 月 19 日，为所有 18 岁及以上成年人接种第三剂作为加强针，至少在第二剂后 6 个月，在 2022 年 1 月 3 日更改为第二剂后至少 5 个月（4,5,6）。在 2021 年 8 月 19 日至 12 月 15 日期间，在美国 21 家医院住院的 2952 名成年人（包括 1385 名 COVID-19 病例患者和 1567 名 COVID-19 阴性对照者）中，比较了 mRNA 疫苗对 COVID-19 相关住院的有效性在符合条件但尚未接种第三剂疫苗的成年人（1251 人）和在发病前至少 7 天接种第三剂疫苗的疫苗合格成年人（312 人）之间。在 1875 名无免疫功能低下的成年人中（包括 1065 名[57%]未接种疫苗者、679 名[36%]接种两剂疫苗者和 131 名[7%]接种三剂[加强针]疫苗者），接种加强针的成年人对 COVID-19 住院的 VE 高于接种两剂疫苗的成年人（97%；95%CI=95%-99%）（p<0.001）。在 1077 名具有免疫功能低下条件的成年人中（包括 324 名[30%]未接种疫苗者、572 名[53%]接种两剂疫苗者和 181 名[17%]接种三剂疫苗者），接种第三剂疫苗以完成基础免疫系列的成年人的 VE 高于接种两剂疫苗的成年人（88%；95%CI=81%-93%）（p<0.001）。在免疫功能低下的成年人中，将第三剂 COVID-19 mRNA 疫苗作为基础免疫系列的一部分，或在免疫功能正常的成年人中作为加强针，可提供对 COVID-19 相关住院的更好保护。
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