McLaughlin John M, Khan Farid, Pugh Sarah, Swerdlow David L, Jodar Luis
Pfizer Vaccines, 500 Arcola Rd., Collegeville, PA, USA.
Lancet Reg Health Am. 2022 May;9:100191. doi: 10.1016/j.lana.2022.100191. Epub 2022 Jan 31.
On Dec 14, 2020, the United States initiated a nationwide COVID-19 vaccination campaign. Demonstrating clear population-level impact following vaccine introduction helps to further elucidate and quantify the public-health benefits of vaccination.
Using a negative binomial regression model we evaluated the ecological association between county-level COVID-19 vaccine uptake and rates of COVID-19 cases and deaths in the United States from April 1, 2021 through October 31, 2021 controlling for a broad set of county-level environmental, sociodemographic, economic, and health-status-related characteristics. County-level data were obtained from several publicly available databases that were merged for analysis.
After adjustment for county-level characteristics, US counties with ≥ 80% of their residents ≥ 12 years of age fully vaccinated against COVID-19 had 30% (95% CI: 25-35; < .001) and 46% (38-52; < .001) lower rates of COVID-19 cases and deaths, respectively, versus those with <50% coverage (reference group). A dose response was observed: counties with 70-79% uptake had 20% (95% CI: 16-24; < .001) and 35% (29-40; < .001) lower rates of cases and deaths, respectively; counties with 60-69% uptake had 8% (5-11; < .001) and 20% (15-24; < .001) lower rates; and counties with 50-59% uptake had 2% (0-4; =.09) and 8% (4-12; < .001) lower rates. Restricting the analysis to the period when the Delta variant was predominant (June 1, 2021 ‒ October 31, 2021) showed similar findings.
Our results showed that US counties with higher proportions of persons ≥ 12 years of age fully vaccinated against COVID-19 had substantially lower rates of COVID-19 cases and deaths-a finding that showed dose response and persisted even in the period when Delta was predominant.
Pfizer.
2020年12月14日，美国启动了全国性的新冠病毒疫苗接种运动。证明疫苗引入后在人群层面产生的明确影响，有助于进一步阐明和量化疫苗接种对公共卫生的益处。
我们使用负二项回归模型，评估了2021年4月1日至2021年10月31日期间美国县级新冠病毒疫苗接种率与新冠病毒病例及死亡发生率之间的生态关联，并控制了一系列广泛的县级环境、社会人口、经济和健康状况相关特征。县级数据来自几个公开可用的数据库，这些数据库被合并用于分析。
在对县级特征进行调整后，12岁及以上居民中新冠病毒疫苗全程接种率≥80%的美国县，与接种率<50%的县（参照组）相比，新冠病毒病例发生率和死亡率分别降低了30%（95%置信区间：25-35；P<0.001）和46%（38-52；P<0.001）。观察到剂量反应：接种率为70-79%的县，病例发生率和死亡率分别降低了20%（95%置信区间：16-24；P<0.001）和35%（29-40；P<0.001）；接种率为60-69%的县，病例发生率和死亡率分别降低了8%（5-11；P<0.001）和20%（15-24；P<0.001）；接种率为50-59%的县，病例发生率和死亡率分别降低了2%（0-4；P=0.09）和8%（4-12；P<0.001）。将分析限制在德尔塔变异株占主导的时期（2021年6月1日至2021年10月31日），结果相似。
我们的结果表明，12岁及以上人群中新冠病毒疫苗全程接种比例较高的美国县，新冠病毒病例发生率和死亡率大幅降低——这一发现显示出剂量反应，并且即使在德尔塔变异株占主导的时期也依然存在。
辉瑞公司。
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