Clalit Research Institute, Innovation Division, Clalit Health Services, Tel Aviv, Israel.
Predictive Medicine Group, Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA.
Nat Commun. 2022 Apr 22;13(1):2202. doi: 10.1038/s41467-022-29858-5.
With the COVID-19 pandemic ongoing, accurate assessment of population immunity and the effectiveness of booster and enhancer vaccine doses is critical. We compare COVID-19-related hospitalization incidence rates in 2,412,755 individuals across four exposure levels: non-recent vaccine immunity (two BNT162b2 COVID-19 vaccine doses five or more months prior), boosted vaccine immunity (three BNT162b2 doses), infection-induced immunity (previous COVID-19 without a subsequent BNT162b2 dose), and enhanced infection-induced immunity (previous COVID-19 with a subsequent BNT162b2 dose). Rates, adjusted for potential demographic, clinical and health-seeking-behavior confounders, were assessed from July-November 2021 when the Delta variant was predominant. Compared with non-recent vaccine immunity, COVID-19-related hospitalization incidence rates were reduced by 89% (87-91%) for boosted vaccine immunity, 66% (50-77%) for infection-induced immunity and 75% (61-83%) for enhanced infection-induced immunity. We demonstrate that infection-induced immunity (enhanced or not) provides more protection against COVID-19-related hospitalization than non-recent vaccine immunity, but less protection than booster vaccination. Additionally, our results suggest that vaccinating individuals with infection-induced immunity further enhances their protection.
随着 COVID-19 大流行的持续，准确评估人群免疫力以及加强针和增效疫苗剂量的效果至关重要。我们比较了在四个暴露水平下，2412755 名个体的 COVID-19 相关住院发病率：非近期疫苗免疫（两剂 BNT162b2 COVID-19 疫苗接种五个月或以上）、加强疫苗免疫（三剂 BNT162b2）、感染诱导免疫（既往 COVID-19 无后续 BNT162b2 剂量）和增强感染诱导免疫（既往 COVID-19 伴随后续 BNT162b2 剂量）。从 2021 年 7 月至 11 月，德尔塔变异株占主导地位时，根据潜在的人口统计学、临床和寻求医疗行为混杂因素进行了调整，评估了这些发病率。与非近期疫苗免疫相比，加强疫苗免疫使 COVID-19 相关住院发病率降低了 89%（87-91%），感染诱导免疫降低了 66%（50-77%），增强感染诱导免疫降低了 75%（61-83%）。我们证明，感染诱导免疫（增强或未增强）对 COVID-19 相关住院的保护作用优于非近期疫苗免疫，但不如加强接种。此外，我们的结果表明，为具有感染诱导免疫的个体接种疫苗可进一步增强其保护作用。
