Coronavirus Disease (COVID-19) Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
Coronavirus Disease (COVID-19) Response, Centers for Disease Control and Prevention, Atlanta, GA, USA.
BMJ. 2022 Apr 27;377:e069317. doi: 10.1136/bmj-2021-069317.
To evaluate the impact of vaccine scale-up on population level covid-19 mortality and incidence in the United States.
Observational study.
US county level case surveillance and vaccine administration data reported from 14 December 2020 to 18 December 2021.
Residents of 2558 counties from 48 US states.
The primary outcome was county covid-19 mortality rates (deaths/100 000 population/county week). The secondary outcome was incidence of covid-19 (cases/100 000 population/county week). Incidence rate ratios were used to compare rates across vaccination coverage levels. The impact of a 10% improvement in county vaccination coverage (defined as at least one dose of a covid-19 vaccine among adults ≥18 years of age) was estimated During the eras of alpha and delta variant predominance, the impact of very low (0-9%), low (10-39%), medium (40-69%), and high (≥70%) vaccination coverage levels was compared.
In total, 30 643 878 cases of covid-19 and 439 682 deaths associated with covid-19 occurred over 132 791 county weeks. A 10% improvement in vaccination coverage was associated with an 8% (95% confidence interval 8% to 9%) reduction in mortality rates and a 7% (6% to 8%) reduction in incidence. Higher vaccination coverage levels were associated with reduced mortality and incidence rates during the eras of alpha and delta variant predominance.
Higher vaccination coverage was associated with lower rates of population level covid-19 mortality and incidence in the US.
评估疫苗接种规模扩大对美国人群 COVID-19 死亡率和发病率的影响。
观察性研究。
2020 年 12 月 14 日至 2021 年 12 月 18 日期间，美国县一级病例监测和疫苗接种数据报告。
来自美国 48 个州的 2558 个县的居民。
主要结局指标为县 COVID-19 死亡率（每 10 万人/县周死亡人数）。次要结局指标为 COVID-19 发病率（每 10 万人/县周病例数）。采用发病率比值比较不同疫苗接种覆盖率水平的发病率。估计了县疫苗接种覆盖率提高 10%（定义为≥18 岁成年人至少接种一剂 COVID-19 疫苗）的影响。在阿尔法和德尔塔变异体占主导地位的时期，比较了极低（0-9%）、低（10-39%）、中（40-69%）和高（≥70%）疫苗接种覆盖率水平的影响。
总共发生了 30643878 例 COVID-19 病例和 439682 例与 COVID-19 相关的死亡病例，涉及 132791 个县周。疫苗接种覆盖率提高 10%与死亡率降低 8%（95%置信区间 8%-9%）和发病率降低 7%（6%-8%）相关。在阿尔法和德尔塔变异体占主导地位的时期，较高的疫苗接种覆盖率与死亡率和发病率的降低相关。
较高的疫苗接种覆盖率与美国人群 COVID-19 死亡率和发病率的降低相关。
