BNT162b2 疫苗对 5 至 11 岁儿童中奥密克戎的有效性。
Effectiveness of BNT162b2 Vaccine against Omicron in Children 5 to 11 Years of Age.
机构信息
From the Saw Swee Hock School of Public Health (S.H.X.T., A.R.C., D.H., K.B.T.) and the Yong Loo Lin School of Medicine (D.C.L.), National University of Singapore, the Ministry of Health (D.H., B.O., K.B.T.), the National Centre for Infectious Diseases (D.C.L.), Tan Tock Seng Hospital (D.C.L.), the Lee Kong Chian School of Medicine, Nanyang Technological University (D.C.L.), and the Centre of Regulatory Excellence, Duke-National University of Singapore Medical School (K.B.T.) - all in Singapore.
出版信息
N Engl J Med. 2022 Aug 11;387(6):525-532. doi: 10.1056/NEJMoa2203209. Epub 2022 Jul 20.
BACKGROUND
Since it was first identified in early November 2021, the B.1.1.529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread quickly and replaced the B.1.617.2 (delta) variant as the dominant variant in many countries. Data on the real-world effectiveness of vaccines against the omicron variant in children are lacking.
METHODS
In a study conducted from January 21, 2022, through April 8, 2022, when the omicron variant was spreading rapidly, we analyzed data on children in Singapore who were 5 to 11 years of age. We assessed the incidences of all reported SARS-CoV-2 infections (confirmed on polymerase-chain-reaction [PCR] assay, rapid antigen testing, or both), SARS-CoV-2 infections confirmed on PCR assay, and coronavirus disease 2019 (Covid-19)-related hospitalizations among unvaccinated, partially vaccinated (≥1 day after the first dose of vaccine and up to 6 days after the second dose), and fully vaccinated children (≥7 days after the second dose). Poisson regression was used to estimate vaccine effectiveness from the incidence rate ratio of outcomes.
RESULTS
A total of 255,936 children were included in the analysis. Among unvaccinated children, the crude incidence rates of all reported SARS-CoV-2 infections, PCR-confirmed SARS-CoV-2 infections, and Covid-19-related hospitalizations were 3303.5, 473.8, and 30.0 per 1 million person-days, respectively. Among partially vaccinated children, vaccine effectiveness was 13.6% (95% confidence interval [CI], 11.7 to 15.5) against all SARS-CoV-2 infections, 24.3% (95% CI, 19.5 to 28.9) against PCR-confirmed SARS-CoV-2 infection, and 42.3% (95% CI, 24.9 to 55.7) against Covid-19-related hospitalization; in fully vaccinated children, vaccine effectiveness was 36.8% (95% CI, 35.3 to 38.2), 65.3% (95% CI, 62.0 to 68.3), and 82.7% (95% CI, 74.8 to 88.2), respectively.
CONCLUSIONS
During a period when the omicron variant was predominant, BNT162b2 vaccination reduced the risks of SARS-CoV-2 infection and Covid-19-related hospitalization among children 5 to 11 years of age.
背景
自 2021 年 11 月初首次发现以来，严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）的 B.1.1.529（奥密克戎）变体迅速传播，并取代了 B.1.617.2（德尔塔）变体，成为许多国家的主要变体。关于疫苗对儿童奥密克戎变体的实际效果的数据尚缺乏。
方法
在 2022 年 1 月 21 日至 2022 年 4 月 8 日期间进行的一项研究中，奥密克戎变体迅速传播时，我们分析了新加坡 5 至 11 岁儿童的数据。我们评估了未接种疫苗、部分接种疫苗（第一剂疫苗接种后≥1 天且第二剂疫苗接种后≤6 天）和完全接种疫苗（第二剂疫苗接种后≥7 天）儿童的所有报告的 SARS-CoV-2 感染（聚合酶链反应 [PCR] 检测、快速抗原检测或两者均阳性确诊）、PCR 检测确诊的 SARS-CoV-2 感染和与 2019 年冠状病毒病（COVID-19）相关的住院治疗的发生率。泊松回归用于从发生率比估计疫苗效果。
结果
共纳入 255936 名儿童进行分析。未接种疫苗的儿童中，所有报告的 SARS-CoV-2 感染、PCR 确诊的 SARS-CoV-2 感染和 COVID-19 相关住院的粗发生率分别为 3303.5、473.8 和 30.0/100000 人天。部分接种疫苗的儿童中，疫苗对所有 SARS-CoV-2 感染的有效性为 13.6%（95%置信区间[CI]，11.7 至 15.5），对 PCR 确诊的 SARS-CoV-2 感染的有效性为 24.3%（95% CI，19.5 至 28.9），对 COVID-19 相关住院的有效性为 42.3%（95% CI，24.9 至 55.7）；完全接种疫苗的儿童中，疫苗的有效性分别为 36.8%（95% CI，35.3 至 38.2）、65.3%（95% CI，62.0 至 68.3）和 82.7%（95% CI，74.8 至 88.2）。
结论
在奥密克戎变体占主导地位的时期，BNT162b2 疫苗降低了 5 至 11 岁儿童感染 SARS-CoV-2 和 COVID-19 相关住院的风险。
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