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2、3 和 4 剂 COVID-19 mRNA 疫苗在 SARS-CoV-2 奥密克戎 BA.1 和 BA.2/BA.2.12.1 亚谱系占主导地位期间对免疫功能正常成年人的有效性 - VISION 网络,10 个州,2021 年 12 月至 2022 年 6 月。

Effectiveness of 2, 3, and 4 COVID-19 mRNA Vaccine Doses Among Immunocompetent Adults During Periods when SARS-CoV-2 Omicron BA.1 and BA.2/BA.2.12.1 Sublineages Predominated - VISION Network, 10 States, December 2021-June 2022.

出版信息

MMWR Morb Mortal Wkly Rep. 2022 Jul 22;71(29):931-939. doi: 10.15585/mmwr.mm7129e1.


DOI:10.15585/mmwr.mm7129e1
PMID:35862287
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9310634/
Abstract

The Omicron variant (B.1.1.529) of SARS-CoV-2, the virus that causes COVID-19, was first identified in the United States in November 2021, with the BA.1 sublineage (including BA.1.1) causing the largest surge in COVID-19 cases to date. Omicron sublineages BA.2 and BA.2.12.1 emerged later and by late April 2022, accounted for most cases.* Estimates of COVID-19 vaccine effectiveness (VE) can be reduced by newly emerging variants or sublineages that evade vaccine-induced immunity (1), protection from previous SARS-CoV-2 infection in unvaccinated persons (2), or increasing time since vaccination (3). Real-world data comparing VE during the periods when the BA.1 and BA.2/BA.2.12.1 predominated (BA.1 period and BA.2/BA.2.12.1 period, respectively) are limited. The VISION network examined 214,487 emergency department/urgent care (ED/UC) visits and 58,782 hospitalizations with a COVID-19-like illness diagnosis among 10 states during December 18, 2021-June 10, 2022, to evaluate VE of 2, 3, and 4 doses of mRNA COVID-19 vaccines (BNT162b2 [Pfizer-BioNTech] or mRNA-1273 [Moderna]) compared with no vaccination among adults without immunocompromising conditions. VE against COVID-19-associated hospitalization 7-119 days and ≥120 days after receipt of dose 3 was 92% (95% CI = 91%-93%) and 85% (95% CI = 81%-89%), respectively, during the BA.1 period, compared with 69% (95% CI = 58%-76%) and 52% (95% CI = 44%-59%), respectively, during the BA.2/BA.2.12.1 period. Patterns were similar for ED/UC encounters. Among adults aged ≥50 years, VE against COVID-19-associated hospitalization ≥120 days after receipt of dose 3 was 55% (95% CI = 46%-62%) and ≥7 days (median = 27 days) after a fourth dose was 80% (95% CI = 71%-85%) during BA.2/BA.2.12.1 predominance. Immunocompetent persons should receive recommended COVID-19 booster doses to prevent moderate to severe COVID-19, including a first booster dose for all eligible persons and second booster dose for adults aged ≥50 years at least 4 months after an initial booster dose. Booster doses should be obtained immediately when persons become eligible..

摘要

新冠病毒(SARS-CoV-2)的奥密克戎变异株(B.1.1.529)于 2021 年 11 月在美国首次被发现,其 BA.1 亚谱系(包括 BA.1.1)导致了迄今为止最大的 COVID-19 病例激增。奥密克戎亚谱系 BA.2 和 BA.2.12.1 随后出现,截至 2022 年 4 月底,占大多数病例。新出现的变异株或亚谱系会降低 COVID-19 疫苗有效性(VE)的估计值,这些变异株或亚谱系逃避了疫苗诱导的免疫(1)、未接种疫苗者既往 SARS-CoV-2 感染的保护作用(2)或疫苗接种后时间的延长(3)。在 BA.1 和 BA.2/BA.2.12.1 占主导地位的时期(BA.1 期和 BA.2/BA.2.12.1 期)比较 VE 的真实世界数据有限。VISION 网络在 2021 年 12 月 18 日至 2022 年 6 月 10 日期间,对 10 个州的 214487 例急诊/紧急护理(ED/UC)就诊和 58782 例 COVID-19 样疾病住院病例进行了检查,以评估 2、3 和 4 剂 mRNA COVID-19 疫苗(BNT162b2[辉瑞-生物技术]或 mRNA-1273[莫德纳])与无免疫功能低下状况的成年人未接种疫苗相比的 VE。在 BA.1 期,接受第 3 剂后 7-119 天和≥120 天,与 BA.2/BA.2.12.1 期相比,COVID-19 相关住院的 VE 分别为 92%(95%CI=91%-93%)和 85%(95%CI=81%-89%);在 BA.1 期,ED/UC 就诊的模式类似。在≥50 岁的成年人中,接受第 3 剂后≥120 天 COVID-19 相关住院的 VE 为 55%(95%CI=46%-62%),接受第 4 剂后≥7 天(中位数=27 天)的 VE 为 80%(95%CI=71%-85%)。在 BA.2/BA.2.12.1 占主导地位期间。免疫功能正常的人应接种推荐的 COVID-19 加强针,以预防中度至重度 COVID-19,包括所有符合条件的人接种第一针加强针,以及至少在初始加强针接种后 4 个月为≥50 岁的成年人接种第二针加强针。当符合条件时,应立即接种加强针。

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本文引用的文献

[1]
Neutralization Escape by SARS-CoV-2 Omicron Subvariants BA.2.12.1, BA.4, and BA.5.

N Engl J Med. 2022-7-7

[2]
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Nat Commun. 2022-6-2

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COVID-19 vaccine effectiveness against the omicron (BA.2) variant in England.

Lancet Infect Dis. 2022-7

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MMWR Morb Mortal Wkly Rep. 2022-4-29

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MMWR Morb Mortal Wkly Rep. 2022-4-1

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Lancet. 2022-3-5

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Protection against the Omicron Variant from Previous SARS-CoV-2 Infection.

N Engl J Med. 2022-3-31

[8]
Effectiveness of a Third Dose of mRNA Vaccines Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance - VISION Network, 10 States, August 2021-January 2022.

MMWR Morb Mortal Wkly Rep. 2022-1-21

[9]
Effectiveness of Covid-19 Vaccines in Ambulatory and Inpatient Care Settings.

N Engl J Med. 2021-10-7

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