Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Vaccine. 2022 Aug 12;40(34):5044-5049. doi: 10.1016/j.vaccine.2022.06.011. Epub 2022 Jun 8.
Real-world vaccine effectiveness (VE) estimates are essential to identify potential groups at higher risk of break-through infections and to guide policy. We assessed the VE of COVID-19 vaccination against COVID-19 hospitalization, while adjusting and stratifying for patient characteristics.
We performed a test-negative case-control study in six Dutch hospitals. The study population consisted of adults eligible for COVID-19 vaccination hospitalized between May 1 and June 28, 2021 with respiratory symptoms. Cases were defined as patients who tested positive for SARS-CoV-2 by PCR during the first 48 h of admission or within 14 days prior to hospital admission. Controls were patients tested negative at admission and did not have a positive test during the 2 weeks prior to hospitalization. VE was calculated using multivariable logistic regression, adjusting for calendar week, sex, age, comorbidity and nursing home residency. Subgroup analysis was performed for age, sex and different comorbidities. Secondary endpoints were ICU-admission and mortality.
379 cases and 255 controls were included of whom 157 (18%) were vaccinated prior to admission. Five cases (1%) and 40 controls (16%) were fully vaccinated (VE: 93%; 95% CI: 81 - 98), and 40 cases (11%) and 70 controls (27%) were partially vaccinated (VE: 70%; 95% CI: 50-82). A strongly protective effect of vaccination was found in all comorbidity subgroups. No ICU-admission or mortality were reported among fully vaccinated cases. Of unvaccinated cases, mortality was 10% and 19% was admitted at the ICU.
COVID-19 vaccination provides a strong protective effect against COVID-19 related hospital admission, in patients with and without comorbidity.
真实世界的疫苗有效性（VE）估计对于确定潜在的突破性感染高风险人群以及指导政策至关重要。我们评估了 COVID-19 疫苗接种对 COVID-19 住院的有效性，同时调整和分层了患者特征。
我们在荷兰的六家医院进行了一项病例对照研究。研究人群包括 2021 年 5 月 1 日至 6 月 28 日期间因呼吸道症状住院且有资格接种 COVID-19 疫苗的成年人。病例定义为在入院的前 48 小时内或入院前 14 天内通过 PCR 检测到 SARS-CoV-2 阳性的患者。对照组为入院时检测结果为阴性且在入院前 2 周内未进行阳性检测的患者。使用多变量逻辑回归计算 VE，调整日历周、性别、年龄、合并症和疗养院居住情况。进行了年龄、性别和不同合并症的亚组分析。次要终点为 ICU 入院和死亡率。
共纳入 379 例病例和 255 例对照，其中 157 例（18%）在入院前接种了疫苗。5 例（1%）和 40 例（16%）为完全接种疫苗（VE：93%；95%CI：81-98），40 例（11%）和 70 例（27%）为部分接种疫苗（VE：70%；95%CI：50-82）。在所有合并症亚组中，疫苗接种均具有很强的保护作用。完全接种疫苗的病例无一例 ICU 入院或死亡。未接种疫苗的病例中，死亡率为 10%，19%的患者入住 ICU。
COVID-19 疫苗接种为有合并症和无合并症的患者提供了针对 COVID-19 相关住院的强大保护作用。
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