2021 年 12 月至 2022 年 1 月奥密克戎疫情期间，纽约市医护人员接种 mRNA 加强疫苗的效果。
Effectiveness of MRNA booster vaccine among healthcare workers in New York City during the Omicron surge, December 2021 to January 2022.
机构信息
Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA.
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
出版信息
Clin Microbiol Infect. 2022 Dec;28(12):1624-1628. doi: 10.1016/j.cmi.2022.07.017. Epub 2022 Aug 3.
OBJECTIVE
To describe effectiveness of mRNA vaccines by comparing 2-dose (2D) and 3-dose (3D) healthcare worker (HCW) recipients in the setting of Omicron variant dominance. Performance of 2D and 3D vaccine series against SARS-CoV-2 variants and the clinical outcomes of HCWs may inform return-to-work guidance.
METHODS
In a retrospective study from December 15, 2020 to January 15, 2022, SARS-CoV-2 infections among HCWs at a large tertiary cancer centre in New York City were examined to estimate infection rates (aggregated positive tests / person-days) and 95% CIs over the Omicron period in 3D and 2D mRNA vaccinated HCWs and were compared using rate ratios. We described the clinical features of post-vaccine infections and impact of prior (pre-Omicron) COVID infection on vaccine effectiveness.
RESULTS
Among the 20857 HCWs in our cohort, 20,660 completed the 2D series with an mRNA vaccine during our study period and 12461 had received a third dose by January 15, 2022. The infection rate ratio for 3D versus 2D vaccinated HCWs was 0.667 (95% CI 0.623, 0.713) for an estimated 3D vaccine effectiveness of 33.3% compared to two doses only during the Omicron dominant period from December 15, 2021 to January 15, 2022. Breakthrough Omicron infections after 3D + 14 days occurred in 1,315 HCWs. Omicron infections were mild, with 16% of 3D and 11% 2D HCWs being asymptomatic.
DISCUSSION
Study demonstrates improved vaccine-derived protection against COVID-19 infection in 3D versus 2D mRNA vaccinees during the Omicron surge. The advantage of 3D vaccination was maintained irrespective of prior COVID-19 infection status.
目的
在奥密克戎变异株占主导地位的情况下，比较 2 剂（2D）和 3 剂（3D）医护人员（HCW）接种者，描述 mRNA 疫苗的有效性。2D 和 3D 疫苗系列对 SARS-CoV-2 变异株的保护性能以及 HCW 的临床结局，可为返工指导提供信息。
方法
在 2020 年 12 月 15 日至 2022 年 1 月 15 日期间，对纽约市一家大型癌症中心的 HCW 进行了 SARS-CoV-2 感染的回顾性研究，以估算奥密克戎期间 3D 和 2D mRNA 接种 HCW 的感染率（聚集阳性检测/人天）和 95%CI，并使用率比值进行比较。我们描述了疫苗接种后感染的临床特征以及先前（奥密克戎之前）COVID 感染对疫苗有效性的影响。
结果
在我们的队列中，有 20857 名 HCW，其中 20660 名完成了 2D 系列的 mRNA 疫苗接种，截至 2022 年 1 月 15 日，有 12461 名 HCW 接种了第三剂。3D 与 2D 接种 HCW 的感染率比值为 0.667（95%CI 0.623，0.713），在奥密克戎主导时期（2021 年 12 月 15 日至 2022 年 1 月 15 日），与仅接种两剂相比，3D 疫苗的有效性估计为 33.3%。在 3D+14 天后，有 1315 名 HCW 发生突破性奥密克戎感染。奥密克戎感染较轻，3D 组中有 16%的 HCW 和 2D 组中有 11%的 HCW 无症状。
讨论
本研究表明，在奥密克戎激增期间，3D mRNA 疫苗接种者与 2D 相比，对 COVID-19 感染的疫苗保护作用有所提高。3D 疫苗接种的优势在既往 COVID-19 感染状态下均得到维持。
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