US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia.
Public Health Service Commissioned Corps, Rockville, Maryland.
JAMA Intern Med. 2022 Oct 1;182(10):1071-1081. doi: 10.1001/jamainternmed.2022.4299.
Understanding risk factors for hospitalization in vaccinated persons and the association of COVID-19 vaccines with hospitalization rates is critical for public health efforts to control COVID-19.
To determine characteristics of COVID-19-associated hospitalizations among vaccinated persons and comparative hospitalization rates in unvaccinated and vaccinated persons.
DESIGN, SETTING, AND PARTICIPANTS: From January 1, 2021, to April 30, 2022, patients 18 years or older with laboratory-confirmed SARS-CoV-2 infection were identified from more than 250 hospitals in the population-based COVID-19-Associated Hospitalization Surveillance Network. State immunization information system data were linked to cases, and the vaccination coverage data of the defined catchment population were used to compare hospitalization rates in unvaccinated and vaccinated individuals. Vaccinated and unvaccinated patient characteristics were compared in a representative sample with detailed medical record review; unweighted case counts and weighted percentages were calculated.
Laboratory-confirmed COVID-19-associated hospitalization, defined as a positive SARS-CoV-2 test result within 14 days before or during hospitalization.
COVID-19-associated hospitalization rates among vaccinated vs unvaccinated persons and factors associated with COVID-19-associated hospitalization in vaccinated persons were assessed.
Using representative data from 192 509 hospitalizations (see Table 1 for demographic information), monthly COVID-19-associated hospitalization rates ranged from 3.5 times to 17.7 times higher in unvaccinated persons than vaccinated persons regardless of booster dose status. From January to April 2022, when the Omicron variant was predominant, hospitalization rates were 10.5 times higher in unvaccinated persons and 2.5 times higher in vaccinated persons with no booster dose, respectively, compared with those who had received a booster dose. Among sampled cases, vaccinated hospitalized patients with COVID-19 were older than those who were unvaccinated (median [IQR] age, 70 [58-80] years vs 58 [46-70] years, respectively; P < .001) and more likely to have 3 or more underlying medical conditions (1926 [77.8%] vs 4124 [51.6%], respectively; P < .001).
In this cross-sectional study of US adults hospitalized with COVID-19, unvaccinated adults were more likely to be hospitalized compared with vaccinated adults; hospitalization rates were lowest in those who had received a booster dose. Hospitalized vaccinated persons were older and more likely to have 3 or more underlying medical conditions and be long-term care facility residents compared with hospitalized unvaccinated persons. The study results suggest that clinicians and public health practitioners should continue to promote vaccination with all recommended doses for eligible persons.
了解接种者住院的风险因素以及 COVID-19 疫苗与住院率的关联，对于控制 COVID-19 的公共卫生工作至关重要。
确定接种者中与 COVID-19 相关的住院的特征，以及未接种者和接种者的住院率比较。
设计、地点和参与者：从 2021 年 1 月 1 日至 2022 年 4 月 30 日，从 250 多家医院的基于人群的 COVID-19 相关住院监测网络中确定了 18 岁或以上有实验室确诊的 SARS-CoV-2 感染的患者。将州免疫信息系统数据与病例联系起来，并使用定义的集水区人群的疫苗接种覆盖率数据比较未接种者和接种者的住院率。对具有详细病历回顾的代表性样本比较了接种者和未接种者的患者特征；计算了未加权病例数和加权百分比。
实验室确诊的 COVID-19 相关住院，定义为住院前 14 天或住院期间 SARS-CoV-2 检测结果阳性。
评估了接种者和未接种者的 COVID-19 相关住院率以及接种者中与 COVID-19 相关住院相关的因素。
使用来自 192509 例住院患者的代表性数据（表 1 中为人口统计学信息），无论加强剂量状态如何，未接种者的每月 COVID-19 相关住院率是接种者的 3.5 至 17.7 倍。2022 年 1 月至 4 月，当 Omicron 变体占主导地位时，未接种者的住院率分别比接种者高 10.5 倍和未接种者高 2.5 倍，未接种者没有接受加强剂量。在抽样病例中，接种 COVID-19 的住院患者比未接种者年龄更大（中位数[IQR]年龄，70[58-80]岁比 58[46-70]岁，分别；P<0.001），并且更有可能有 3 种或更多基础疾病（分别为 1926[77.8%]和 4124[51.6%]；P<0.001）。
在这项针对美国 COVID-19 住院成年人的横断面研究中，与接种者相比，未接种者更有可能住院；接种加强剂量者的住院率最低。与未接种的住院患者相比，接种疫苗的住院患者年龄更大，并且更有可能有 3 种或更多基础疾病，并且是长期护理机构的居民。研究结果表明，临床医生和公共卫生工作者应继续为符合条件的人推广所有推荐剂量的疫苗接种。
