美国新冠疫情之前及期间13价肺炎球菌结合疫苗儿科常规接种计划的完成情况与依从性
PCV13 Pediatric Routine Schedule Completion and Adherence Before and During the COVID-19 Pandemic in the United States.
作者信息
Huang Liping, Nguyen Jennifer L, Alfred Tamuno, Perdrizet Johnna, Cane Alejandro, Arguedas Adriano
机构信息
Patient and Health Impact, Pfizer Inc, 235 East 42nd Street, New York City, NY, 10017, USA.
Vaccines Medical Development and Scientific/Clinical Affairs, Pfizer Inc, Collegeville, PA, USA.
出版信息
Infect Dis Ther. 2022 Dec;11(6):2141-2158. doi: 10.1007/s40121-022-00699-5. Epub 2022 Oct 10.
INTRODUCTION
A 13-valent pneumococcal conjugate vaccine (PCV13) was licensed to protect against emerging Streptococcus pneumoniae serotypes. Healthcare services, including routine childhood immunizations, were disrupted as a result of coronavirus disease 2019 (COVID-19). This study compared PCV13 routine vaccination completion and adherence among US infants before and during the COVID-19 pandemic and the relationship between primary and booster dose completion and adherence.
METHODS
Retrospective data from Optum's de-identified Clinformatics Data Mart were used to create three cohorts using data collected between January 2017 and December 2020: cohort 1 (C1), pre-COVID; cohort 2 (C2), cross-COVID; and cohort 3 (C3), during COVID. Study endpoints were completion and adherence to the primary PCV13 series (analyzed using univariate logistic regression) and completion of and adherence to the booster dose (analyzed descriptively).
RESULTS
The analysis included 142,853 infants in C1, 27,211 infants in C2, and 53,306 infants in C3. Among infants with at least 8 months of follow-up from birth, three-primary-dose completion (receipt of all three doses within 8 months after birth) and adherence (receipt of doses at recommended times) were significantly higher before (C1 and C2) versus during (C3) COVID-19 (odds ratio [OR] 1.12 [95% confidence interval [CI] 1.07, 1.16] and OR 1.10 [95% CI 1.05, 1.15], respectively). A significantly higher percentage of infants received a booster dose before versus during COVID-19 (83.2% vs. 80.2%; OR 1.23; 95% CI 1.17, 1.29); similarly, booster dose adherence was higher before than during COVID-19 (51.2% vs. 47.4%; OR 1.17; 95% CI 1.13, 1.21). The odds of booster dose completion were 8.26 (95% CI 7.92, 8.60) and 7.90 (95% CI 7.14, 8.74) times as likely in infants who completed all three primary doses than in infants who did not complete primary doses before COVID-19 and during COVID-19, respectively.
CONCLUSIONS
PCV13 full completion was lower during the COVID-19 pandemic compared with pre-pandemic (79.0% vs. 77.1%).
引言
13价肺炎球菌结合疫苗（PCV13）已获许可用于预防新出现的肺炎链球菌血清型。2019年冠状病毒病（COVID-19）导致包括儿童常规免疫接种在内的医疗服务中断。本研究比较了COVID-19大流行之前和期间美国婴儿PCV13常规疫苗接种的完成情况和依从性，以及基础免疫和加强免疫剂量完成情况与依从性之间的关系。
方法
利用Optum去识别化的临床信息数据集市中的回顾性数据，使用2017年1月至2020年12月期间收集的数据创建三个队列：队列1（C1），COVID-19之前；队列2（C2），跨COVID-19时期；队列3（C3），COVID-19期间。研究终点为基础PCV13系列疫苗接种的完成情况和依从性（采用单因素逻辑回归分析）以及加强免疫剂量的完成情况和依从性（采用描述性分析）。
结果
分析纳入了C1队列中的142,853名婴儿、C2队列中的27,211名婴儿和C3队列中的53,306名婴儿。在出生后至少随访8个月的婴儿中，与COVID-19期间（C3）相比，COVID-19之前（C1和C2）的三剂基础免疫接种完成率（出生后8个月内接种全部三剂）和依从性（在推荐时间接种疫苗）显著更高（优势比[OR]分别为1.12[置信区间[CI]95%：1.07，1.16]和1.10[95%CI：1.05，1.15]）。与COVID-19期间相比，COVID-19之前接受加强免疫剂量的婴儿比例显著更高（83.2%对80.2%；OR 1.23；95%CI 1.17，1.29）；同样，COVID-19之前加强免疫剂量的依从性高于COVID-19期间（51.2%对47.4%；OR 1.17；95%CI 1.13，1.21）。在COVID-19之前和期间，完成全部三剂基础免疫的婴儿完成加强免疫剂量的几率分别是未完成基础免疫婴儿的8.26倍（95%CI 7.92，8.60）和7.90倍（95%CI 7.14，8.74）。
结论
与大流行前相比，COVID-19大流行期间PCV13全程接种率较低（79.0%对77.1%）。
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