卡塔尔儿童和青少年中的新冠疫苗保护作用。

Covid-19 Vaccine Protection among Children and Adolescents in Qatar.

机构信息

From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.).

出版信息

N Engl J Med. 2022 Nov 17;387(20):1865-1876. doi: 10.1056/NEJMoa2210058. Epub 2022 Nov 2.

DOI:10.1056/NEJMoa2210058

PMID:36322837

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9644642/

Abstract

BACKGROUND

The BNT162b2 vaccine against coronavirus disease 2019 (Covid-19) has been authorized for use in children 5 to 11 years of age and adolescents 12 to 17 years of age but in different antigen doses.

METHODS

We assessed the real-world effectiveness of the BNT162b2 vaccine against infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children and adolescents in Qatar. To compare the incidence of SARS-CoV-2 infection in the national cohort of vaccinated participants with the incidence in the national cohort of unvaccinated participants, we conducted three matched, retrospective, target-trial, cohort studies - one assessing data obtained from children 5 to 11 years of age after the B.1.1.529 (omicron) variant became prevalent and two assessing data from adolescents 12 to 17 years of age before the emergence of the omicron variant (pre-omicron study) and after the omicron variant became prevalent. Associations were estimated with the use of Cox proportional-hazards regression models.

RESULTS

Among children, the overall effectiveness of the 10-μg primary vaccine series against infection with the omicron variant was 25.7% (95% confidence interval [CI], 10.0 to 38.6). Effectiveness was highest (49.6%; 95% CI, 28.5 to 64.5) right after receipt of the second dose but waned rapidly thereafter and was negligible after 3 months. Effectiveness was 46.3% (95% CI, 21.5 to 63.3) among children 5 to 7 years of age and 16.6% (95% CI, -4.2 to 33.2) among those 8 to 11 years of age. Among adolescents, the overall effectiveness of the 30-μg primary vaccine series against infection with the omicron variant was 30.6% (95% CI, 26.9 to 34.1), but many adolescents had been vaccinated months earlier. Effectiveness waned over time since receipt of the second dose. Effectiveness was 35.6% (95% CI, 31.2 to 39.6) among adolescents 12 to 14 years of age and 20.9% (95% CI, 13.8 to 27.4) among those 15 to 17 years of age. In the pre-omicron study, the overall effectiveness of the 30-μg primary vaccine series against SARS-CoV-2 infection among adolescents was 87.6% (95% CI, 84.0 to 90.4) and waned relatively slowly after receipt of the second dose.

CONCLUSIONS

Vaccination in children was associated with modest, rapidly waning protection against omicron infection. Vaccination in adolescents was associated with stronger, more durable protection, perhaps because of the larger antigen dose. (Funded by Weill Cornell Medicine-Qatar and others.).

摘要

背景

针对 2019 年冠状病毒病（COVID-19）的 BNT162b2 疫苗已获准用于 5 至 11 岁儿童和 12 至 17 岁青少年，但使用的抗原剂量不同。

方法

我们评估了 BNT162b2 疫苗在卡塔尔儿童和青少年中针对严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）感染的真实世界有效性。为了比较接种参与者的全国队列中 SARS-CoV-2 感染的发生率与未接种参与者的全国队列中的发生率，我们进行了三项匹配的回顾性目标试验队列研究-一项评估 B.1.1.529（奥密克戎）变体流行后 5 至 11 岁儿童的数据，两项评估奥密克戎变体出现前和流行后 12 至 17 岁青少年的数据（奥密克戎前研究）。使用 Cox 比例风险回归模型估计关联。

结果

在儿童中，10-μg 初级疫苗系列对奥密克戎变体感染的总体有效性为 25.7%（95%置信区间[CI]，10.0 至 38.6）。在第二剂接种后立即获得的效果最高（49.6%；95%CI，28.5 至 64.5），但此后迅速减弱，3 个月后效果可忽略不计。5 至 7 岁儿童的有效性为 46.3%（95%CI，21.5 至 63.3），8 至 11 岁儿童的有效性为 16.6%（95%CI，-4.2 至 33.2）。在青少年中，30-μg 初级疫苗系列对奥密克戎变体感染的总体有效性为 30.6%（95%CI，26.9 至 34.1），但许多青少年在数月前已接种疫苗。自第二剂接种以来，有效性随时间逐渐减弱。12 至 14 岁青少年的有效性为 35.6%（95%CI，31.2 至 39.6），15 至 17 岁青少年的有效性为 20.9%（95%CI，13.8 至 27.4）。在奥密克戎前研究中，30-μg 初级疫苗系列对青少年 SARS-CoV-2 感染的总体有效性为 87.6%（95%CI，84.0 至 90.4），并且在第二剂接种后相对缓慢减弱。