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BNT162b2 疫苗对以色列青少年感染的有效性下降。

Waning Effectiveness of the BNT162b2 Vaccine Against Infection in Adolescents in Israel.

机构信息

Department of Epidemiology of Microbial Diseases and Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, Connecticut, USA.

Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel.

出版信息

Clin Infect Dis. 2023 Jan 6;76(1):113-118. doi: 10.1093/cid/ciac315.


DOI:10.1093/cid/ciac315
PMID:36484301
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10202431/
Abstract

BACKGROUND: The short-term effectiveness of a 2-dose regimen of the BioNTech/Pfizer BNT162b2 vaccine for adolescents has been demonstrated. However, little is known about the long-term effectiveness in this age group. It is known, however, that waning of vaccine-induced immunity against infection in adult populations is evident within a few months. METHODS: Leveraging the database of Maccabi Healthcare Services (MHS), we conducted a matched case-control design for evaluating the association between time since vaccination and the incidence of infections, where 2 outcomes were evaluated: documented SARS-CoV-2 infection (regardless of symptoms) and symptomatic infection (COVID-19). Cases were defined as individuals aged 12-16 with a positive polymerase chain reaction (PCR) test occurring between 15 June and 8 December 2021, when the Delta variant was dominant in Israel. Controls were adolescents who had not tested positive previously. RESULTS: We estimated a peak vaccine effectiveness between 2 weeks and 3 months following receipt of the second dose, with 85% (95% confidence interval [CI]: 84-86%) and 90% (95% CI: 89-91%) effectiveness against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19), respectively. However, in line with findings for adults, waning effectiveness was evident. Long-term protection was reduced to 73% (95% CI: 68-77%) against infection and 79% (95% CI: 73-83%) against COVID-19 3-5 months after the second dose and waned to 53% (95% CI: 46-60%) against infection and 66% (95% CI: 59-72%) against COVID-19 after 5 months. CONCLUSIONS: Although vaccine-induced protection against both infection and COVID-19 continues over time in adolescents, the protection wanes with time since vaccination, starting 3 months after inoculation and continuing for more than 5 months.

摘要

背景:两剂 BioNTech/Pfizer BNT162b2 疫苗对青少年的短期有效性已得到证实。然而,对于该年龄段的长期有效性知之甚少。然而,众所周知,在成人人群中,疫苗诱导的针对感染的免疫力会在几个月内逐渐减弱。

方法:利用 Maccabi 医疗保健服务(MHS)的数据库,我们采用病例对照设计来评估接种疫苗时间与感染发生率之间的关联,评估了 2 种结果:有记录的 SARS-CoV-2 感染(无论症状如何)和有症状感染(COVID-19)。病例定义为 12-16 岁个体,在 2021 年 6 月 15 日至 12 月 8 日期间,当 Delta 变体在以色列占主导地位时,他们的聚合酶链反应(PCR)检测呈阳性。对照组是以前未检测出阳性的青少年。

结果:我们估计在第二剂接种后 2 周到 3 个月内疫苗的有效性达到峰值,对严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染和 2019 年冠状病毒病(COVID-19)的有效性分别为 85%(95%置信区间[CI]:84-86%)和 90%(95%CI:89-91%)。然而,与成人的研究结果一致,有效性逐渐减弱。第二剂接种后 3-5 个月,对感染的长期保护作用降低至 73%(95%CI:68-77%),对 COVID-19 的保护作用降低至 79%(95%CI:73-83%),5 个月后对感染的保护作用降低至 53%(95%CI:46-60%),对 COVID-19 的保护作用降低至 66%(95%CI:59-72%)。

结论:尽管青少年接种疫苗后对感染和 COVID-19 的保护作用会随着时间的推移而持续,但自接种疫苗以来,保护作用会随着时间的推移而减弱,从接种后 3 个月开始,并持续超过 5 个月。

相似文献

[1]
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[2]
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[3]
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[7]
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[2]
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[3]
Biases in COVID-19 vaccine effectiveness studies using cohort design.

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[4]
Low Risk of SARS-CoV-2 Reinfection for Fully or Boosted mRNA Vaccinated Subjects in Sicily: A Population-Based Study Using Real-World Data.

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[5]
SARS-CoV-2 mRNA Vaccine Elicits Sustained T Cell Responses Against the Omicron Variant in Adolescents.

Immune Netw. 2023-8-11

[6]
Evaluation of Waning of SARS-CoV-2 Vaccine-Induced Immunity: A Systematic Review and Meta-analysis.

JAMA Netw Open. 2023-5-1

[7]
Hybrid immunity against reinfection with SARS-CoV-2 following a previous SARS-CoV-2 infection and single dose of the BNT162b2 vaccine in children and adolescents: a target trial emulation.

Lancet Microbe. 2023-7

[8]
Effectiveness of BNT162b2 vaccine against SARS-CoV-2 Delta and Omicron infection in adolescents, Norway, August 2021 to January 2022.

Int J Infect Dis. 2023-5

[9]
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[10]
Enhanced virulence and waning vaccine-elicited antibodies account for breakthrough infections caused by SARS-CoV-2 delta and beyond.

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本文引用的文献

[1]
Covid-19 Vaccine Effectiveness against the Omicron (B.1.1.529) Variant.

N Engl J Med. 2022-4-21

[2]
How Common is Long COVID in Children and Adolescents?

Pediatr Infect Dis J. 2021-12-1

[3]
Odds of Testing Positive for SARS-CoV-2 Following Receipt of 3 vs 2 Doses of the BNT162b2 mRNA Vaccine.

JAMA Intern Med. 2022-2-1

[4]
Deaths in children and young people in England after SARS-CoV-2 infection during the first pandemic year.

Nat Med. 2022-1

[5]
Correlation of SARS-CoV-2-breakthrough infections to time-from-vaccine.

Nat Commun. 2021-11-4

[6]
Viral loads of Delta-variant SARS-CoV-2 breakthrough infections after vaccination and booster with BNT162b2.

Nat Med. 2021-12

[7]
Waning Immunity after the BNT162b2 Vaccine in Israel.

N Engl J Med. 2021-12-9

[8]
Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar.

N Engl J Med. 2021-12-9

[9]
Waning Immune Humoral Response to BNT162b2 Covid-19 Vaccine over 6 Months.

N Engl J Med. 2021-12-9

[10]
Effectiveness of BNT162b2 Vaccine in Adolescents during Outbreak of SARS-CoV-2 Delta Variant Infection, Israel, 2021.

Emerg Infect Dis. 2021-11

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