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18岁以下儿童中不同类型新冠疫苗的安全性、有效性和免疫原性:系统评价与荟萃分析的更新

Safety, Efficacy, and Immunogenicity of Varying Types of COVID-19 Vaccines in Children Younger Than 18 Years: An Update of Systematic Review and Meta-Analysis.

作者信息

Tian Yan, Chen Long, Shi Yuan

机构信息

Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.

National Clinical Research Center for Child Health and Disorders, Chongqing 400014, China.

出版信息

Vaccines (Basel). 2022 Dec 30;11(1):87. doi: 10.3390/vaccines11010087.

Abstract

Vaccination is one of the most effective measures for children as the epidemic progresses. However, there is a significant research gap in the meta-analysis of the COVID-19 vaccines for children younger than 18 years. This study is a comprehensive review of different COVID-19 vaccines. Published articles were retrieved from PubMed, Embase, and the Cochrane Library. Twelve randomized controlled trials (RCTs) of COVID-19 vaccines were included in the review until 21 October 2022. Most local and systemic adverse reactions were predominantly mild to moderate in severity and disappeared quickly after different types of vaccines. The subunit vaccine had the highest safety. The significant risk was lower in the subunit vaccine group after the initial (RR 1.66, 95% CI 1.26-2.17, = 0.0003) and booster vaccination (RR 1.40, 95% CI 1.02-1.92, = 0.04). Younger children had a more outstanding safety profile in the mRNA and inactivated vaccine groups. The humoral immune response was proportional to the number of doses in the inactivated and the adenovirus vaccine groups, and the strength of immunogenicity was negatively correlated with age in the inactivated vaccine. The mRNA and the subunit vaccines provided satisfactory prevention against COVID-19, especially seven days after the booster dose. However, more research and longer-term follow-up are needed to assess the duration of immune responses, efficacy, and safety.

摘要

随着疫情的发展,接种疫苗是对儿童最有效的措施之一。然而,在对18岁以下儿童的新冠疫苗进行的荟萃分析中,存在显著的研究空白。本研究是对不同新冠疫苗的全面综述。从PubMed、Embase和Cochrane图书馆检索已发表的文章。截至2022年10月21日,该综述纳入了12项新冠疫苗的随机对照试验(RCT)。大多数局部和全身不良反应的严重程度主要为轻至中度,在接种不同类型疫苗后很快消失。亚单位疫苗的安全性最高。在初次接种(RR 1.66,95%CI 1.26 - 2.17,P = 0.0003)和加强接种后(RR 1.40,95%CI 1.02 - 1.92,P = 0.04),亚单位疫苗组的显著风险较低。年龄较小的儿童在mRNA疫苗组和灭活疫苗组中的安全性表现更为突出。在灭活疫苗组和腺病毒疫苗组中,体液免疫反应与接种剂量数成正比,在灭活疫苗中免疫原性强度与年龄呈负相关。mRNA疫苗和亚单位疫苗对新冠病毒提供了令人满意的预防效果,尤其是在加强剂量接种七天后。然而,需要更多的研究和长期随访来评估免疫反应的持续时间、疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a209/9864967/e6b94512bc7a/vaccines-11-00087-g001.jpg

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