School of Health Management, Xihua University, Chengdu, China.
Faculty of Geosciences and Environmental Engineering, Southwest Jiaotong University, Chengdu, China.
Front Immunol. 2023 Mar 3;14:1113156. doi: 10.3389/fimmu.2023.1113156. eCollection 2023.
In the coronavirus disease 2019 (COVID-19) pandemic, vaccinations were essential in preventing COVID-19 infections and related mortality in older adults. The objectives of this study were to evaluate the effectiveness and safety of the COVID-19 vaccines in older adults. We systematically searched the electronic bibliographic databases of PubMed, Web of Science, Embase, Cochrane Library, ClinicalTrials.gov, Research Square, and OpenGrey, as well as other sources of gray literature, for studies published between January 1, 2020, and October 1, 2022. We retrieved 22 randomized controlled trials (RCTs), with a total of 3,404,696 older adults (aged over 60 years) participating, that were included in the meta-analysis. No significant publication bias was found. In the cumulative meta-analysis, we found that the COVID-19 vaccines were effective in preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (OR = 0.38, 95% CI = 0.23-0.65, = 0.0004) and in reducing the number of COVID-19-related deaths (OR = 0.16, 95% CI = 0.10-0.25, < 0.00001) in elderly people. Antibody seroconversion (AS) and geometric mean titer (GMT) levels significantly increased in vaccinated older adults [OR = 24.42, 95% CI = 19.29-30.92; standardized mean difference (SMD) = 0.92, 95% CI = 0.64-1.20, respectively]. However, local and systemic adverse events after COVID-19 vaccine administration were found in older adults (OR = 2.57, 95% CI = 1.83-3.62, < 0.00001). Although vaccination might induce certain adverse reactions in the elderly population, the available evidence showed that the COVID-19 vaccines are effective and tolerated, as shown by the decrease in COVID-19-related deaths in older adults. It needs to be made abundantly clear to elderly people that the advantages of vaccination far outweigh any potential risks. Therefore, COVID-19 vaccination should be considered as the recommended strategy for the control of this disease by preventing SARS-CoV-2 infection and related deaths in older adults. More RCTs are needed to increase the certainty of the evidence and to verify our conclusions.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022319698, identifier CRD42022319698.
在 2019 年冠状病毒病（COVID-19）大流行期间，接种疫苗对于预防老年人 COVID-19 感染和相关死亡至关重要。本研究旨在评估 COVID-19 疫苗在老年人中的有效性和安全性。
我们系统地检索了 PubMed、Web of Science、Embase、Cochrane 图书馆、ClinicalTrials.gov、Research Square 和 OpenGrey 以及其他灰色文献来源，以获取 2020 年 1 月 1 日至 2022 年 10 月 1 日期间发表的研究。我们纳入了总计 3404696 名老年人（年龄≥60 岁）的 22 项随机对照试验（RCT）进行荟萃分析。
我们未发现显著的发表偏倚。在累积荟萃分析中，我们发现 COVID-19 疫苗可有效预防严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染（OR=0.38，95%CI=0.23-0.65，=0.0004），并降低老年人 COVID-19 相关死亡人数（OR=0.16，95%CI=0.10-0.25，<0.00001）。接种疫苗的老年人的抗体血清转化率（AS）和几何平均滴度（GMT）水平显著升高[OR=24.42，95%CI=19.29-30.92；标准化均数差值（SMD）=0.92，95%CI=0.64-1.20，分别]。然而，我们在老年人中发现 COVID-19 疫苗接种后会出现局部和全身不良事件（OR=2.57，95%CI=1.83-3.62，<0.00001）。
尽管疫苗接种可能会在老年人群中引起某些不良反应，但现有证据表明 COVID-19 疫苗是有效且耐受的，因为它降低了老年人的 COVID-19 相关死亡人数。需要向老年人明确说明，接种疫苗的好处远远超过任何潜在风险。因此，COVID-19 疫苗接种应被视为预防 SARS-CoV-2 感染和相关死亡的推荐策略，以控制老年人中的这种疾病。需要更多的 RCT 来提高证据的确定性并验证我们的结论。
