2022 年 9 月至 2023 年 4 月，在有和无免疫功能低下情况的成年人中，二价 mRNA 疫苗预防 COVID-19 相关住院和重症的持久性估计 - VISION 网络。
Estimates of Bivalent mRNA Vaccine Durability in Preventing COVID-19-Associated Hospitalization and Critical Illness Among Adults with and Without Immunocompromising Conditions - VISION Network, September 2022-April 2023.
出版信息
MMWR Morb Mortal Wkly Rep. 2023 May 26;72(21):579-588. doi: 10.15585/mmwr.mm7221a3.
On September 1, 2022, CDC's Advisory Committee on Immunization Practices (ACIP) recommended a single bivalent mRNA COVID-19 booster dose for persons aged ≥12 years who had completed at least a monovalent primary series. Early vaccine effectiveness (VE) estimates among adults aged ≥18 years showed receipt of a bivalent booster dose provided additional protection against COVID-19-associated emergency department and urgent care visits and hospitalizations compared with that in persons who had received only monovalent vaccine doses (1); however, insufficient time had elapsed since bivalent vaccine authorization to assess the durability of this protection. The VISION Network* assessed VE against COVID-19-associated hospitalizations by time since bivalent vaccine receipt during September 13, 2022-April 21, 2023, among adults aged ≥18 years with and without immunocompromising conditions. During the first 7-59 days after vaccination, compared with no vaccination, VE for receipt of a bivalent vaccine dose among adults aged ≥18 years was 62% (95% CI = 57%-67%) among adults without immunocompromising conditions and 28% (95% CI = 10%-42%) among adults with immunocompromising conditions. Among adults without immunocompromising conditions, VE declined to 24% (95% CI = 12%-33%) among those aged ≥18 years by 120-179 days after vaccination. VE was generally lower for adults with immunocompromising conditions. A bivalent booster dose provided the highest protection, and protection was sustained through at least 179 days against critical outcomes, including intensive care unit (ICU) admission or in-hospital death. These data support updated recommendations allowing additional optional bivalent COVID-19 vaccine doses for certain high-risk populations. All eligible persons should stay up to date with recommended COVID-19 vaccines.
2022 年 9 月 1 日，疾病预防控制中心免疫实践咨询委员会（ACIP）建议，至少完成了一剂单价基础疫苗接种的 12 岁及以上人群接种一剂 bivalent mRNA COVID-19 加强针。针对 18 岁及以上成年人的早期疫苗有效性（VE）估计表明，与仅接种单价疫苗的人群相比，接种 bivalent 加强针可提供针对 COVID-19 相关急诊和紧急护理就诊以及住院的额外保护（1）；然而，自 bivalent 疫苗获得授权以来，时间不足，无法评估这种保护的持久性。VISION 网络*评估了自 2022 年 9 月 13 日至 2023 年 4 月 21 日期间，18 岁及以上人群在 bivalent 疫苗接种后不同时间点因 COVID-19 相关住院的 VE，无论是否存在免疫功能低下的情况。在接种后 7-59 天内，与未接种疫苗相比，18 岁及以上人群接种 bivalent 疫苗的 VE 在无免疫功能低下的人群中为 62%（95%CI=57%-67%），在有免疫功能低下的人群中为 28%（95%CI=10%-42%）。在无免疫功能低下的成年人中，接种后 120-179 天 VE 下降至 24%（95%CI=12%-33%）。对于免疫功能低下的成年人，VE 普遍较低。bivalent 加强针提供了最高的保护，并且至少在 179 天内对关键结果（包括 ICU 入院或住院死亡）的保护持续存在。这些数据支持更新的建议，允许某些高危人群额外选择接种 bivalent COVID-19 疫苗。所有符合条件的人都应及时接种推荐的 COVID-19 疫苗。
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