Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91101, USA.
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91101, USA.
Vaccine. 2023 Jun 29;41(29):4212-4219. doi: 10.1016/j.vaccine.2023.06.016. Epub 2023 Jun 5.
We evaluated relative vaccine effectiveness (rVE) of 4- vs. 3-dose mRNA-1273 against SARS-CoV-2 infection, and COVID-19 hospitalization and death in immunocompetent adults aged ≥50 years at Kaiser Permanente Southern California. We included 178,492 individuals who received a fourth dose of mRNA-1273, and 178,492 randomly selected 3-dose recipients who were matched to 4-dose recipients by age, sex, race/ethnicity, and third dose date. Adjusted 4- vs. 3-dose rVE against SARS-CoV-2 infection, COVID-19 hospitalization, and COVID-19 hospitalization death were 25.9 % (23.5 %, 28.2 %), 67.3 % (58.7 %, 74.1 %), and 72.5 % (-35.9 %, 95.2 %), respectively. Adjusted rVE against SARS-CoV-2 infection ranged between 19.8 % and 39.1 % across subgroups. Adjusted rVE against SARS-CoV-2 infection and COVID-19 hospitalization decreased 2-4 months after the fourth dose. Four mRNA-1273 doses provided significant protection against COVID-19 outcomes compared with 3 doses, consistent in various subgroups of demographic and clinical characteristics, although rVE varied and waned over time.
我们评估了加利福尼亚州凯撒永久医疗集团免疫功能正常的≥50 岁成年人中，mRNA-1273 接种 4 剂与 3 剂相比针对 SARS-CoV-2 感染、COVID-19 住院和死亡的相对疫苗有效性（rVE）。我们纳入了 178492 名接受第 4 剂 mRNA-1273 的个体，以及随机选择的 178492 名接受第 3 剂的个体，这些个体通过年龄、性别、种族/民族和第 3 剂接种日期与第 4 剂接种者匹配。调整后 4 剂与 3 剂 rVE 对 SARS-CoV-2 感染、COVID-19 住院和 COVID-19 住院死亡的保护效力分别为 25.9%（23.5%，28.2%）、67.3%（58.7%，74.1%）和 72.5%（-35.9%，95.2%）。在亚组之间，调整后的 rVE 对 SARS-CoV-2 感染的保护效力在 19.8%至 39.1%之间。在第 4 剂接种后 2-4 个月，调整后的 rVE 对 SARS-CoV-2 感染和 COVID-19 住院的保护效力降低。与 3 剂相比，4 剂 mRNA-1273 对 COVID-19 结局提供了显著的保护作用，在各种人口统计学和临床特征的亚组中一致，尽管 rVE 随时间变化而波动。
