2021年12月至2022年2月，在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）奥密克戎BA.1变体占主导期间，VISION网络中为预防与新冠病毒疾病（COVID-19）相关的住院而需要接种新冠病毒加强针的人数：一项回顾性队列研究。
Number needed to vaccinate with a COVID-19 booster to prevent a COVID-19-associated hospitalization during SARS-CoV-2 Omicron BA.1 variant predominance, December 2021-February 2022, VISION Network: a retrospective cohort study.
作者信息
Adams Katherine, Riddles John J, Rowley Elizabeth A K, Grannis Shaun J, Gaglani Manjusha, Fireman Bruce, Hartmann Emily, Naleway Allison L, Stenehjem Edward, Hughes Alexandria, Dalton Alexandra F, Natarajan Karthik, Dascomb Kristin, Raiyani Chandni, Irving Stephanie A, Sloan-Aagard Chantel, Kharbanda Anupam B, DeSilva Malini B, Dixon Brian E, Ong Toan C, Keller Jean, Dickerson Monica, Grisel Nancy, Murthy Kempapura, Nanez Juan, Fadel William F, Ball Sarah W, Patel Palak, Arndorfer Julie, Mamawala Mufaddal, Valvi Nimish R, Dunne Margaret M, Griggs Eric P, Embi Peter J, Thompson Mark G, Link-Gelles Ruth, Tenforde Mark W
机构信息
Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Westat, Rockville, MD, USA.
出版信息
Lancet Reg Health Am. 2023 Jul;23:100530. doi: 10.1016/j.lana.2023.100530. Epub 2023 Jun 14.
BACKGROUND
Understanding the usefulness of additional COVID-19 vaccine doses-particularly given varying disease incidence-is needed to support public health policy. We characterize the benefits of COVID-19 booster doses using number needed to vaccinate (NNV) to prevent one COVID-19-associated hospitalization or emergency department encounter.
METHODS
We conducted a retrospective cohort study of immunocompetent adults at five health systems in four U.S. states during SARS-CoV-2 Omicron BA.1 predominance (December 2021-February 2022). Included patients completed a primary mRNA COVID-19 vaccine series and were either eligible to or received a booster dose. NNV were estimated using hazard ratios for each outcome (hospitalization and emergency department encounters), with results stratified by three 25-day periods and site.
FINDINGS
1,285,032 patients contributed 938 hospitalizations and 2076 emergency department encounters. 555,729 (43.2%) patients were aged 18-49 years, 363,299 (28.3%) 50-64 years, and 366,004 (28.5%) ≥65 years. Most patients were female (n = 765,728, 59.6%), White (n = 990,224, 77.1%), and non-Hispanic (n = 1,063,964, 82.8%). 37.2% of patients received a booster and 62.8% received only two doses. Median estimated NNV to prevent one hospitalization was 205 (range 44-615) and NNV was lower across study periods for adults aged ≥65 years (110, 46, and 88, respectively) and those with underlying medical conditions (163, 69, and 131, respectively). Median estimated NNV to prevent one emergency department encounter was 156 (range 75-592).
INTERPRETATION
The number of patients needed to receive a booster dose was highly dependent on local disease incidence, outcome severity, and patient risk factors for moderate-to-severe disease.
FUNDING
Funding was provided by the Centers for Disease Control and Prevention though contract 75D30120C07986 to Westat, Inc. and contract 75D30120C07765 to Kaiser Foundation Hospitals.
背景
了解额外剂量的新冠疫苗的效用——尤其是考虑到不同的疾病发病率——对于支持公共卫生政策至关重要。我们通过预防一次新冠相关住院或急诊就诊所需的接种人数（NNV）来描述新冠疫苗加强针的益处。
方法
我们对美国四个州五个医疗系统中免疫功能正常的成年人进行了一项回顾性队列研究，研究期间为新冠病毒奥密克戎BA.1毒株占主导的时期（2021年12月至2022年2月）。纳入的患者完成了新冠mRNA疫苗基础系列接种，并且有资格接种或已接种加强针。使用每个结局（住院和急诊就诊）的风险比估计NNV，结果按三个25天周期和地点进行分层。
结果
1,285,032名患者出现了938次住院和2076次急诊就诊。555,729名（43.2%）患者年龄在18至49岁之间，363,299名（28.3%）患者年龄在50至64岁之间，366,004名（28.5%）患者年龄≥65岁。大多数患者为女性（n = 765,728，59.6%）、白人（n = 990,224，77.1%）和非西班牙裔（n = 1,063,964，82.8%）。37.2%的患者接种了加强针，62.8%的患者仅接种了两剂。预防一次住院的估计NNV中位数为205（范围44 - 615），在研究期间，年龄≥65岁的成年人（分别为110、46和88）以及有基础疾病的成年人（分别为163、69和131）的NNV较低。预防一次急诊就诊的估计NNV中位数为156（范围75 - 592）。
解读
需要接种加强针的患者数量高度依赖于当地的疾病发病率、结局严重程度以及患者发生中重度疾病的风险因素。
资金来源
资金由疾病控制与预防中心提供，通过与Westat公司签订的75D30120C07986号合同以及与凯撒基金会医院签订的75D30120C07765号合同。
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