Salas Joanne, Morley John E, Hoft Daniel F, Scherrer Jeffrey F
Department of Family and Community Medicine, Saint Louis University School of Medicine, 1008 S. Spring, St. Louis, MO 63110, United States.
Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, 3545 Lafayette Ave, 4th Floor, St. Louis, MO 63104, United States.
Prev Med Rep. 2023 Jun 25;35:102302. doi: 10.1016/j.pmedr.2023.102302. eCollection 2023 Oct.
Influenza, tetanus, diphtheria, and herpes zoster (HZ) vaccination received within 10 years of the COVID-19 pandemic have been associated with less severe COVID-19 infection. We expanded on this evidence to determine if a receiving two different vaccinations (i.e., HZ and tetanus, diphtheria, and pertussis (Tdap)) was associated with a lower risk for COVID-19 hospitalization. De-identified medical record data from a large mid-western health care system was used to determine if, compared to those with neither HZ or Tdap vaccination, patients with either HZ or Tdap and patients with both HZ and Tdap vaccination had lower risk for COVID-19 hospitalization between 4/1/2020 and 12/31/2020. Confounding was controlled using entropy balancing. Patients (n = 363,293) were 71.5 (±8.4) years of age, 57.8% female and 89.2% White race. Prior to controlling for confounding, as compared to patients without either vaccination, those that had either HZ or Tdap were significantly less likely to have a COVID-19 hospitalization (RR = 0.85; 95 %CI: 0.75-0.95). The risk for hospitalization decreased further among those with both HZ and Tdap vaccination (RR = 0.45; 95 %CI:0.28-0.71). After controlling for confounding, including healthy patient bias, receiving both vs. neither vaccinations remained significantly associated with a lower risk of COVID-19 hospitalization (RR = 0.48; 95 %CI: 0.26-0.90). Receiving both Tdap and HZ vaccination is associated with lower risk for COVID-19 hospitalization. Whether there is any benefit of past vaccination exposure in COVID-19 vaccinated patients should be investigated.
在新冠疫情大流行的10年内接种流感、破伤风、白喉和带状疱疹（HZ）疫苗，与新冠病毒感染症状较轻有关。我们进一步研究了这一证据，以确定接种两种不同疫苗（即HZ疫苗和破伤风、白喉、百日咳（Tdap）疫苗）是否与新冠住院风险较低相关。我们使用了美国中西部一个大型医疗系统的匿名医疗记录数据，来确定在2020年4月1日至2020年12月31日期间，与未接种HZ或Tdap疫苗的患者相比，接种了HZ或Tdap疫苗以及同时接种了HZ和Tdap疫苗的患者新冠住院风险是否更低。我们使用熵平衡法控制混杂因素。患者（n = 363,293）年龄为71.5（±8.4）岁，57.8%为女性，89.2%为白人。在控制混杂因素之前，与未接种任何疫苗的患者相比，接种了HZ或Tdap疫苗的患者新冠住院的可能性显著降低（风险比RR = 0.85；95%置信区间CI：0.75 - 0.95）。同时接种HZ和Tdap疫苗的患者住院风险进一步降低（RR = 0.45；95%CI：0.28 - 0.71）。在控制了包括健康患者偏倚在内的混杂因素后，接种两种疫苗与未接种疫苗相比，仍然与较低的新冠住院风险显著相关（RR = 0.48；95%CI：0.26 - 0.90）。接种Tdap和HZ疫苗与较低的新冠住院风险相关。新冠疫苗接种者过去的疫苗接种暴露是否有任何益处值得研究。
