Taks Esther J M, Föhse Konstantin, J C F M Moorlag Simone, Hoogerwerf Jacobien, van Crevel Reinout, van Werkhoven Cornelis H, Netea Mihai G, Ten Oever Jaap
Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
Vaccine X. 2023 Jul 6;14:100344. doi: 10.1016/j.jvacx.2023.100344. eCollection 2023 Aug.
Protective heterologous beneficial effects of vaccines have been reported, and in this study we aimed to assess the impact of routine pneumococcal and influenza vaccination on the incidence and symptom duration of COVID-19 in a population of Dutch older adults.
This cohort study is a secondary analysis of the BCG-CORONA-ELDERLY study, a randomised controlled trial on the effect of BCG vaccination on the cumulative incidence of respiratory tract infections requiring medical intervention in adults ≥60 years. The primary outcome was the cumulative incidence of a self-reported positive SARS-CoV-2 PCR test, and was assessed using a Fine-Gray competing risks model adjusted for baseline characteristics at enrolment. We analysed data from November 1st 2020 until the end of the main study in May 2021.
Routine vaccination data 2020/2021 were available for 1963/2014 (97.5 %) participants; 44/1963 (2.2 %) were excluded due to COVID-19 before vaccination. 1076/1919 (56.1 %) had received the influenza vaccine and 289/1919 (15.1 %) the pneumococcal vaccine. The cumulative incidence of COVID-19 was 0.030 (95 %CI 0.021-0.041) in those vaccinated against influenza compared to 0.029 (95 %CI 0.019-0.041) in the unvaccinated group (subdistribution hazard ratio (SDHR) 1.018; 95 %CI 0.602-1.721). For pneumococcal vaccination the cumulative incidence was 0.031 (95 %CI 0.015-0.056) for the vaccinated and 0.029 (95 %CI 0.022-0.038) for non-vaccinated individuals (SDHR 0.961; 95 %CI 0.443-2.085). BCG vaccination in the previous year and sex were not significant effect modifiers in the primary analysis. Duration of fever, cough and dyspnoea was also not significantly different between treatment arms.
Neither influenza nor pneumococcal vaccination was associated with a lower incidence or shorter duration of COVID-19 symptoms in older adults.
已有关于疫苗的保护性异源有益作用的报道，在本研究中，我们旨在评估常规肺炎球菌疫苗和流感疫苗接种对荷兰老年人群中新冠病毒病（COVID-19）发病率和症状持续时间的影响。
本队列研究是对卡介苗-新冠-老年人（BCG-CORONA-ELDERLY）研究的二次分析，该研究是一项关于卡介苗接种对60岁及以上成年人中需要医疗干预的呼吸道感染累积发病率影响的随机对照试验。主要结局是自我报告的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）聚合酶链反应（PCR）检测阳性的累积发病率，并使用根据入组时基线特征调整的Fine-Gray竞争风险模型进行评估。我们分析了2020年11月1日至2021年5月主要研究结束的数据。
2020/2021年的常规疫苗接种数据可用于1963/2014名（97.5%）参与者；44/1963名（2.2%）因接种疫苗前感染COVID-19而被排除。1076/1919名（56.1%）接种了流感疫苗，289/1919名（15.1%）接种了肺炎球菌疫苗。接种流感疫苗者中COVID-19的累积发病率为0.030（95%置信区间0.021-0.041），未接种组为0.029（95%置信区间0.019-0.041）（亚分布风险比（SDHR）1.018；95%置信区间0.602-1.721）。对于肺炎球菌疫苗接种，接种者的累积发病率为0.031（95%置信区间0.015-0.056），未接种者为0.029（95%置信区间0.022-0.038）（SDHR 0.961；95%置信区间0.443-2.085）。前一年的卡介苗接种和性别在主要分析中不是显著的效应修饰因素。各治疗组之间发热、咳嗽和呼吸困难的持续时间也没有显著差异。
在老年人中，流感疫苗和肺炎球菌疫苗接种均与较低的COVID-19发病率或较短的症状持续时间无关。
