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疫苗接种对实验室确诊病例个体中 COVID-19 感染或死亡的影响:病例对照研究。

Impact of vaccination on infection or death from COVID-19 in individuals with laboratory-confirmed cases: Case-control study.

机构信息

Instituto Mexicano del Seguro Social, Coordinación de Calidad de Insumos y Laboratorios Especializados, Coahuila, Mexico.

Instituto Mexicano del Seguro Social, Coordinación de Vigilancia Epidemiológica, Coahuila, Mexico.

出版信息

PLoS One. 2023 Aug 3;18(8):e0265698. doi: 10.1371/journal.pone.0265698. eCollection 2023.

Abstract

OBJECTIVES

The objective of this study is to estimate the effectiveness of COVID-19 vaccines in people treated within the social security system whose vaccination status was reported to the epidemiological surveillance system.

STUDY DESIGN

Case-control study.

METHODS

This was a case-control study conducted. The records of individuals with suspected cases of COVID-19 registered in the epidemiological surveillance system between February 1 and June 30, 2021, were studied. RT-qPCR was performed to determine SARS-CoV-2 infection; those with a positive result were considered cases, and those with a negative result were considered controls. The ratio between cases and controls was 1:1.3. The crude and adjusted vaccine effectiveness was considered the prevention of symptomatic infection and death and calculated as the difference between the dose and the risk, with a survival analysis among vaccinated people.

RESULTS

A total of 94,416 individuals were included, of whom 40,192 were considered cases and 54,224 controls; 3,781 (4.00%) had been vaccinated against COVID-19. Vaccination also proved to be a protective factor against COVID-19, especially in the population who received a second dose (OR = 0.31; 95% CI 0.28-0.35). With the application of the vaccine, there was a protective effect against mortality (OR = 0.76; 95% CI 0.66-0.87). Disease prevention was higher for the BNT162-2 mRNA vaccine (82%) followed by the ChAdOx1 vaccine (33%). In the survival analysis, vaccination provided a protective effect.

CONCLUSIONS

There was a positive impact of vaccines for the prevention of symptomatic COVID-19, with a second dose generating greater efficacy and a reduction in deaths.

摘要

目的

本研究旨在评估向传染病监测系统报告接种状况的社会保障系统内治疗人群中 COVID-19 疫苗的有效性。

设计

病例对照研究。

方法

本研究采用病例对照设计。研究对象为 2021 年 2 月 1 日至 6 月 30 日期间在传染病监测系统中登记的疑似 COVID-19 病例的个人记录。通过 RT-qPCR 确定 SARS-CoV-2 感染;阳性结果者视为病例,阴性结果者视为对照。病例与对照的比例为 1:1.3。考虑了疫苗的粗效力和调整后的效力,即预防有症状感染和死亡的效力,计算方法为剂量与风险的差值,并对接种人群进行生存分析。

结果

共纳入 94416 人,其中 40192 人被认为是病例,54224 人是对照;3781 人(4.00%)接种了 COVID-19 疫苗。接种疫苗也被证明是 COVID-19 的保护因素,特别是在接种第二剂疫苗的人群中(OR=0.31;95%CI 0.28-0.35)。应用疫苗可降低病死率(OR=0.76;95%CI 0.66-0.87)。BNT162-2 mRNA 疫苗的疾病预防效果较高(82%),其次是 ChAdOx1 疫苗(33%)。在生存分析中,疫苗提供了保护作用。

结论

疫苗对预防有症状 COVID-19 具有积极影响,接种第二剂疫苗可提高疗效并降低死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f967/10399771/f294d8ecb056/pone.0265698.g001.jpg

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