Sheba Pandemic Research Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
The Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
JAMA Netw Open. 2023 Sep 5;6(9):e2332813. doi: 10.1001/jamanetworkopen.2023.32813.
COVID-19 and seasonal influenza vaccines were previously given separately, although their coadministration is warranted for vaccination adherence. Limited data on their coadministration have been published.
To compare the reactogenicity and immunogenicity of COVID-19 and influenza vaccinations administered together with those of COVID-19 vaccination alone.
DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study included health care workers at a large tertiary medical center in Israel who received the Influvac Tetra (Abbott) influenza vaccine (2022/2023), the Omicron BA.4/BA.5-adapted bivalent (Pfizer/BioNTech) vaccine, or both. Vaccination began in September 2022, and data were collected until January 2023. Vaccines were offered to all employees and were coadministered or given separately. Adverse reaction questionnaires were sent, and serologic samples were also collected.
Receiving COVID-19 vaccine, influenza vaccine, or both.
The main outcomes for the reactogenicity analysis were symptoms following vaccine receipt, assessed by a digital questionnaire: any local symptoms; fever; weakness or fatigue; any systemic symptoms; and their duration. The immunogenicity analysis' outcome was postvaccination anti-spike IgG titer.
This study included 2 cohorts for 2 separate analyses. The reactogenicity analysis included 588 participants (of 649 questionnaire responders): 85 in the COVID-19 vaccine-alone group (median [IQR] age, 71 [58-74] years; 56 [66%] female); 357 in the influenza vaccine-alone group (median [IQR] age, 55 [40-65] years; 282 [79%] female); and 146 in the coadministration group (median [IQR] age, 61 [50-71] years; 81 [55%] female). The immunogenicity analysis included 151 participants: 74 participants in the COVID-19 vaccine group (median [IQR] age, 67 [56-73] years; 45 [61%] female) and 77 participants in the coadministration group (median [IQR] age, 60 [49-73] years; 42 [55%] female). Compared with COVID-19 vaccination alone, the risk of systemic symptoms was similar in the coadministration group (odds ratio, 0.82; 95% CI, 0.43-1.56). Geometric mean titers in the coadministration group were estimated to be 0.84 (95% CI, 0.69-1.04) times lower than in the COVID-19 vaccine-alone group.
In this cohort study of health care workers who received a COVID-19 vaccine, an influenza vaccine, or both, coadministration was not associated with substantially inferior immune response or to more frequent adverse events compared with COVID-19 vaccine administration alone, supporting the coadministration of these vaccines.
尽管同时接种 COVID-19 和季节性流感疫苗有助于提高疫苗接种的依从性，但此前这两种疫苗是分开接种的。目前已发表了一些关于同时接种这两种疫苗的有限数据。
比较 COVID-19 和流感疫苗联合接种与单独接种 COVID-19 疫苗的反应原性和免疫原性。
设计、设置和参与者：本前瞻性队列研究纳入了以色列一家大型三级医疗中心的卫生保健工作者，他们接种了 Influvac Tetra（Abbott）流感疫苗（2022/2023 年）、Omicron BA.4/BA.5 适应性二价（辉瑞/生物科技）疫苗或两者均接种。疫苗接种于 2022 年 9 月开始，数据收集持续到 2023 年 1 月。疫苗提供给所有员工，并可联合或单独接种。接种后通过数字问卷评估不良反应，并采集血清样本。
接种 COVID-19 疫苗、流感疫苗或两者均接种。
反应原性分析的主要结局是接种疫苗后的症状，通过数字问卷评估：任何局部症状；发热；虚弱或疲劳；任何全身症状；以及其持续时间。免疫原性分析的结局是接种后抗刺突 IgG 滴度。
本研究包括 2 个队列进行 2 项独立分析。反应原性分析纳入了 588 名参与者（649 名问卷应答者中的 588 名）：85 名单独接种 COVID-19 疫苗者（中位[IQR]年龄，71[58-74]岁；56[66%]为女性）；357 名单独接种流感疫苗者（中位[IQR]年龄，55[40-65]岁；282[79%]为女性）；146 名联合接种者（中位[IQR]年龄，61[50-71]岁；81[55%]为女性）。免疫原性分析纳入了 151 名参与者：74 名单独接种 COVID-19 疫苗者（中位[IQR]年龄，67[56-73]岁；45[61%]为女性）和 77 名联合接种者（中位[IQR]年龄，60[49-73]岁；42[55%]为女性）。与单独接种 COVID-19 疫苗相比，联合接种组发生全身症状的风险相似（比值比，0.82；95%CI，0.43-1.56）。联合接种组的几何平均滴度估计比单独接种 COVID-19 疫苗组低 0.84（95%CI，0.69-1.04）倍。
在这项针对接种 COVID-19 疫苗、流感疫苗或两者均接种的卫生保健工作者的队列研究中，与单独接种 COVID-19 疫苗相比，联合接种并不会显著降低免疫反应或增加不良反应的发生频率，支持同时接种这两种疫苗。
