2021年10月至2022年7月美国医护人员中新冠病毒2019 mRNA疫苗加强针的有效性

Effectiveness of a Messenger RNA Vaccine Booster Dose Against Coronavirus Disease 2019 Among US Healthcare Personnel, October 2021-July 2022.

作者信息

Plumb Ian D, Mohr Nicholas M, Hagen Melissa, Wiegand Ryan, Dumyati Ghinwa, Harland Karisa K, Krishnadasan Anusha, Gist Jade James, Abedi Glen, Fleming-Dutra Katherine E, Chea Nora, Lee Jane, Barter Devra, Brackney Monica, Fridkin Scott K, Wilson Lucy E, Lovett Sara A, Ocampo Valerie, Phipps Erin C, Marcus Tiffanie M, Smithline Howard A, Hou Peter C, Lee Lilly C, Moran Gregory J, Krebs Elizabeth, Steele Mark T, Lim Stephen C, Schrading Walter A, Chinnock Brian, Beiser David G, Faine Brett, Haran John P, Nandi Utsav, Chipman Anne K, LoVecchio Frank, Talan David A, Pilishvili Tamara

机构信息

National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Department of Emergency Medicine, University of Iowa, Iowa City, Iowa, USA.

出版信息

Open Forum Infect Dis. 2023 Sep 8;10(10):ofad457. doi: 10.1093/ofid/ofad457. eCollection 2023 Oct.

DOI:10.1093/ofid/ofad457

PMID:37799130

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10549208/

Abstract

BACKGROUND

Protection against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease 2019 [COVID-19]) can limit transmission and the risk of post-COVID conditions, and is particularly important among healthcare personnel. However, lower vaccine effectiveness (VE) has been reported since predominance of the Omicron SARS-CoV-2 variant.

METHODS

We evaluated the VE of a monovalent messenger RNA (mRNA) booster dose against COVID-19 from October 2021 to June 2022 among US healthcare personnel. After matching case-participants with COVID-19 to control-participants by 2-week period and site, we used conditional logistic regression to estimate the VE of a booster dose compared with completing only 2 mRNA doses >150 days previously, adjusted for multiple covariates.

RESULTS

Among 3279 case-participants and 3998 control-participants who had completed 2 mRNA doses, we estimated that the VE of a booster dose against COVID-19 declined from 86% (95% confidence interval, 81%-90%) during Delta predominance to 65% (58%-70%) during Omicron predominance. During Omicron predominance, VE declined from 73% (95% confidence interval, 67%-79%) 14-60 days after the booster dose, to 32% (4%-52%) ≥120 days after a booster dose. We found that VE was similar by age group, presence of underlying health conditions, and pregnancy status on the test date, as well as among immunocompromised participants.

CONCLUSIONS

A booster dose conferred substantial protection against COVID-19 among healthcare personnel. However, VE was lower during Omicron predominance, and waning effectiveness was observed 4 months after booster dose receipt during this period. Our findings support recommendations to stay up to date on recommended doses of COVID-19 vaccines for all those eligible.

摘要

背景

预防有症状的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染（冠状病毒病2019 [COVID-19]）可限制传播及感染后状况的风险，这在医护人员中尤为重要。然而，自奥密克戎SARS-CoV-2变体占主导以来，疫苗有效性（VE）有所降低。

方法

我们评估了2021年10月至2022年6月期间美国医护人员中单价信使核糖核酸（mRNA）加强剂量对COVID-19的疫苗有效性。在按2周时间段和地点将COVID-19病例参与者与对照参与者匹配后，我们使用条件逻辑回归来估计加强剂量与仅在150天前完成2剂mRNA相比的疫苗有效性，并针对多个协变量进行了调整。

结果

在完成2剂mRNA的3279例病例参与者和3998例对照参与者中，我们估计加强剂量对COVID-19的疫苗有效性在德尔塔毒株占主导期间从86%（95%置信区间，81%-90%）降至奥密克戎毒株占主导期间的65%（58%-70%）。在奥密克戎毒株占主导期间，疫苗有效性在加强剂量后14 - 60天从73%（95%置信区间，67%-79%）降至加强剂量后≥120天的32%（4%-52%）。我们发现，按年龄组、检测当日是否存在基础健康状况、妊娠状态以及免疫功能低下的参与者来看，疫苗有效性相似。