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mRNA COVID-19 疫苗在儿童中的疫苗有效性评估:系统评价和荟萃分析。

Evaluation of vaccine effectiveness of mRNA COVID-19 vaccines in children: a systematic review and meta-analysis.

机构信息

Department of Pediatrics, Chongqing University Jiangjin Hospital, Chongqing, China.

出版信息

Eur Rev Med Pharmacol Sci. 2024 Mar;28(6):2584-2592. doi: 10.26355/eurrev_202403_35764.

Abstract

OBJECTIVE

To evaluate the vaccine effectiveness (VE) of mRNA COVID-19 vaccines in children using a meta-analysis approach.

MATERIALS AND METHODS

Relevant studies on the use of mRNA COVID-19 vaccines in children were identified through computerized searches. VE-related indicators were extracted, and data analysis was performed using the R software with the meta-package.

RESULTS

This study included a total of 12 relevant articles involving 9,963,732 participants from multiple centers in different countries, including the United States, Canada, Singapore, Israel, South Korea, and Qatar. The administered vaccine types included BNT162b2 and mRNA-1273. Participants were categorized into partially immunized (one dose of vaccine) and fully immunized (two doses of vaccine). Four articles reported VE after one dose of vaccine, while 12 reported VE after two doses. Heterogeneity analysis indicated significant heterogeneity among the studies, warranting the use of a random-effects model for analysis. Meta-analysis results revealed that the VE of partial immunization ranged from 16.61 (95% CI: 6.32-25.77) to 34.30 (95% CI: 24.21-43.04), with a pooled VE of 22.80 (95% CI: 15.68-29.32). The VE after full immunization ranged from 16.14 (95% CI: 14.42-17.83) to 90.47 (95% CI: 67.42-97.21), with a pooled VE of 56.17 (95% CI: 41.12-67.37). Meta-regression analysis showed no statistically significant correlation between VE and time (p>0.05).

CONCLUSIONS

Both partial and full immunization of the BNT162b2 mRNA vaccine provide benefits in reducing infection rates. VE varies over time and is closely associated with viral mutations and waning immunity. The specific mechanisms require further investigation.

摘要

目的

采用荟萃分析方法评估 mRNA COVID-19 疫苗在儿童中的疫苗有效性(VE)。

材料和方法

通过计算机检索,确定了有关儿童使用 mRNA COVID-19 疫苗的相关研究。提取 VE 相关指标,并使用 R 软件的 meta 包进行数据分析。

结果

本研究共纳入来自美国、加拿大、新加坡、以色列、韩国和卡塔尔等多个国家多个中心的 12 项相关研究,共涉及 9963732 名参与者。接种的疫苗类型包括 BNT162b2 和 mRNA-1273。参与者分为部分免疫(一剂疫苗)和完全免疫(两剂疫苗)。有 4 篇文章报道了一剂疫苗后的 VE,12 篇文章报道了两剂疫苗后的 VE。异质性分析表明,研究之间存在显著异质性,需要使用随机效应模型进行分析。荟萃分析结果显示,部分免疫的 VE 范围为 16.61(95%CI:6.32-25.77)至 34.30(95%CI:24.21-43.04),合并 VE 为 22.80(95%CI:15.68-29.32)。完全免疫后的 VE 范围为 16.14(95%CI:14.42-17.83)至 90.47(95%CI:67.42-97.21),合并 VE 为 56.17(95%CI:41.12-67.37)。元回归分析表明,VE 与时间之间无统计学相关性(p>0.05)。

结论

BNT162b2 mRNA 疫苗的部分和完全免疫均可降低感染率。VE 随时间变化,与病毒突变和免疫衰减密切相关。具体机制需要进一步研究。

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