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在哥伦比亚四个城市(2021-2022 年)进行的回顾性基于人群的队列研究中评估科兴疫苗的真实世界效果。

Real-world effectiveness of the CoronaVac vaccine in a retrospective population-based cohort in four Colombian cities (2021-2022).

机构信息

Grupo Epidemiología, Universidad de Antioquia, Medellín, Colombia.

Grupo Epidemiología, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación Clínica - PECET (GIC-PECET), Universidad de Antioquia, Medellín, Colombia.

出版信息

Int J Infect Dis. 2024 Oct;147:107156. doi: 10.1016/j.ijid.2024.107156. Epub 2024 Aug 2.

Abstract

OBJECTIVES

The National Vaccination Plan against SARS-CoV-2/COVID-19 was launched by the Ministry of Health and Social Protection on 14 February 2021. The main objective of this study was to evaluate the effectiveness of the CoronaVac in preventing the three clinical outcomes of infection, hospitalisation, or death, in a real-world scenario.

DESIGN

This was a population-based retrospective dynamic cohort study using a multivariate Cox model to calculate hazard ratios to estimate vaccine effectiveness from 17 February 2021 to 30 June 2022. The data were collected from surveillance systems for 12 months for each individual. Four cities were selected on the basis of the reliability of their data bases.

RESULTS

The rates of CoronaVac effectiveness were 32% (95% confidence interval [CI] 31-33) for preventing infection, 55% (95% CI 54-56) for hospitalisation, and 90% (95% CI 89-90) for death, at the end of follow-up. These findings were more consistent during the first 4 months. Compared with the unvaccinated group, homologous booster doses appeared to increase effectiveness in preventing hospitalisation, whereas heterologous booster doses increased protection for both hospitalisation and death. Booster doses did not improve effectiveness among those already vaccinated with CoronaVac, even when they received heterologous boosters.

CONCLUSIONS

CoronaVac demonstrated effectiveness in preventing death and hospitalisation during the first year of follow-up, but its effectiveness in preventing infection was lower, decreasing rapidly after the first 4 months of follow-up. The effectiveness was higher among children aged between 3 and 12 years, and among adults aged ≥60 years. Booster doses did not improve effectiveness among those already vaccinated with CoronaVac.

摘要

目的

2021 年 2 月 14 日,卫生部和社会保障部启动了针对 SARS-CoV-2/COVID-19 的全国疫苗接种计划。本研究的主要目的是评估科兴疫苗在真实环境下预防感染、住院或死亡这三种临床结局的有效性。

设计

这是一项基于人群的回顾性动态队列研究,使用多变量 Cox 模型计算风险比,以估计从 2021 年 2 月 17 日至 2022 年 6 月 30 日的疫苗有效性。数据来自 12 个月的监测系统,每个个体的数据都收集了 12 个月。基于数据库的可靠性,选择了四个城市。

结果

在随访结束时,科兴疫苗预防感染的有效率为 32%(95%置信区间[CI]31-33),预防住院的有效率为 55%(95%CI 54-56),预防死亡的有效率为 90%(95%CI 89-90)。这些发现在前 4 个月更为一致。与未接种疫苗组相比,同源加强针似乎增加了预防住院的有效性,而异源加强针增加了对住院和死亡的保护。在已经接种科兴疫苗的人群中,加强针并不能提高疫苗的有效性,即使他们接种了异源加强针。

结论

在随访的第一年,科兴疫苗在预防死亡和住院方面表现出有效性,但预防感染的有效性较低,在随访的前 4 个月后迅速下降。3 至 12 岁儿童和≥60 岁成年人的有效性更高。在已经接种科兴疫苗的人群中,加强针并不能提高疫苗的有效性。

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