Center for Computational Biology, School of Public Health.
College of Statistics, Data Science, and Society.
J Infect Dis. 2024 Nov 15;230(5):e1082-e1091. doi: 10.1093/infdis/jiae387.
Pneumococcal carriage is associated with increased acquisition and duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among adults. While pneumococcal conjugate vaccines (PCVs) prevent carriage of vaccine-serotype pneumococci, their potential impact on coronavirus disease 2019 (COVID-19)-related outcomes remains poorly understood in populations with prevalent immunity against SARS-CoV-2.
We undertook a retrospective cohort study of adults aged ≥65 years in the Kaiser Permanente Southern California healthcare system who had received ≥2 COVID-19 vaccine doses, comparing risk of SARS-CoV-2 infection between 1 January 2021 and 31 December 2022 among recipients and nonrecipients of 13-valent PCV (PCV13) employing multiple strategies to mitigate bias from differential test-seeking behavior.
The ajusted hazard ratio of confirmed SARS-CoV-2 infection comparing PCV13 recipients to nonrecipients was 0.92 (95% confidence interval [CI], .90-.95), corresponding to prevention of 3.9 (95% CI, 2.6-5.3) infections per 100 person-years. Following receipt of 2, 3, and ≥4 COVID-19 vaccine doses, aHRs (95% CI) were 0.85 (.81-.89), 0.94 (.90-.97), and 0.99 (.93-1.04), respectively. The aHR (95% CI) for persons who had not received COVID-19 vaccination in the preceding 6 months was 0.90 (.86-.93), versus 0.94 (.91-.98) within 6 months after COVID-19 vaccination. Similarly, aHRs (95% CI) were 0.92 (.89-.94) for persons without history of documented SARS-CoV-2 infection, versus 1.00 (.90-1.12) for persons with documented prior infection.
Among older adults who had received ≥2 COVID-19 vaccine doses, PCV13 was associated with modest protection against SARS-CoV-2 infection. Protective effects of PCV13 were greater among individuals expected to have weaker immune protection against SARS-CoV-2 infection.
肺炎球菌定植与成年人严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染的获得和持续时间增加有关。虽然肺炎球菌结合疫苗（PCV）可预防疫苗血清型肺炎球菌定植，但在对 SARS-CoV-2 具有普遍免疫力的人群中，它们对 2019 年冠状病毒病（COVID-19）相关结局的潜在影响仍知之甚少。
我们对 Kaiser Permanente 南加州医疗保健系统中≥65 岁的成年人进行了一项回顾性队列研究，这些成年人接受了≥2 剂 COVID-19 疫苗，通过多种策略比较了 2021 年 1 月 1 日至 2022 年 12 月 31 日期间接受和未接受 13 价肺炎球菌结合疫苗（PCV13）的成年人中 SARS-CoV-2 感染的风险，以减轻因寻求检测的差异而产生的偏倚。
与未接受 PCV13 的成年人相比，接受 PCV13 的成年人确认 SARS-CoV-2 感染的调整后危险比为 0.92（95%置信区间[CI]，0.90-0.95），相当于每 100 人年预防 3.9（95%CI，2.6-5.3）例感染。在接受 2、3 和≥4 剂 COVID-19 疫苗后，调整后危险比（95%CI）分别为 0.85（0.81-0.89）、0.94（0.90-0.97）和 0.99（0.93-1.04）。在过去 6 个月内未接种 COVID-19 疫苗的人群的调整后危险比（95%CI）为 0.90（0.86-0.93），而在 COVID-19 疫苗接种后 6 个月内为 0.94（0.91-0.98）。同样，无 SARS-CoV-2 感染史的人群的调整后危险比（95%CI）为 0.92（0.89-0.94），而有 SARS-CoV-2 感染史的人群为 1.00（0.90-1.12）。
在接受≥2 剂 COVID-19 疫苗的老年人中，PCV13 与 SARS-CoV-2 感染的适度保护有关。在预期对 SARS-CoV-2 感染的免疫保护较弱的个体中，PCV13 的保护作用更大。
