National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Influenza Other Respir Viruses. 2024 Nov;18(11):e70027. doi: 10.1111/irv.70027.
Assessments of COVID-19 vaccine effectiveness are needed to monitor the protection provided by updated vaccines against severe COVID-19. We evaluated the effectiveness of original monovalent and bivalent (ancestral strain and Omicron BA.4/5) COVID-19 vaccination against COVID-19-associated hospitalization and severe in-hospital outcomes.
During September 8, 2022 to August 31, 2023, adults aged ≥ 18 years hospitalized with COVID-19-like illness were enrolled at 26 hospitals in 20 US states. Using a test-negative case-control design, we estimated vaccine effectiveness (VE) with multivariable logistic regression adjusted for age, sex, race/ethnicity, admission date, and geographic region.
Among 7028 patients, 2924 (41.6%) were COVID-19 case patients, and 4104 (58.4%) were control patients. Compared to unvaccinated patients, absolute VE against COVID-19-associated hospitalization was 6% (-7%-17%) for original monovalent doses only (median time since last dose [IQR] = 421 days [304-571]), 52% (39%-61%) for a bivalent dose received 7-89 days earlier, and 13% (-10%-31%) for a bivalent dose received 90-179 days earlier. Absolute VE against COVID-19-associated invasive mechanical ventilation or death was 51% (34%-63%) for original monovalent doses only, 61% (35%-77%) for a bivalent dose received 7-89 days earlier, and 50% (11%-71%) for a bivalent dose received 90-179 days earlier.
Bivalent vaccination provided protection against COVID-19-associated hospitalization and severe in-hospital outcomes within 3 months of receipt, followed by a decline in protection to a level similar to that remaining from previous original monovalent vaccination by 3-6 months. These results underscore the benefit of remaining up to date with recommended COVID-19 vaccines.
需要评估 COVID-19 疫苗的有效性，以监测更新的疫苗对严重 COVID-19 的保护作用。我们评估了原始单价和双价（原始株和奥密克戎 BA.4/5）COVID-19 疫苗对 COVID-19 相关住院和严重住院结局的有效性。
在 2022 年 9 月 8 日至 2023 年 8 月 31 日期间，在美国 20 个州的 26 家医院招募了因 COVID-19 样疾病住院的年龄≥18 岁的成年人。使用病例对照试验设计，我们使用多变量逻辑回归估计疫苗有效性（VE），并根据年龄、性别、种族/民族、入院日期和地理区域进行调整。
在 7028 名患者中，2924 名（41.6%）为 COVID-19 病例患者，4104 名（58.4%）为对照患者。与未接种疫苗的患者相比，仅接受原始单价疫苗接种的 COVID-19 相关住院的绝对 VE 为 6%（-7%至-17%）（末次接种后中位时间[IQR]为 421 天[304-571]），接受 bivalent 剂量接种的患者 VE 为 52%（39%-61%），接种 bivalent 剂量的时间为 7-89 天，而接受 bivalent 剂量接种的患者 VE 为 13%（-10%至-31%），接种 bivalent 剂量的时间为 90-179 天。仅接受原始单价疫苗接种的 COVID-19 相关有创机械通气或死亡的绝对 VE 为 51%（34%-63%），接受 bivalent 剂量接种的患者 VE 为 61%（35%-77%），接种 bivalent 剂量的时间为 7-89 天，而接受 bivalent 剂量接种的患者 VE 为 50%（11%-71%），接种 bivalent 剂量的时间为 90-179 天。
在接种 bivalent 疫苗后 3 个月内，bivalent 疫苗接种对 COVID-19 相关住院和严重住院结局提供了保护，随后保护作用下降，至 3-6 个月时与先前接受的原始单价疫苗接种剩余的保护作用相似。这些结果强调了及时接种推荐的 COVID-19 疫苗的重要性。
