Volkman Hannah R, Nguyen Jennifer L, Mustapha Mustapha M, Yang Jingyan, Jodar Luis, McLaughlin John M
Pfizer Inc., New York, NY, USA.
Department of Population Health, Hofstra University, Hempstead, NY, USA.
Commun Med (Lond). 2025 May 3;5(1):151. doi: 10.1038/s43856-025-00882-y.
Based on high population immunity to SARS-CoV-2 from prior infection, vaccination, or both, in fall 2023, regulatory agencies globally authorized/approved a single mRNA XBB.1.5-adapted vaccine dose for individuals aged ≥5 years regardless of prior vaccination.
We conducted a systematic review on vaccine effectiveness (VE) of a single COVID-19 mRNA dose in individuals with a history of prior infection compared to individuals who were (i) SARS-CoV-2 naïve, (ii) unvaccinated with prior infection, and (iii) vaccinated with >1 dose with or without prior infection. We searched MEDLINE and Embase for studies published January 2021-October 2023. Data were synthesized following Synthesis Without Meta-Analysis guidelines; bias was assessed using the Newcastle-Ottawa Scale. This study was registered with PROSPERO (CRD42023453257).
Eighteen studies were eligible. None of these studies reported bivalent or XBB.1.5-adapted VE, and none reported VE for immunocompromised populations or children aged <5 years. Among those with prior infection, a single mRNA dose increased protection by 8-71% against infection (during Omicron BA.1, BA.4/5, or XBB predominance), 39-67% against symptomatic infection (BA.1, BA.2, or BA.4/5), and 25-60% against hospitalization or hospitalization or death (BA.1). VE of one dose was comparable to two doses among those with prior infection, and higher than following two doses without prior infection.
A single dose of original mRNA COVID-19 vaccine provides similar protection to two doses for immunocompetent individuals aged ≥5 years in the current setting of high pre-existing immunity. This supports current recommendations for one dose to be given in advance of the respiratory season, regardless of history of infection or vaccination, with considerations for additional doses for certain populations including young children, older adults, and the immunocompromised.
基于2023年秋季之前感染、接种疫苗或两者兼而有之所形成的针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的高人群免疫力，全球监管机构批准了针对≥5岁个体的单剂mRNA XBB.1.5适配疫苗，无论其既往接种情况如何。
我们对有既往感染史的个体接种单剂新冠病毒mRNA疫苗的疫苗效力（VE）进行了系统评价，并与以下个体进行了比较：（i）未感染过SARS-CoV-2的个体；（ii）有既往感染史但未接种疫苗的个体；（iii）有或无既往感染史且接种过超过1剂疫苗的个体。我们检索了MEDLINE和Embase数据库中2021年1月至2023年10月发表的研究。数据按照非荟萃分析合成指南进行合成；使用纽卡斯尔-渥太华量表评估偏倚。本研究已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号：CRD42023453257）。
18项研究符合纳入标准。这些研究均未报告二价或XBB.1.5适配疫苗效力，也未报告免疫功能低下人群或＜5岁儿童的疫苗效力。在有既往感染史的个体中，单剂mRNA疫苗可使感染防护力提高8%至71%（在奥密克戎BA.1、BA.4/5或XBB为主的时期），使有症状感染防护力提高39%至67%（BA.1、BA.2或BA.4/5），使住院或住院或死亡防护力提高25%至60%（BA.1）。对于有既往感染史的个体，单剂疫苗效力与两剂相当，且高于无既往感染史接种两剂后的效力。
在当前已有高免疫力的情况下，单剂原始mRNA新冠疫苗为≥5岁免疫功能正常个体提供的保护与两剂相当。这支持了当前在呼吸道疾病季节来临前接种一剂疫苗的建议，无论感染史或接种史如何，同时考虑为包括幼儿、老年人和免疫功能低下者在内的特定人群接种额外剂量疫苗。
