在孟加拉国人群中奥密克戎变异株占主导期间评估新冠疫苗的有效性:一项检测呈阴性设计测量。

Evaluating the effectiveness of COVID-19 vaccines during a period of Omicron variant predominance among Bangladeshi population: A test-negative design measurement.

作者信息

Islam Md Taufiqul, Khanam Farhana, Ahmmed Faisal, Rajib Md Nazmul Hasan, Hossen Md Ismail, Haque Shahinur, Biswas Prasanta Kumar, Ashrafi Shah Ali Akbar, Alam Ahmed Nawsher, Billah Mallick Masum, Rahman Mohammed Ziaur, Bin Manjur Omar Hamza, Habib Mohammad Tanbir, Afrad Mokibul Hassan, Shamsuzzaman S M, Saleh Ahmed Abu, Sumon Mostafa Aziz, Rashed Asif, Shirin Tahmina, Clemens John D, Qadri Firdausi

机构信息

International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.

Health Information Unit, Directorate General of Health Services, Health Services Division, Ministry of Health and Family Welfare, Dhaka, Bangladesh.

出版信息

Hum Vaccin Immunother. 2025 Dec;21(1):2518644. doi: 10.1080/21645515.2025.2518644. Epub 2025 Jun 28.

Abstract

The study was conducted to estimate the protective effectiveness (PE) of complete primary or booster dose regimens of COVID-19 vaccines deployed in Bangladesh. The study was conducted in four hospitals in Dhaka between December 30, 2021, and August 31, 2022 following a test-negative design. Patients aged ≥18 years attended with COVID-like symptoms were enrolled and tested for RT-PCR. Test-negative controls were matched to confirmed cases at a 1:1 ratio considering site, date, and age groups. Conditional logistic regression was used to estimate the PE considering the association between receipt of complete primary with or without a booster regimen and development of COVID-19 disease symptoms. Whole genome sequencing (WGS) was carried out to confirm the variants. RT-PCR positive 847 cases were matched to 847 controls. WGS of strains revealed 6% to be the Delta variant and 94% was Omicron variant. The PE conferred by receipt of complete primary regimen with or without booster dose of any vaccine revealed no significant protection (15%, 95% CI: -11 to 36,  = .23) against any COVID-19 disease or severe disease (14%, 95%CI: -23 to 39,  = .42). However, there was a protective association between receipt of complete primary regimen with or without booster dose of one mRNA vaccine (Pfizer-BioNTech) against any COVID-19 disease (88% (95% CI: 26 to 98,  = .023)) for the first 90 days. The analysis suggested little vaccine effectiveness during Omicron surge, with the possible exception of one mRNA-vaccine 90 days after dosing.

摘要

开展这项研究是为了评估在孟加拉国部署的新冠疫苗完整基础免疫或加强免疫方案的保护效力(PE)。该研究于2021年12月30日至2022年8月31日在达卡的四家医院采用检测阴性设计进行。年龄≥18岁出现新冠样症状的患者入组并进行逆转录聚合酶链反应(RT-PCR)检测。检测阴性对照按照地点、日期和年龄组以1:1的比例与确诊病例匹配。采用条件逻辑回归来评估PE,同时考虑接受完整基础免疫(无论有无加强免疫方案)与出现新冠疾病症状之间的关联。进行全基因组测序(WGS)以确认病毒变体。847例RT-PCR阳性病例与847例对照匹配。菌株的WGS显示6%为德尔塔变体,94%为奥密克戎变体。接受任何疫苗的完整基础免疫方案(无论有无加强剂量)所赋予的PE显示,对任何新冠疾病或重症疾病均无显著保护作用(15%,95%置信区间:-11至36,P = 0.23)。然而,在最初的90天内,接受一种信使核糖核酸疫苗(辉瑞-BioNTech)的完整基础免疫方案(无论有无加强剂量)与预防任何新冠疾病之间存在保护关联(88%(95%置信区间:26至98,P = 0.023))。分析表明,在奥密克戎毒株激增期间疫苗效力较低,可能的例外是一种信使核糖核酸疫苗在接种90天后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb1/12218421/01f510ac2e81/KHVI_A_2518644_F0002_OC.jpg

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