美国成年癌症患者中新冠病毒疾病2019（COVID-19）疫苗加强针的接种情况及有效性

COVID-19 Vaccine Booster Uptake and Effectiveness Among US Adults With Cancer.

作者信息

Skarbinski Jacek, Elkin Eric P, Ziemba Yonah C, Kazemian Elham, Wilson Brigid M, Siddiqui Hinnah, Schleicher Cheryl B, Hsiao Crystal A, Nugent Joshua R, Reckamp Karen L, Merchant Akil, Crawford James M, Zidar David A, Kushi Lawrence H, Figueiredo Jane C

机构信息

Division of Research, Kaiser Permanente Northern California, Pleasanton.

Department of Infectious Diseases, Oakland Medical Center, Kaiser Permanente Northern California, Oakland.

出版信息

JAMA Oncol. 2025 Jul 17. doi: 10.1001/jamaoncol.2025.2020.

DOI:10.1001/jamaoncol.2025.2020

PMID:40674059

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12272354/

Abstract

IMPORTANCE

Persons with cancer are at increased risk of severe COVID-19 infection, but the additional benefit of COVID-19 boosters is unclear.

OBJECTIVE

To assess COVID-19 vaccine effectiveness (VE) and number needed to vaccinate (NNV) among persons with cancer of an additional dose of the monovalent COVID-19 vaccine.

DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study conducted in 4 health care systems in the US among persons with cancer receiving chemotherapy or immunotherapy. Statistical analysis was conducted between March 2023 and August 2024.

EXPOSURES

Receipt of an additional dose of the monovalent COVID-19 vaccine before January 1, 2022, with follow-up until August 31, 2022, and the bivalent COVID-19 vaccine from September 1, 2022, to August 31, 2023.

MAIN OUTCOMES AND MEASURES

COVID-19 hospitalization, diagnosed COVID-19, and COVID-19-related intensive care unit (ICU) admission.

RESULTS

Among 72 831 persons with cancer (17 922 female individuals [24.6%]), 69% received a monovalent booster by January 1, 2022. During 34 006 person-years of follow-up, the COVID-19 hospitalization rate was 30.5 per 1000 person-years among patients who received a monovalent booster vs 41.9 per 1000 person-years among patients who received the primary series alone, with an adjusted VE of 29.2% (95% CI, 19.9%-37.3%) and NNV to prevent 1 COVID-19 hospitalization of 166 (95% CI, 130-244). There was also significant VE to prevent diagnosed COVID-19 (8.5% [95% CI, 3.7%-13.0%]) and COVID-19-related ICU admission (35.6% [95% CI, 20.0%-48.3%]). Among 88 417 persons with cancer (24 589 female individuals [27.8%]) with 81 027 person-years of follow-up during the bivalent period, patients who received this booster (38%) had a COVID-19 hospitalization rate of 13.4 per 1000 person-years vs 21.7 per 1000 person-years among persons who did not receive a bivalent vaccine, with an adjusted VE of 29.9% (95% CI, 19.4%-39.1%) and NNV to prevent 1 COVID-19 hospitalization of 451 (95% CI, 345-697); the adjusted VE was 30.1% (95% CI, 7.7%-47.0%) to prevent COVID-19-related ICU admission.

CONCLUSIONS AND RELEVANCE

In this retrospective cohort study, COVID-19 booster vaccinations were associated with significant protection against severe COVID-19, with a favorable NNV among persons with cancer. However, uptake of COVID-19 vaccine boosters was low, and interventions are therefore justified to increase COVID-19 uptake in this high-risk population.

摘要

重要性

癌症患者感染重症 COVID-19 的风险增加，但 COVID-19 加强针的额外益处尚不清楚。

目的

评估癌症患者接种一剂单价 COVID-19 疫苗后的 COVID-19 疫苗有效性（VE）和需接种人数（NNV）。

设计、设置和参与者：在美国 4 个医疗系统中对接受化疗或免疫治疗的癌症患者进行的回顾性队列研究。统计分析于 2023 年 3 月至 2024 年 8 月进行。

暴露因素

在 2022 年 1 月 1 日前接种一剂单价 COVID-19 疫苗，并随访至 2022 年 8 月 31 日，以及在 2022 年 9 月 1 日至 2023 年 8 月 31 日接种二价 COVID-19 疫苗。

主要结局和测量指标

COVID-19 住院、确诊的 COVID-19 以及与 COVID-19 相关的重症监护病房（ICU）入院。

结果

在 72831 名癌症患者（17922 名女性[24.6%]）中，69%在 2022 年 1 月 1 日前接种了单价加强针。在 34006 人年的随访期间，接种单价加强针的患者中 COVID-19 住院率为每 1000 人年 30.5 例，而仅接受初始系列疫苗接种的患者中为每 1000 人年 41.9 例，调整后的 VE 为 29.2%（95%CI，19.9%-37.3%），预防 1 例 COVID-19 住院的 NNV 为 166（95%CI，130-244）。预防确诊 COVID-19 也有显著的 VE（8.5%[95%CI，3.7%-13.0%]）以及预防与 COVID-19 相关的 ICU 入院（35.6%[95%CI，20.0%-48.3%]）。在二价疫苗接种期间的 88417 名癌症患者（24589 名女性[27.8%]）中，有 81027 人年的随访，接种该加强针的患者（38%）中 COVID-19 住院率为每 1000 人年 13.4 例，未接种二价疫苗的患者中为每 1000 人年 21.7 例，调整后的 VE 为 29.9%（95%CI，19.4%-39.1%），预防 1 例 COVID-19 住院的 NNV 为 451（95%CI，345-697）；预防与 COVID-19 相关的 ICU 入院的调整后 VE 为 30.1%（95%CI，7.7%-47.0%）。