SARS-CoV-2 疫苗在现实环境中高危国家人群中的有效性。
SARS-CoV-2 Vaccine Effectiveness in a High-Risk National Population in a Real-World Setting.
机构信息
VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, Weill Cornell Medical College, New York, New York, and Weill Cornell Medical College and Hamad Medical Corporation, Doha, Qatar (A.A.B.).
Yale School of Medicine, New Haven, Connecticut (S.B.O.).
出版信息
Ann Intern Med. 2021 Oct;174(10):1404-1408. doi: 10.7326/M21-1577. Epub 2021 Jul 20.
BACKGROUND
With the emergency use authorization of multiple vaccines against SARS-CoV-2 infection, data are urgently needed to determine their effectiveness in a real-world setting.
OBJECTIVE
To evaluate the short-term effectiveness of vaccines in preventing SARS-CoV-2 infection.
DESIGN
Test-negative case-control study using conditional logistic regression.
SETTING
U.S. Department of Veterans Affairs health care system.
PARTICIPANTS
All veterans who had testing for SARS-CoV-2 infection between 15 December 2020 and 4 March 2021 and no confirmed infection before 15 December 2020.
INTERVENTION
SARS-CoV-2 vaccination with either the BNT-162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine as part of routine clinical care.
MEASUREMENTS
Effectiveness of vaccination against confirmed SARS-CoV-2 infection.
RESULTS
Among 54 360 persons who tested positive and 54 360 propensity score-matched control participants, the median age was 61 years, 83.6% were male, and 62% were White. Median body mass index was 31 kg/m among those who tested positive and 30 kg/m among those who tested negative. Among those who tested positive, 9800 (18.0%) had been vaccinated; among those who tested negative, 17 825 (32.8%) had been vaccinated. Overall vaccine effectiveness 7 or more days after the second dose was 97.1% (95% CI, 96.6% to 97.5%). Effectiveness was 96.2% (CI, 95.5% to 96.9%) for the Pfizer-BioNTech BNT-162b2 vaccine and 98.2% (CI, 97.5% to 98.6%) for the Moderna mRNA-1273 vaccine. Effectiveness remained above 95% regardless of age group, sex, race, or presence of comorbidities.
LIMITATIONS
Predominantly male population; lack of data on disease severity, mortality, and effectiveness by SARS-CoV-2 variants of concern; and short-term follow-up.
CONCLUSION
Currently used vaccines against SARS-CoV-2 infection are highly effective in preventing confirmed infection in a high-risk population in a real-world setting.
PRIMARY FUNDING SOURCE
None.
背景
随着多种针对 SARS-CoV-2 感染的疫苗获得紧急使用授权，迫切需要数据来确定它们在真实环境中的有效性。
目的
评估疫苗在预防 SARS-CoV-2 感染方面的短期效果。
设计
使用条件逻辑回归的病例对照研究。
设置
美国退伍军人事务部医疗保健系统。
参与者
所有在 2020 年 12 月 15 日至 2021 年 3 月 4 日期间接受 SARS-CoV-2 感染检测且在 2020 年 12 月 15 日之前未确诊感染的退伍军人。
干预措施
接种 BNT-162b2（辉瑞-生物科技）或 mRNA-1273（莫德纳）疫苗中的任何一种疫苗，作为常规临床护理的一部分。
测量指标
疫苗对确诊 SARS-CoV-2 感染的有效性。
结果
在 54360 名检测呈阳性者和 54360 名倾向评分匹配的对照参与者中，中位年龄为 61 岁，83.6%为男性，62%为白人。在检测呈阳性者中，中位体重指数为 31kg/m，在检测呈阴性者中为 30kg/m。在检测呈阳性者中，有 9800 人（18.0%）已接种疫苗；在检测呈阴性者中，有 17825 人（32.8%）已接种疫苗。第二剂疫苗接种后 7 天以上的总体疫苗有效性为 97.1%（95%CI，96.6%至 97.5%）。辉瑞-生物科技的 BNT-162b2 疫苗的有效性为 96.2%（CI，95.5%至 96.9%），莫德纳的 mRNA-1273 疫苗的有效性为 98.2%（CI，97.5%至 98.6%）。无论年龄组、性别、种族或是否存在合并症，疫苗有效性均保持在 95%以上。
局限性
主要为男性人群；缺乏关于疾病严重程度、死亡率和与关注的 SARS-CoV-2 变体相关的有效性的数据；以及短期随访。
结论
目前用于预防 SARS-CoV-2 感染的疫苗在真实环境中对高危人群预防确诊感染非常有效。
主要资金来源
无。
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