mRNA 疫苗接种在预防 COVID-19 相关有创机械通气和死亡方面的有效性-美国，2021 年 3 月-2022 年 1 月。
Effectiveness of mRNA Vaccination in Preventing COVID-19-Associated Invasive Mechanical Ventilation and Death - United States, March 2021-January 2022.
出版信息
MMWR Morb Mortal Wkly Rep. 2022 Mar 25;71(12):459-465. doi: 10.15585/mmwr.mm7112e1.
COVID-19 mRNA vaccines (BNT162b2 [Pfizer-BioNTech] and mRNA-1273 [Moderna]) are effective at preventing COVID-19-associated hospitalization (1-3). However, how well mRNA vaccines protect against the most severe outcomes of these hospitalizations, including invasive mechanical ventilation (IMV) or death is uncertain. Using a case-control design, mRNA vaccine effectiveness (VE) against COVID-19-associated IMV and in-hospital death was evaluated among adults aged ≥18 years hospitalized at 21 U.S. medical centers during March 11, 2021-January 24, 2022. During this period, the most commonly circulating variants of SARS-CoV-2, the virus that causes COVID-19, were B.1.1.7 (Alpha), B.1.617.2 (Delta), and B.1.1.529 (Omicron). Previous vaccination (2 or 3 versus 0 vaccine doses before illness onset) in prospectively enrolled COVID-19 case-patients who received IMV or died within 28 days of hospitalization was compared with that among hospitalized control patients without COVID-19. Among 1,440 COVID-19 case-patients who received IMV or died, 307 (21%) had received 2 or 3 vaccine doses before illness onset. Among 6,104 control-patients, 4,020 (66%) had received 2 or 3 vaccine doses. Among the 1,440 case-patients who received IMV or died, those who were vaccinated were older (median age = 69 years), more likely to be immunocompromised* (40%), and had more chronic medical conditions compared with unvaccinated case-patients (median age = 55 years; immunocompromised = 10%; p<0.001 for both). VE against IMV or in-hospital death was 90% (95% CI = 88%-91%) overall, including 88% (95% CI = 86%-90%) for 2 doses and 94% (95% CI = 91%-96%) for 3 doses, and 94% (95% CI = 88%-97%) for 3 doses during the Omicron-predominant period. COVID-19 mRNA vaccines are highly effective in preventing COVID-19-associated death and respiratory failure treated with IMV. CDC recommends that all persons eligible for vaccination get vaccinated and stay up to date with COVID-19 vaccination (4).
COVID-19 mRNA 疫苗（BNT162b2[辉瑞-生物科技]和 mRNA-1273[莫德纳]）在预防 COVID-19 相关住院方面非常有效（1-3）。然而，mRNA 疫苗在预防这些住院最严重的结果方面的效果如何，包括有创机械通气（IMV）或死亡，尚不清楚。本研究使用病例对照设计，评估了在 2021 年 3 月 11 日至 2022 年 1 月 24 日期间，在美国 21 家医疗中心住院的年龄≥18 岁的成年人中，mRNA 疫苗对 COVID-19 相关 IMV 和住院内死亡的有效性。在此期间，引起 COVID-19 的 SARS-CoV-2 病毒的最常见循环变体为 B.1.1.7（阿尔法）、B.1.617.2（德尔塔）和 B.1.1.529（奥密克戎）。在前瞻性纳入的接受 IMV 或在住院后 28 天内死亡的 COVID-19 病例患者中，比较了发病前接受过 2 或 3 剂疫苗接种的患者与未感染 COVID-19 的住院对照患者的情况。在 1440 例接受 IMV 或死亡的 COVID-19 病例患者中，有 307 例（21%）在发病前接受了 2 或 3 剂疫苗接种。在 6104 例对照患者中，有 4020 例（66%）接受了 2 或 3 剂疫苗接种。在 1440 例接受 IMV 或死亡的病例患者中，接种疫苗的患者年龄较大（中位数年龄=69 岁），免疫功能低下的可能性更高（40%），与未接种疫苗的病例患者相比，合并更多的慢性疾病（中位数年龄=55 岁；免疫功能低下=10%；均<0.001）。总体而言，mRNA 疫苗对 IMV 或住院内死亡的有效性为 90%（95%CI=88%-91%），包括 2 剂的 88%（95%CI=86%-90%）和 3 剂的 94%（95%CI=91%-96%），在奥密克戎流行期间为 3 剂的 94%（95%CI=88%-97%）。COVID-19 mRNA 疫苗在预防 COVID-19 相关死亡和需要 IMV 治疗的呼吸衰竭方面非常有效。CDC 建议所有符合条件的人都应接种疫苗并及时更新 COVID-19 疫苗接种（4）。
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