既往感染、疫苗接种和混合免疫对有症状的 Alpha、Beta 和 Delta SARS-CoV-2 感染的影响：一项观察性研究。
Effects of previous infection, vaccination, and hybrid immunity against symptomatic Alpha, Beta, and Delta SARS-CoV-2 infections: an observational study.
机构信息
Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.
Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.
出版信息
EBioMedicine. 2023 Sep;95:104734. doi: 10.1016/j.ebiom.2023.104734. Epub 2023 Jul 27.
BACKGROUND
Protection against SARS-CoV-2 symptomatic infection and severe COVID-19 of previous infection, mRNA two-dose vaccination, mRNA three-dose vaccination, and hybrid immunity of previous infection and vaccination were investigated in Qatar for the Alpha, Beta, and Delta variants.
METHODS
Six national, matched, test-negative, case-control studies were conducted between January 18 and December 18, 2021 on a sample of 239,120 PCR-positive tests and 6,103,365 PCR-negative tests.
FINDINGS
Effectiveness of previous infection against Alpha, Beta, and Delta reinfection was 89.5% (95% CI: 85.5-92.3%), 87.9% (95% CI: 85.4-89.9%), and 90.0% (95% CI: 86.7-92.5%), respectively. Effectiveness of two-dose BNT162b2 vaccination against Alpha, Beta, and Delta infection was 90.5% (95% CI, 83.9-94.4%), 80.5% (95% CI: 79.0-82.0%), and 58.1% (95% CI: 54.6-61.3%), respectively. Effectiveness of three-dose BNT162b2 vaccination against Delta infection was 91.7% (95% CI: 87.1-94.7%). Effectiveness of hybrid immunity of previous infection and two-dose BNT162b2 vaccination was 97.4% (95% CI: 95.4-98.5%) against Beta infection and 94.5% (95% CI: 92.8-95.8%) against Delta infection. Effectiveness of previous infection and three-dose BNT162b2 vaccination was 98.1% (95% CI: 85.7-99.7%) against Delta infection. All five forms of immunity had >90% protection against severe, critical, or fatal COVID-19 regardless of variant. Similar effectiveness estimates were observed for mRNA-1273. A mathematical model accurately predicted hybrid immunity protection by assuming that the individual effects of previous infection and vaccination acted independently.
INTERPRETATION
Hybrid immunity, offering the strongest protection, was mathematically predicted by assuming that the immunities obtained from previous infection and vaccination act independently, without synergy or redundancy.
FUNDING
The Biomedical Research Program and the Biostatistics, Epidemiology, and the Biomathematics Research Core, both at Weill Cornell Medicine-Qatar, Ministry of Public Health, Hamad Medical Corporation, Sidra Medicine, Qatar Genome Programme, Qatar University Biomedical Research Center, and Qatar University Internal Grant ID QUCG-CAS-23/24-114.
背景
在卡塔尔，针对 Alpha、Beta 和 Delta 变体，研究了先前感染、mRNA 两剂接种、mRNA 三剂接种和先前感染与接种混合免疫对 SARS-CoV-2 有症状感染和严重 COVID-19 的保护作用。
方法
在 2021 年 1 月 18 日至 12 月 18 日期间，进行了六项全国性、匹配的、无对照、病例对照研究，样本为 239120 例 PCR 阳性检测和 6103365 例 PCR 阴性检测。
结果
先前感染对 Alpha、Beta 和 Delta 再感染的有效性分别为 89.5%（95%CI：85.5-92.3%）、87.9%（95%CI：85.4-89.9%）和 90.0%（95%CI：86.7-92.5%）。两剂 BNT162b2 疫苗接种对 Alpha、Beta 和 Delta 感染的有效性分别为 90.5%（95%CI，83.9-94.4%）、80.5%（95%CI：79.0-82.0%）和 58.1%（95%CI：54.6-61.3%）。三剂 BNT162b2 疫苗接种对 Delta 感染的有效性为 91.7%（95%CI：87.1-94.7%）。先前感染和两剂 BNT162b2 疫苗接种的混合免疫对 Beta 感染的有效性为 97.4%（95%CI：95.4-98.5%），对 Delta 感染的有效性为 94.5%（95%CI：92.8-95.8%）。先前感染和三剂 BNT162b2 疫苗接种对 Delta 感染的有效性为 98.1%（95%CI：85.7-99.7%）。所有五种免疫形式对严重、危急或致命 COVID-19 的保护率均超过 90%，无论变体如何。对 mRNA-1273 也观察到类似的有效性估计。一种数学模型通过假设先前感染和疫苗接种获得的免疫作用独立，而没有协同或冗余，准确预测了混合免疫的保护作用。
解释
混合免疫提供了最强的保护作用，这是通过假设先前感染和疫苗接种获得的免疫作用独立，而没有协同或冗余，从而在数学上预测的。
资金
生物医学研究计划和生物统计学、流行病学和生物数学研究核心，均隶属于卡塔尔威尔康奈尔医学院、卫生部、哈马德医疗公司、西德拉医学、卡塔尔基因组计划、卡塔尔大学生物医学研究中心和卡塔尔大学内部资助 ID QUCG-CAS-23/24-114。
Zotero 插件