ChAdOx1、CoronaVac、BNT162b2、mRNA-1273 和 Ad26.COV2.S 疫苗对 Mu、Delta 和奥密克戎变异株有症状和住院患者的有效性和保护持续时间的比较：一项病例对照研究。

Comparative effectiveness and duration of protection of ChAdOx1, CoronaVac, BNT162b2, mRNA-1273, and Ad26.COV2.S COVID-19 vaccines for symptomatic and hospitalized Mu, Delta, and Omicron: A test-negative case-control study.

机构信息

ALZAK Foundation, Cartagena, Colombia; Universidad del Sinú, Cartagena, Colombia.

Secretary of Health, Bogota, Colombia.

出版信息

Vaccine. 2023 Oct 6;41(42):6291-6299. doi: 10.1016/j.vaccine.2023.08.072. Epub 2023 Sep 9.

DOI:10.1016/j.vaccine.2023.08.072

PMID:37679278

Abstract

OBJECTIVE

We carried out a study to estimate the vaccine effectiveness (VE) of homologous vaccination schedules against COVID-19, using data from mandatory information systems from Bogota, Colombia.

METHODS

A test-negative case-control study in adults from Bogota (Colombia), between March 1st of 2021 and February 25th of 2022. We assess VE among symptomatic COVID-19 cases during the Mul, Delta, and Omicron predominance periods in Bogota, with controls matched by sex, age (±5 years), and date of testing (±7 days), using a case:control ratio of 1:1. We selected homologous vaccination schedules with ChAdOx1, CoronaVac, BNT162b2, mRNA-1273, and Ad26.COV2.S. VE was reported as one minus the odds ratio in adjusted conditional logistic regressions, with their 95% confidence intervals (CI). A p-value < 0.05 was considered statistically significant.

RESULTS

52,913 cases were matched to controls, 16,722 for Mu, 14,094 for Delta, and 22,097 for Omicron. VE was high against COVID-19 during Mu weeks with full vaccination using the monovalent BNT162b2 (VE: 69; 95% CI, 65 to 72) vaccine and ChAdOx1 (VE: 64; 95% CI, 31 to 81) and significantly lower with CoronaVac (P < 0.001) and Ad26.COV2.S (P = 0.005). During Delta, VE against COVID-19 was higher with BNT162b2 (VE: 55; 95% CI, 51 to 58). The VE for COVID-19 cases during Omicron was higher with a booster dose of monovalent BNT162b2 (VE: 45; 95% CI, 34 to 54). The VE of primary series and booster for ChAdOx1, Ad26.COV2.S, and CoronaVac did not show protection for Omicron.

CONCLUSION

Our study provides further evidence on the protective effect of mRNA vaccines for Omicron, and warrant that the duration of protection against symptomatic infection may last for only a few months.

摘要

目的

我们开展了一项研究，使用来自哥伦比亚波哥大的强制性信息系统的数据，来估计同源疫苗接种方案对 COVID-19 的疫苗效力（VE）。

方法

这是一项在 2021 年 3 月 1 日至 2022 年 2 月 25 日期间在哥伦比亚波哥大进行的成年人病例对照研究。我们评估了 COVID-19 症状病例在波哥大 Mu、Delta 和 Omicron 流行期间的 VE，对照病例通过性别、年龄（±5 岁）和检测日期（±7 天）进行匹配，病例对照比例为 1:1。我们选择了使用 ChAdOx1、CoronaVac、BNT162b2、mRNA-1273 和 Ad26.COV2.S 的同源疫苗接种方案。VE 以调整后的条件逻辑回归计算的比值比（OR）的倒数报告，并给出 95%置信区间（CI）。p 值<0.05 被认为具有统计学意义。

结果

共匹配了 52913 例病例和对照，其中 16722 例为 Mu 周，14094 例为 Delta 周，22097 例为 Omicron 周。在 Mu 周，完全接种单价 BNT162b2（VE：69；95%CI，65 至 72）和 ChAdOx1（VE：64；95%CI，31 至 81）疫苗对 COVID-19 的 VE 较高，而 CoronaVac（P<0.001）和 Ad26.COV2.S（P=0.005）的 VE 显著降低。在 Delta 周，BNT162b2 对 COVID-19 的 VE 更高（VE：55；95%CI，51 至 58）。在 Omicron 周，接种单价 BNT162b2 加强针的 COVID-19 病例的 VE 更高（VE：45；95%CI，34 至 54）。ChAdOx1、Ad26.COV2.S 和 CoronaVac 的初级系列和加强针的 VE 对 Omicron 均未显示出保护作用。