2023 - 2024年更新的（单价XBB.1.5）新冠疫苗针对SARS-CoV-2奥密克戎XBB和BA.2.86/JN.1谱系预防住院的有效性及临床严重程度比较 - IVY网络，26家医院，2023年10月18日 - 2024年3月9日

Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccination Against SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 Lineage Hospitalization and a Comparison of Clinical Severity-IVY Network, 26 Hospitals, October 18, 2023-March 9, 2024.

作者信息

Ma Kevin C, Surie Diya, Lauring Adam S, Martin Emily T, Leis Aleda M, Papalambros Leigh, Gaglani Manjusha, Columbus Christie, Gottlieb Robert L, Ghamande Shekhar, Peltan Ithan D, Brown Samuel M, Ginde Adit A, Mohr Nicholas M, Gibbs Kevin W, Hager David N, Saeed Safa, Prekker Matthew E, Gong Michelle Ng, Mohamed Amira, Johnson Nicholas J, Srinivasan Vasisht, Steingrub Jay S, Khan Akram, Hough Catherine L, Duggal Abhijit, Wilson Jennifer G, Qadir Nida, Chang Steven Y, Mallow Christopher, Kwon Jennie H, Parikh Bijal, Exline Matthew C, Vaughn Ivana A, Ramesh Mayur, Safdar Basmah, Mosier Jarrod, Harris Estelle S, Shapiro Nathan I, Felzer Jamie, Zhu Yuwei, Grijalva Carlos G, Halasa Natasha, Chappell James D, Womack Kelsey N, Rhoads Jillian P, Baughman Adrienne, Swan Sydney A, Johnson Cassandra A, Rice Todd W, Casey Jonathan D, Blair Paul W, Han Jin H, Ellington Sascha, Lewis Nathaniel M, Thornburg Natalie, Paden Clinton R, Atherton Lydia J, Self Wesley H, Dawood Fatimah S, DeCuir Jennifer

机构信息

Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.

University of Michigan, Ann Arbor, Michigan, USA.

出版信息

Clin Infect Dis. 2024 Aug 6. doi: 10.1093/cid/ciae405.

DOI:10.1093/cid/ciae405

PMID:39107255

Abstract

BACKGROUND

Assessing variant-specific COVID-19 vaccine effectiveness (VE) and severity can inform public health risk assessments and decisions about vaccine composition. BA.2.86 and its descendants, including JN.1 (referred to collectively as "JN lineages"), emerged in late 2023 and exhibited substantial divergence from co-circulating XBB lineages.

METHODS

We analyzed patients hospitalized with COVID-19-like illness at 26 hospitals in 20 U.S. states admitted October 18, 2023-March 9, 2024. Using a test-negative, case-control design, we estimated effectiveness of an updated 2023-2024 (Monovalent XBB.1.5) COVID-19 vaccine dose against sequence-confirmed XBB and JN lineage hospitalization using logistic regression. Odds of severe outcomes, including intensive care unit (ICU) admission and invasive mechanical ventilation (IMV) or death, were compared for JN versus XBB lineage hospitalizations using logistic regression.

RESULTS

585 case-patients with XBB lineages, 397 case-patients with JN lineages, and 4,580 control-patients were included. VE in the first 7-89 days after receipt of an updated dose was 54.2% (95% CI = 36.1%-67.1%) against XBB lineage hospitalization and 32.7% (95% CI = 1.9%-53.8%) against JN lineage hospitalization. Odds of ICU admission (adjusted odds ratio [aOR] 0.80; 95% CI = 0.46-1.38) and IMV or death (aOR 0.69; 95% CI = 0.34-1.40) were not significantly different among JN compared to XBB lineage hospitalizations.

CONCLUSIONS

Updated 2023-2024 COVID-19 vaccination provided protection against both XBB and JN lineage hospitalization, but protection against the latter may be attenuated by immune escape. Clinical severity of JN lineage hospitalizations was not higher relative to XBB.

摘要

背景

评估特定变异株的新冠疫苗有效性（VE）和严重程度可为公共卫生风险评估及疫苗成分决策提供依据。BA.2.86及其后代，包括JN.1（统称为“JN谱系”）于2023年末出现，并与共同流行的XBB谱系表现出显著差异。

方法

我们分析了2023年10月18日至2024年3月9日期间美国20个州26家医院收治的类似新冠疾病住院患者。采用检测阴性的病例对照设计，我们使用逻辑回归估计了2023 - 2024年更新的（单价XBB.1.5）新冠疫苗剂量针对序列确认的XBB和JN谱系住院的有效性。使用逻辑回归比较了JN谱系与XBB谱系住院患者发生严重结局的几率，包括重症监护病房（ICU）入院、有创机械通气（IMV）或死亡。

结果

纳入了585例XBB谱系病例患者、397例JN谱系病例患者和4580例对照患者。接种更新剂量后最初7 - 89天内，针对XBB谱系住院的疫苗有效性为54.2%（95%置信区间 = 36.1% - 67.1%），针对JN谱系住院的疫苗有效性为32.7%（95%置信区间 = 1.9% - 53.8%）。与XBB谱系住院患者相比，JN谱系住院患者的ICU入院几率（调整后的优势比[aOR] 0.80；95%置信区间 = 0.46 - 1.38）以及IMV或死亡几率（aOR 0.69；95%置信区间 = 0.34 - 1.40）无显著差异。