美国成年人中mRNA新冠疫苗及混合免疫在预防SARS-CoV-2感染和有症状的新冠病毒病方面的有效性

Effectiveness of mRNA COVID-19 Vaccines and Hybrid Immunity in Preventing SARS-CoV-2 Infection and Symptomatic COVID-19 Among Adults in the United States.

作者信息

Feldstein Leora R, Ruffin Jasmine, Wiegand Ryan E, Borkowf Craig B, James-Gist Jade, Babu Tara M, Briggs-Hagen Melissa, Chappell James, Chu Helen Y, Englund Janet A, Kuntz Jennifer L, Lauring Adam S, Lo Natalie, Carone Marco, Lockwood Christina, Martin Emily T, Midgley Claire M, Monto Arnold S, Naleway Allison L, Ogilvie Tara, Saydah Sharon, Schmidt Mark A, Schmitz Jonathan E, Smith Ning, Sohn Ine, Starita Lea, Talbot H Keipp, Weil Ana A, Grijalva Carlos G

机构信息

Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington.

出版信息

J Infect Dis. 2025 Apr 15;231(4):e743-e753. doi: 10.1093/infdis/jiaf007.

DOI:10.1093/infdis/jiaf007

PMID:39774936

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11998566/

Abstract

BACKGROUND

Understanding protection against SARS-CoV-2 infection by vaccine and hybrid immunity is important for informing public health strategies as new variants emerge.

METHODS

We analyzed data from 3 cohort studies spanning 1 September 2022 to 31 July 2023 to estimate COVID-19 vaccine effectiveness (VE) against SARS-CoV-2 infection and symptomatic COVID-19 among adults with and without prior infection in the United States. Participants collected weekly nasal swabs irrespective of symptoms, participated in annual blood draws, and completed periodic surveys, which included vaccination status and infection history. Swabs were tested molecularly for SARS-CoV-2. VE was estimated by Cox proportional hazards models for the hazard ratios of infections, adjusting for covariates. VE was calculated considering prior infection and recency of vaccination.

RESULTS

Among 3344 adults, the adjusted VE of a bivalent vaccine against infection was 37.2% (95% CI, 12.3%-55.7%) within 7 to 59 days of vaccination and 21.1% (95% CI, -0.5% to 37.1%) within 60 to 179 days of vaccination when compared with participants who were unvaccinated or had received an original monovalent vaccine dose ≥180 days prior. Overall, the adjusted VE of a bivalent vaccine against infection, in conjunction with prior infection, was 62.2% (95% CI, 46.0%-74.5%) within 7 to 179 days of vaccination and 39.4% (95% CI, 12.5%-61.6%) at ≥180 days when compared with naive participants who were unvaccinated or had received a monovalent vaccine dose ≥180 days prior.

CONCLUSIONS

Adults with prior infection and recent vaccination had high protection against infection and symptomatic illness. Recent vaccination alone provided moderate protection.

摘要

背景

随着新变种出现，了解疫苗和混合免疫对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的防护作用对于制定公共卫生策略至关重要。

方法

我们分析了2022年9月1日至2023年7月31日期间3项队列研究的数据，以评估美国有或无既往感染史的成年人中，2019冠状病毒病（COVID-19）疫苗对SARS-CoV-2感染及有症状COVID-19的有效性（VE）。参与者无论有无症状，每周采集鼻拭子，每年进行血液检测，并完成定期调查，其中包括疫苗接种状况和感染史。对鼻拭子进行SARS-CoV-2分子检测。通过Cox比例风险模型估计感染风险比的VE，并对协变量进行调整。根据既往感染情况和疫苗接种时间计算VE。

结果

在3344名成年人中，与未接种疫苗或在≥180天前接种过原始单价疫苗剂量的参与者相比，二价疫苗接种后7至59天内对感染的调整后VE为37.2%（95%置信区间[CI]，12.3%-55.7%），接种后60至179天内为21.1%（95%CI，-0.5%至37.1%）。总体而言，与未接种疫苗或在≥180天前接种过单价疫苗剂量的未感染参与者相比，二价疫苗接种后7至179天内结合既往感染对感染的调整后VE为62.2%（95%CI，46.0%-74.5%），≥180天时为39.4%（95%CI，12.5%-61.6%）。