Effects of Previous Infection and Vaccination on Symptomatic Omicron Infections.
Effects of Previous Infection and Vaccination on Symptomatic Omicron Infections.
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DOI：
10.1056/nejmoa2203965
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发表时间：
2022-07-07
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天然免疫、疫苗接种以及两者对症状性严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）感染omicron（B.1.1.529）变异体的BA.1或BA.2亚系的保护作用尚不清楚。我们于2021年12月23日至2022年2月21日在卡塔尔进行了一项全国性、匹配、检测阴性、病例对照研究，以评估BNT 162 b2疫苗接种的有效性。（Pfizer-BioNTech）或mRNA-1273（Moderna），由于先前感染了除omicron以外的变体而产生的天然免疫，以及针对症状性omicron感染和针对严重、危重或致命的2019冠状病毒病（Covid-19）的混合免疫（既往感染和疫苗接种）。既往单独感染对症状性BA.2感染的有效性为46.1%（95%置信区间[CI]，39.5 - 51.9）。接种两剂BNT 162 b2且既往无感染的有效性可以忽略不计（-1.1%; 95%CI，-7.1至4.6），但几乎所有人都在6个月前接种了第二剂。三个剂量的BNT 162 b2且无既往感染的有效性为52.2%（95%CI，48.1至55.9）。既往感染和2剂BNT 162 b2的有效性为55.1%（95% CI，50.9至58.9），既往感染和3剂BNT 162 b2的有效性为77.3%（95% CI，72.4至81.4）。单独的既往感染、单独的BNT 162 b2疫苗接种和混合免疫都对BA.2感染引起的严重、危重或致命的Covid-19表现出很强的有效性（>70%）。在针对BA.1感染和用mRNA-1273接种的有效性分析中观察到类似的结果。既往感染、疫苗接种和混合免疫对症状性BA.1和BA.2感染的保护作用无明显差异。接种疫苗加强了对以前感染过的人的保护。由先前感染和最近的加强疫苗接种产生的混合免疫赋予了最强的保护。（由Weill Cornell Medicine-Qatar和其他人资助。
The protection conferred by natural immunity, vaccination, and both against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with the BA.1 or BA.2 sublineages of the omicron (B.1.1.529) variant is unclear. We conducted a national, matched, test-negative, case–control study in Qatar from December 23, 2021, through February 21, 2022, to evaluate the effectiveness of vaccination with BNT162b2 (Pfizer–BioNTech) or mRNA-1273 (Moderna), natural immunity due to previous infection with variants other than omicron, and hybrid immunity (previous infection and vaccination) against symptomatic omicron infection and against severe, critical, or fatal coronavirus disease 2019 (Covid-19). The effectiveness of previous infection alone against symptomatic BA.2 infection was 46.1% (95% confidence interval [CI], 39.5 to 51.9). The effectiveness of vaccination with two doses of BNT162b2 and no previous infection was negligible (−1.1%; 95% CI, −7.1 to 4.6), but nearly all persons had received their second dose more than 6 months earlier. The effectiveness of three doses of BNT162b2 and no previous infection was 52.2% (95% CI, 48.1 to 55.9). The effectiveness of previous infection and two doses of BNT162b2 was 55.1% (95% CI, 50.9 to 58.9), and the effectiveness of previous infection and three doses of BNT162b2 was 77.3% (95% CI, 72.4 to 81.4). Previous infection alone, BNT162b2 vaccination alone, and hybrid immunity all showed strong effectiveness (>70%) against severe, critical, or fatal Covid-19 due to BA.2 infection. Similar results were observed in analyses of effectiveness against BA.1 infection and of vaccination with mRNA-1273. No discernable differences in protection against symptomatic BA.1 and BA.2 infection were seen with previous infection, vaccination, and hybrid immunity. Vaccination enhanced protection among persons who had had a previous infection. Hybrid immunity resulting from previous infection and recent booster vaccination conferred the strongest protection. (Funded by Weill Cornell Medicine–Qatar and others.)