SARS-CoV-2 Vaccine Effectiveness in a High-Risk National Population in a Real-World Setting
SARS-CoV-2 Vaccine Effectiveness in a High-Risk National Population in a Real-World Setting
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DOI：
10.7326/m21-1577
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发表时间：
2021-10-01
影响因子：
39.2
通讯作者：
Mayr, Florian B.
中科院分区：
文献类型：
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作者：
Butt, Adeel A.;Omer, Saad B.;Mayr, Florian B.
背景资料：随着针对SARS-CoV-2感染的多种疫苗的紧急使用授权，迫切需要数据来确定它们在现实世界中的有效性。目的：评估疫苗在预防SARS-CoV-2感染中的短期有效性。设计：使用条件logistic回归的测试阴性病例对照研究。设置：美国退伍军人事务部卫生保健系统。参与者：所有退伍军人在2020年12月15日至2021年3月4日期间进行了SARS-CoV-2感染检测，并且在2020年12月15日之前没有确诊感染。干预：SARS-CoV-2疫苗接种BNT-162 b2（Pfizer-BioNTech）或mRNA-1273（Moderna）疫苗作为常规临床护理的一部分。测量：疫苗接种对确诊的SARS-CoV-2感染的有效性。结果：在54360名检测呈阳性的人和54360名倾向评分匹配的对照参与者中，中位年龄为61岁，83.6%为男性，62%为白色。在检测结果为阳性的受试者中，中位体重指数为31 kg/m2，在检测结果为阴性的受试者中，中位体重指数为30 kg/m2。在检测呈阳性的人中，有9 800人（18.0%）接种过疫苗;在检测呈阴性的人中，有17 825人（32.8%）接种过疫苗。第二次接种后7天或7天以上的总体疫苗有效性为97.1%（95% CI，96.6%至97.5%）。Pfizer-BioNTech BNT-162 b2疫苗的有效性为96.2%（CI，95.5%至96.9%），Moderna mRNA-1273疫苗的有效性为98.2%（CI，97.5%至98.6%）。有效性保持在95%以上，无论年龄组，性别，种族，或存在的comorbidity.Limitations：主要是男性人群;缺乏数据的疾病严重程度，死亡率和有效性的SARS-CoV-2变异的关注;和短期follows.Conclusion：目前使用的疫苗对SARS-CoV-2感染是非常有效的预防确诊感染的高危人群在现实世界的设置。
Background: With the emergency use authorization of multiple vaccines against SARS-CoV-2 infection, data are urgently needed to determine their effectiveness in a real-world setting.Objective: To evaluate the short-term effectiveness of vaccines in preventing SARS-CoV-2 infection.Design: Test-negative case-control study using conditional logistic regression.Setting: U.S. Department of Veterans Affairs health care system.Participants: All veterans who had testing for SARS-CoV-2 infection between 15 December 2020 and 4 March 2021 and no confirmed infection before 15 December 2020.Intervention: SARS-CoV-2 vaccination with either the BNT-162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine as part of routine clinical care.Measurements: Effectiveness of vaccination against confirmed SARS-CoV-2 infection.Results: Among 54 360 persons who tested positive and 54 360 propensity score-matched control participants, the median age was 61 years, 83.6% were male, and 62% were White. Median body mass index was 31 kg/m(2) among those who tested positive and 30 kg/m(2) among those who tested negative. Among those who tested positive, 9800 (18.0%) had been vaccinated; among those who tested negative, 17 825 (32.8%) had been vaccinated. Overall vaccine effectiveness 7 or more days after the second dose was 97.1% (95% CI, 96.6% to 97.5%). Effectiveness was 96.2% (CI, 95.5% to 96.9%) for the Pfizer-BioNTech BNT-162b2 vaccine and 98.2% (CI, 97.5% to 98.6%) for the Moderna mRNA-1273 vaccine. Effectiveness remained above 95% regardless of age group, sex, race, or presence of comorbidities.Limitations: Predominantly male population; lack of data on disease severity, mortality, and effectiveness by SARSCoV-2 variants of concern; and short-term follow-up.Conclusion: Currently used vaccines against SARS-CoV-2 infection are highly effective in preventing confirmed infection in a high-risk population in a real-world setting.