Risk of COVID-19 after natural infection or vaccination.
Risk of COVID-19 after natural infection or vaccination.
复制标题
DOI：
10.1016/j.ebiom.2023.104799
复制
发表时间：
2023-10
期刊：
影响因子：
11.1
通讯作者：
中科院分区：
文献类型：
--
作者：
虽然疫苗已经确立了针对COVID-19的效用，但三期疗效研究通常没有全面评估以前感染或混合免疫（以前感染加疫苗接种）提供的保护。来自美国政府支持的统一疫苗试验的个体患者数据为解决这一问题提供了前所未有的样本人群。我们通过3 - 6个月的随访，描述了之前的SARS-CoV-2感染和混合免疫在大流行早期对COVID-19的保护效果，并与疫苗相关的保护进行了比较。在对Moderna、AstraZeneca、Janssen和Novavax COVID-19疫苗临床试验的事后交叉方案分析中，我们根据入组和治疗时的既往感染状况将参与者分为四组：无既往感染/安慰剂；以前感染/安慰剂;既往无感染/未接种疫苗；以及以前的感染/疫苗。主要结局是最终研究注射后7-15天（按原始方案）rt - pcr确诊的COVID-19。我们计算了粗略的并调整了疗效指标。先前感染/安慰剂的参与者与之前没有感染/安慰剂的参与者相比，未来感染COVID-19的风险降低了92%（总风险比[HR]: 0.08; 95% CI: 0.05-0.13）。在单剂量Janssen参与者中，混合免疫比单独接种疫苗提供更大的保护（HR: 0.03; 95% CI: 0.01-0.10）。在其他试验中，观察到的感染太少，无法对混合免疫与单独接种疫苗进行统计推断。疫苗接种、先前感染和混合免疫都提供了几乎完全的预防严重疾病的保护。以前的感染、任何混合免疫和两剂疫苗接种都在早期德尔塔时期对有症状和严重的COVID-19提供了实质性的保护。因此，作为自然感染的替代品，疫苗接种仍然是最安全的保护方法。
While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. .
登录
查看更多内容
影响因子：
56.3
作者：
Hardt, Karin;Vandebosch, An;Sadoff, Jerald;Le Gars, Mathieu;Truyers, Carla;Lowson, David;Van Dromme, Ilse;Vingerhoets, Johan;Kamphuis, Tobias;Scheper, Gert;Ruiz-Guinazu, Javier;Faust, Saul N.;Spinner, Christoph D.;Schuitemaker, Hanneke;Van Hoof, Johan;Douoguih, Macaya;Struyf, Frank
通讯作者：
Struyf, Frank
DOI：
10.1056/nejmoa2105290
发表时间：
2021-12-16
期刊：
The New England journal of medicine
影响因子：
--
作者：
Falsey AR;Sobieszczyk ME;Hirsch I;Sproule S;Robb ML;Corey L;Neuzil KM;Hahn W;Hunt J;Mulligan MJ;McEvoy C;DeJesus E;Hassman M;Little SJ;Pahud BA;Durbin A;Pickrell P;Daar ES;Bush L;Solis J;Carr QO;Oyedele T;Buchbinder S;Cowden J;Vargas SL;Guerreros Benavides A;Call R;Keefer MC;Kirkpatrick BD;Pullman J;Tong T;Brewinski Isaacs M;Benkeser D;Janes HE;Nason MC;Green JA;Kelly EJ;Maaske J;Mueller N;Shoemaker K;Takas T;Marshall RP;Pangalos MN;Villafana T;Gonzalez-Lopez A;AstraZeneca AZD1222 Clinical Study Group
通讯作者：
AstraZeneca AZD1222 Clinical Study Group
影响因子：
2
作者：
Fintzi, Jonathan;Follmann, Dean
通讯作者：
Follmann, Dean
影响因子：
105.7
作者：
Greenland, Sander;Mansournia, Mohammad Ali;Altman, Douglas G.
通讯作者：
Altman, Douglas G.
DOI：
10.1056/nejmoa2035389
发表时间：
2021-02-04
期刊：
The New England journal of medicine
影响因子：
--
作者：
Baden LR;El Sahly HM;Essink B;Kotloff K;Frey S;Novak R;Diemert D;Spector SA;Rouphael N;Creech CB;McGettigan J;Khetan S;Segall N;Solis J;Brosz A;Fierro C;Schwartz H;Neuzil K;Corey L;Gilbert P;Janes H;Follmann D;Marovich M;Mascola J;Polakowski L;Ledgerwood J;Graham BS;Bennett H;Pajon R;Knightly C;Leav B;Deng W;Zhou H;Han S;Ivarsson M;Miller J;Zaks T;COVE Study Group
通讯作者：
COVE Study Group