Effectiveness of SARS-CoV-2 Vaccination in a Veterans Affairs Cohort of Patients With Inflammatory Bowel Disease With Diverse Exposure to Immunosuppressive Medications.
Effectiveness of SARS-CoV-2 Vaccination in a Veterans Affairs Cohort of Patients With Inflammatory Bowel Disease With Diverse Exposure to Immunosuppressive Medications.
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DOI：
10.1053/j.gastro.2021.05.044
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发表时间：
2021-09
期刊：
影响因子：
29.4
通讯作者：
Mahmud N
中科院分区：
文献类型：
--
作者：
Khan N;Mahmud N
针对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的疫苗接种迅速扩大；然而，临床试验排除了服用免疫抑制药物的患者，如炎症性肠病(IBD)患者。因此，我们探索了冠状病毒病2019年(新冠肺炎)疫苗接种对不同免疫抑制药物暴露的IBD患者后续感染的实际效果。这是一项对退伍军人健康管理局在2020年12月18日之前诊断为IBD的患者进行的回顾性队列研究，这一天是退伍军人健康管理局患者疫苗接种计划的开始日期。IBD的药物暴露包括美沙拉明、硫嘌呤、抗肿瘤坏死因子生物制剂、vedolizumab、ustekinumab、tofacitinib、甲氨蝶呤和皮质类固醇的使用。我们使用逆概率加权和与接种状态的Cox回归作为时间更新暴露，并根据发病率计算疫苗效果。队列包括14,697名患者，其中7321名患者接受了至少1剂疫苗(45.2%辉瑞，54.8%莫德纳)。该队列的平均年龄为68岁，其中92.2%为男性，80.4%为白人，61.8%患有溃疡性结肠炎。在截至2021年4月20日的跟踪数据中，未接种疫苗的人感染SARS-CoV-2的原始比例最高(197[1.34%]比7[0.11%]完全接种)。完全接种状态，而不是部分接种状态，与未接种状态相比，感染风险降低69%(风险比，0.31，95%可信区间0.17-0.56；P<；.001)，相当于80.4%的有效率。针对SARS-CoV-2感染的全面疫苗接种(第二次接种后7天)在不同免疫抑制药物暴露的广泛IBD队列中具有∼80.4%的有效性。这些结果可能有助于提高患者和提供者在这些环境下进行疫苗接种的意愿。
Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly expanded; however, clinical trials excluded patients taking immunosuppressive medications such as those with inflammatory bowel disease (IBD). Therefore, we explored real-world effectiveness of coronavirus disease 2019 (COVID-19) vaccination on subsequent infection in patients with IBD with diverse exposure to immunosuppressive medications. This was a retrospective cohort study of patients in the Veterans Health Administration with IBD diagnosed before December 18, 2020, the start date of the Veterans Health Administration patient vaccination program. IBD medication exposures included mesalamine, thiopurines, anti-tumor necrosis factor biologic agents, vedolizumab, ustekinumab, tofacitinib, methotrexate, and corticosteroid use. We used inverse probability weighting and Cox’s regression with vaccination status as a time-updating exposure and computed vaccine effectiveness from incidence rates. The cohort comprised 14,697 patients, 7321 of whom received at least 1 vaccine dose (45.2% Pfizer, 54.8% Moderna). The cohort had median age 68 years, 92.2% were men, 80.4% were White, and 61.8% had ulcerative colitis. In follow-up data through April 20, 2021, unvaccinated individuals had the highest raw proportion of SARS-CoV-2 infection (197 [1.34%] vs 7 [0.11%] fully vaccinated). Full vaccination status, but not partial vaccination status, was associated with a 69% reduced hazard of infection relative to an unvaccinated status (hazard ratio, 0.31, 95% confidence interval, 0.17–0.56; P < .001), corresponding to an 80.4% effectiveness. Full vaccination (> 7 days after the second dose) against SARS-CoV-2 infection has an ∼80.4% effectiveness in a broad IBD cohort with diverse exposure to immunosuppressive medications. These results may serve to increase patient and provider willingness to pursue vaccination in these settings.
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BNT162B2 mRNA COVID-19疫苗的安全性和功效。
DOI：
10.1056/nejmoa2034577
发表时间：
2020-12-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Polack FP;Thomas SJ;Kitchin N;Absalon J;Gurtman A;Lockhart S;Perez JL;Pérez Marc G;Moreira ED;Zerbini C;Bailey R;Swanson KA;Roychoudhury S;Koury K;Li P;Kalina WV;Cooper D;Frenck RW Jr;Hammitt LL;Türeci Ö;Nell H;Schaefer A;Ünal S;Tresnan DB;Mather S;Dormitzer PR;Şahin U;Jansen KU;Gruber WC;C4591001 Clinical Trial Group
通讯作者：
C4591001 Clinical Trial Group
影响因子：
29.4
作者：
Wong SY;Dixon R;Martinez Pazos V;Gnjatic S;Colombel JF;Cadwell K;ICARUS-IBD Working Group
通讯作者：
ICARUS-IBD Working Group
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
影响因子：
2
作者：
Austin, Peter C.
通讯作者：
Austin, Peter C.
影响因子：
3.7
作者：
Jones, Mark;Fowler, Robert
通讯作者：
Fowler, Robert