Protection against Covid-19 by BNT162b2 Booster across Age Groups.
Protection against Covid-19 by BNT162b2 Booster across Age Groups.
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DOI：
10.1056/nejmoa2115926
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发表时间：
2021-12-23
期刊：
影响因子：
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通讯作者：
Milo R
中科院分区：
文献类型：
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作者：
Bar-On YM;Goldberg Y;Mandel M;Bodenheimer O;Freedman L;Alroy-Preis S;Ash N;Huppert A;Milo R
在对60岁及以上人群接种第三剂（加强针）BNT162b2信使核糖核酸疫苗（辉瑞 - 生物新技术公司）取得有希望的初步结果之后，以色列的加强针接种活动逐渐扩展到至少在5个月前接种了第二剂疫苗的较年轻年龄组人群。
我们从以色列卫生部数据库中提取了2021年7月30日至10月10日期间的数据，这些数据涉及4696865名16岁及以上且至少在5个月前接种了两剂BNT162b2疫苗的人。在主要分析中，我们比较了至少在12天前接种了加强针的人群（加强针组）与未接种加强针的人群（非加强针组）中确诊的2019冠状病毒病（Covid - 19）、重症和死亡的发生率。在次要分析中，我们比较了加强针组与在3至7天前接种了加强针的人群（加强针接种后早期组）的发生率。我们使用泊松回归模型在对可能的混杂因素进行调整后估计了比率。
加强针组的确诊感染率比非加强针组低约10倍（五个年龄组的范围为9.0到17.2），且比加强针接种后早期组低4.9到10.8倍。在主要分析中，调整后的比率差异为每10万人 - 天57.0到89.5例感染，在次要分析中为34.4到38.3例。在主要分析和次要分析中，60岁及以上人群中加强针组的重症发生率分别低17.9倍（95%置信区间[CI]，15.1到21.2）和6.5倍（95%CI，5.1到8.2），40到59岁人群中分别低21.7倍（95%CI，10.6到44.2）和3.7倍（95%CI，1.3到10.2）。在主要分析和次要分析中，60岁及以上人群中调整后的比率差异为每10万人 - 天5.4和1.9例重症，40到59岁人群中为0.6和0.1例。在60岁及以上人群中，主要分析中的死亡率低14.7倍（95%CI，10.0到21.4），次要分析中低4.9倍（95%CI，3.1到7.9）。在主要分析和次要分析中，调整后的比率差异为每10万人 - 天2.1和0.8例死亡。
在研究的各个年龄组中，接种BNT162b2疫苗加强针的参与者确诊Covid - 19和患重症的比率明显低于未接种者。
After promising initial results from the administration of a third (booster) dose of the BNT162b2 messenger RNA vaccine (Pfizer–BioNTech) to persons 60 years of age or older, the booster campaign in Israel was gradually expanded to persons in younger age groups who had received a second dose at least 5 months earlier. We extracted data for the period from July 30 to October 10, 2021, from the Israel Ministry of Health database regarding 4,696,865 persons 16 years of age or older who had received two doses of BNT162b2 at least 5 months earlier. In the primary analysis, we compared the rates of confirmed coronavirus disease 2019 (Covid-19), severe illness, and death among those who had received a booster dose at least 12 days earlier (booster group) with the rates among those who had not received a booster (nonbooster group). In a secondary analysis, we compared the rates in the booster group with the rates among those who had received a booster 3 to 7 days earlier (early postbooster group). We used Poisson regression models to estimate rate ratios after adjusting for possible confounding factors. The rate of confirmed infection was lower in the booster group than in the nonbooster group by a factor of approximately 10 (range across five age groups, 9.0 to 17.2) and was lower in the booster group than in the early postbooster group by a factor of 4.9 to 10.8. The adjusted rate difference ranged from 57.0 to 89.5 infections per 100,000 person-days in the primary analysis and from 34.4 to 38.3 in the secondary analysis. The rates of severe illness in the primary and secondary analyses were lower in the booster group by a factor of 17.9 (95% confidence interval [CI], 15.1 to 21.2) and 6.5 (95% CI, 5.1 to 8.2), respectively, among those 60 years of age or older and by a factor of 21.7 (95% CI, 10.6 to 44.2) and 3.7 (95% CI, 1.3 to 10.2) among those 40 to 59 years of age. The adjusted rate difference in the primary and secondary analyses was 5.4 and 1.9 cases of severe illness per 100,000 person-days among those 60 years of age or older and 0.6 and 0.1 among those 40 to 59 years of age. Among those 60 years of age or older, mortality was lower by a factor of 14.7 (95% CI, 10.0 to 21.4) in the primary analysis and 4.9 (95% CI, 3.1 to 7.9) in the secondary analysis. The adjusted rate difference in the primary and secondary analyses was 2.1 and 0.8 deaths per 100,000 person-days. Across the age groups studied, rates of confirmed Covid-19 and severe illness were substantially lower among participants who received a booster dose of the BNT162b2 vaccine than among those who did not.