Covid-19 Vaccine Effectiveness in New York State.
Covid-19 Vaccine Effectiveness in New York State.
复制标题
DOI：
10.1056/nejmoa2116063
复制
发表时间：
2022-01-13
期刊：
影响因子：
--
通讯作者：
Zucker HA
中科院分区：
文献类型：
--
作者：
Rosenberg ES;Dorabawila V;Easton D;Bauer UE;Kumar J;Hoen R;Hoefer D;Wu M;Lutterloh E;Conroy MB;Greene D;Zucker HA
来自美国的关于美国食品和药物管理局目前授权的三种冠状病毒病2019年(新冠肺炎)疫苗有效性的人口数据有限。目前尚不清楚疗效下降是由于免疫力减弱、严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的B.1.617.2(Delta)变异，还是其他原因。我们使用纽约州8,690,825名成年人的数据来评估BNT162b2、mRNA1273和Ad26.COV2.S疫苗对实验室确认的新冠肺炎和新冠肺炎住院(即入院时或之后诊断为新冠肺炎)的有效性。我们通过连接全州测试、医院和疫苗登记数据库，将根据接种疫苗产品、年龄和完全接种的月份定义的队列与特定年龄的未接种队列进行比较。我们评估了2021年5月1日至9月3日期间对新冠肺炎的疫苗有效性，以及2021年5月1日至8月31日期间新冠肺炎的住院效果。有150,865人因新冠肺炎而住院，14,477人因新冠肺炎住院。在2021年5月1日的一周内，当Delta变异体占流通变异体的1.8%时，针对新冠肺炎的疫苗有效性中值为BNT162b2为91.3%(范围为84.1-97.0)，mRNA1273为96.9%(范围为93.7-98.0)，Ad26.COV2.S为86.6%(范围为77.8-89.7)。随后，所有队列的有效性同时下降，中位数为93.4%(范围为在5月1日的一周内)到7月10日左右的最低点73.5%(范围在13.8到90.0之间)，当时Delta变体的患病率为85.3%。到8月28日的那一周，当Delta变异的患病率为99.6%时，有效率为74.2%(范围为63.4至86.8)。在18-年龄段的成年人中，新冠肺炎对住院治疗的有效性几乎全部高于86%，没有明显的时间趋势。从5月到8月，在接受BNT162b2(从94.8%到88.6%)或mRNA-1273(从97.1%到93.7%)的65岁或65岁以上的人中，有效性下降了。Ad26.COV2.S疫苗的免疫效果低于其他疫苗，无随时间变化的趋势(范围为80.0%~90.6%)。在Delta变异变得占主导地位后，这三种疫苗对新冠肺炎的有效性下降。针对住院治疗的有效性仍然很高，温和的下降仅限于65岁或以上的BNT162b2和mRNA1273接受者。
Population-based data from the United States on the effectiveness of the three coronavirus disease 2019 (Covid-19) vaccines currently authorized by the Food and Drug Administration are limited. Whether declines in effectiveness are due to waning immunity, the B.1.617.2 (delta) variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or other causes is unknown. We used data for 8,690,825 adults in New York State to assess the effectiveness of the BNT162b2, mRNA-1273, and Ad26.COV2.S vaccines against laboratory-confirmed Covid-19 and hospitalization with Covid-19 (i.e., Covid-19 diagnosed at or after admission). We compared cohorts defined according to vaccine product received, age, and month of full vaccination with age-specific unvaccinated cohorts by linking statewide testing, hospital, and vaccine registry databases. We assessed vaccine effectiveness against Covid-19 from May 1 through September 3, 2021, and against hospitalization with Covid-19 from May 1 through August 31, 2021. There were 150,865 cases of Covid-19 and 14,477 hospitalizations with Covid-19. During the week of May 1, 2021, when the delta variant made up 1.8% of the circulating variants, the median vaccine effectiveness against Covid-19 was 91.3% (range, 84.1 to 97.0) for BNT162b2, 96.9% (range, 93.7 to 98.0) for mRNA-1273, and 86.6% (range, 77.8 to 89.7) for Ad26.COV2.S. Subsequently, effectiveness declined contemporaneously in all cohorts, from a median of 93.4% (range, 77.8 to 98.0) during the week of May 1 to a nadir of 73.5% (range, 13.8 to 90.0) around July 10, when the prevalence of the delta variant was 85.3%. By the week of August 28, when the prevalence of the delta variant was 99.6%, the effectiveness was 74.2% (range, 63.4 to 86.8). Effectiveness against hospitalization with Covid-19 among adults 18 to 64 years of age remained almost exclusively greater than 86%, with no apparent time trend. Effectiveness declined from May through August among persons 65 years of age or older who had received BNT162b2 (from 94.8 to 88.6%) or mRNA-1273 (from 97.1 to 93.7%). The effectiveness of Ad26.COV2.S was lower than that of the other vaccines, with no trend observed over time (range, 80.0 to 90.6%). The effectiveness of the three vaccines against Covid-19 declined after the delta variant became predominant. The effectiveness against hospitalization remained high, with modest declines limited to BNT162b2 and mRNA-1273 recipients 65 years of age or older.