Effectiveness estimates of three COVID-19 vaccines based on observational data from Puerto Rico.
Effectiveness estimates of three COVID-19 vaccines based on observational data from Puerto Rico.
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DOI：
10.1016/j.lana.2022.100212
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发表时间：
2022-05
期刊：
影响因子：
--
通讯作者：
Irizarry RA
中科院分区：
文献类型：
--
作者：
Robles-Fontán MM;Nieves EG;Cardona-Gerena I;Irizarry RA
2021年7月15日，随着58%的人口完全接种疫苗，波多黎各开始出现COVID-19激增。2021年7月22日，波多黎各政府开始实施一系列严格的疫苗强制规定。两个月后，超过70%的人口接种了疫苗，超过美国任何一个州，实验室确认的SARS-CoV-2大幅下降。强制执行任务的决定以及卫生部目前关于助推器的建议，都是以这里提供的数据和有效性估计为指导的。从2020年12月15日波多黎各开始接种疫苗到2021年10月15日，共有2，276，966人接种了COVID-19疫苗。在此期间，报告了112，726例实验室确认的SARS-CoV-2感染。这些数据使我们能够量化免疫活动的结果，并比较mRNA-1273（Moderna），BNT 162 b2（Pfizer）和Ad26.COV2.S（J&J）疫苗的有效性。我们从卫生署获得了疫苗接种情况、SARS-CoV-2检测结果以及COVID-19住院和死亡人数。我们拟合了统计模型，调整了随时间变化的发病率和年龄组，以估计自接种疫苗以来，针对实验室确认的SARS-CoV-2感染以及COVID-19住院和死亡的疫苗有效性。最终剂量后两周，mRNA-1273、BNT 162 b2和Ad26.COV2.S疫苗分别具有90%（95%CI：88-91）、87%（85-88）和64%（58-69）的有效性。五个月后，有效性分别下降到约70%，50%和40%。我们没有发现证据表明，在Delta变异成为主导后，有效性有所不同。对于那些感染者来说，疫苗为所有年龄组的COVID-19住院和死亡提供了进一步的保护，这种条件效应并没有及时减弱。mRNA-1273和BNT 162 b2疫苗在所有年龄组中均高度有效。尽管对SARS-CoV-2感染的保护作用减弱，但五个月后它们仍然有效。Ad26.COV2.S疫苗是有效的，但与mRNA疫苗相比程度较低。尽管在感染的条件下，对不良后果的保护并没有减弱，但随着时间的推移，有效性的减弱导致对严重COVID-19后果的保护下降。RAI的工作部分由NIH Grant R35 GM 131802资助。
On July 15, 2021, with 58% of the population fully vaccinated, the start of a COVID-19 surge was observed in Puerto Rico. On July 22, 2021, the government of Puerto Rico started imposing a series of strict vaccine mandates. Two months later, over 70% of the population was vaccinated, more than in any US state, and laboratory-confirmed SARS-CoV-2 had dropped substantially. The decision to impose mandates, as well as current Department of Health recommendations related to boosters, were guided by the data and the effectiveness estimates presented here. Between December 15, 2020, when the vaccination process began in Puerto Rico, and October 15, 2021, 2,276,966 individuals were fully vaccinated against COVID-19. During this period 112,726 laboratory-confirmed SARS-CoV-2 infections were reported. These data permitted us to quantify the outcomes of the immunization campaign and to compare effectiveness of the mRNA-1273 (Moderna), BNT162b2 (Pfizer), and Ad26.COV2.S (J&J) vaccines. We obtained vaccination status, SARS-CoV-2 test results, and COVID-19 hospitalizations and deaths, from the Department of Health. We fit statistical models that adjusted for time-varying incidence rates and age group to estimate vaccine effectiveness, since the time of vaccination, against lab-confirmed SARS-CoV-2 infection, and COVID-19 hospitalization and death. Two weeks after final dose, the mRNA-1273, BNT162b2, and Ad26.COV2.S vaccines had an effectiveness of 90% (95% CI: 88–91), 87% (85–88), and, 64% (58–69), respectively. After five months, effectiveness waned to about 70%, 50%, and 40%, respectively. We found no evidence that effectiveness was different after the Delta variant became dominant. For those infected, the vaccines provided further protection against COVID-19 hospitalization and deaths across all age groups, and this conditional effect did not wane in time. The mRNA-1273 and BNT162b2 vaccines were highly effective across all age groups. They were still effective after five months although the protection against SARS-CoV-2 infection waned. The Ad26.COV2.S vaccine was effective but to a lesser degree compared to the mRNA vaccines. Although, conditional on infection, protection against adverse outcomes did not wane, the waning in effectiveness resulted in a decreased protection against serious COVID-19 outcomes across time. RAI's work was partly funded by NIH Grant R35GM131802.
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影响因子：
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10.1056/nejmoa2110362
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2021-10-07
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The New England journal of medicine
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