Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar.
Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar.
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DOI：
10.1056/nejmoa2114114
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发表时间：
2021-12-09
期刊：
影响因子：
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通讯作者：
Abu-Raddad LJ
中科院分区：
文献类型：
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作者：
Chemaitelly H;Tang P;Hasan MR;AlMukdad S;Yassine HM;Benslimane FM;Al Khatib HA;Coyle P;Ayoub HH;Al Kanaani Z;Al Kuwari E;Jeremijenko A;Kaleeckal AH;Latif AN;Shaik RM;Abdul Rahim HF;Nasrallah GK;Al Kuwari MG;Al Romaihi HE;Butt AA;Al-Thani MH;Al Khal A;Bertollini R;Abu-Raddad LJ
疫苗对严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）感染或2019冠状病毒病（Covid-19）的保护作用减弱是一个令人担忧的问题。在卡塔尔，B.1.351（或β）和B.1.617.2（或δ）变体占主要发病率，聚合酶链反应测试是大规模进行的，因此BNT 162 b2（Pfizer-BioNTech）疫苗对感染和疾病的有效性的持久性尚不清楚。我们使用匹配的测试阴性病例对照研究设计来评估2021年1月1日至9月5日期间疫苗对任何SARS-CoV-2感染以及任何严重、危重或致命的Covid-19病例的有效性。在首次给药后的前2周内，BNT 162 b2对任何SARS-CoV-2感染的估计有效性可忽略不计。在首次给药后第3周增加至36.8%（95%置信区间[CI]，33.2 - 40.2），在第2次给药后第1个月达到峰值77.5%（95% CI，76.4 - 78.6）。此后，有效性逐渐下降，第4个月后下降加速，第2次给药后5 - 7个月达到约20%。对有症状感染者的有效性高于对无症状感染者的有效性，但同样减弱。变体特异性有效性以相同的模式减弱。到第一剂后第三周，针对任何严重、危重或致命的Covid-19病例的有效率迅速增加至66.1%（95%CI，56.8至73.5），并在第二剂后的前2个月内达到96%或更高;有效性在大约这个水平持续6个月。BNT 162 b2诱导的对SARS-CoV-2感染的保护作用在第二次给药后达到峰值后迅速减弱，但对住院和死亡的保护作用在第二次给药后持续6个月。（由Weill Cornell Medicine-Qatar和其他人资助。
Waning of vaccine protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 (Covid-19) is a concern. The persistence of BNT162b2 (Pfizer–BioNTech) vaccine effectiveness against infection and disease in Qatar, where the B.1.351 (or beta) and B.1.617.2 (or delta) variants have dominated incidence and polymerase-chain-reaction testing is done on a mass scale, is unclear. We used a matched test-negative, case–control study design to estimate vaccine effectiveness against any SARS-CoV-2 infection and against any severe, critical, or fatal case of Covid-19, from January 1 to September 5, 2021. Estimated BNT162b2 effectiveness against any SARS-CoV-2 infection was negligible in the first 2 weeks after the first dose. It increased to 36.8% (95% confidence interval [CI], 33.2 to 40.2) in the third week after the first dose and reached its peak at 77.5% (95% CI, 76.4 to 78.6) in the first month after the second dose. Effectiveness declined gradually thereafter, with the decline accelerating after the fourth month to reach approximately 20% in months 5 through 7 after the second dose. Effectiveness against symptomatic infection was higher than effectiveness against asymptomatic infection but waned similarly. Variant-specific effectiveness waned in the same pattern. Effectiveness against any severe, critical, or fatal case of Covid-19 increased rapidly to 66.1% (95% CI, 56.8 to 73.5) by the third week after the first dose and reached 96% or higher in the first 2 months after the second dose; effectiveness persisted at approximately this level for 6 months. BNT162b2-induced protection against SARS-CoV-2 infection appeared to wane rapidly following its peak after the second dose, but protection against hospitalization and death persisted at a robust level for 6 months after the second dose. (Funded by Weill Cornell Medicine–Qatar and others.)