Post-vaccination SARS-CoV-2 infection: risk factors and illness profile in a prospective, observational community-based case-control study
Post-vaccination SARS-CoV-2 infection: risk factors and illness profile in a prospective, observational community-based case-control study
复制标题
疫苗接种后 SARS-CoV-2 感染：基于社区的前瞻性、观察性病例对照研究中的危险因素和疾病概况
DOI：
10.1101/2021.05.24.21257738
复制
发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Antonelli M
中科院分区：
文献类型：
--
作者：
Antonelli M
背景COVID-19疫苗在临床试验和真实世界数据中显示出出色的疗效，但尽管接种了疫苗，仍有一些人感染了SARS-CoV-2。本研究旨在确定与SARS-CoV-2疫苗接种后感染相关的风险因素，并描述疫苗接种后疾病的特征。MethodsAmong 1，102，192名来自COVID症状研究的接种疫苗的英国成年人，2394例（0.2%）疫苗接种后SARS-CoV-2感染病例在2020年12月8日至2021年5月1日期间被确定。使用一组检测为阴性的接种疫苗的个体作为对照组，我们评估了年龄、虚弱、合并症、区域水平的剥夺和生活方式因素与感染的相关性。使用第二个未接种疫苗病例对照组评估了疫苗接种后的疾病特征。发现虚弱的老年人（OR=2.78，95%CI =[1.98-3.89]，p值<0.0001）和生活在最贫困地区的个人（OR=1.22与中间组相比，CI[1.04-1.43]，p值=0.01）疫苗接种后感染的几率增加。没有肥胖的个体（OR=0.6，CI[0.44-0.82]，p值=0.001）和报告健康饮食的个体（OR=0.73，CI[0.62-0.86]，p值<0.0001）的风险较低。接种疫苗与住院几率降低（OR=0.36，CI[0.28-0.46]，p值<0.0001）和急性症状负担高（OR=0.51，CI[0.42-0.61]，p值<0.0001）相关。在老年人中，接种疫苗后≥28天患病的风险较低（OR=0.72，CI[0.51-1.00]，p值=0.05）。与阳性未接种疫苗的个体相比，阳性接种疫苗的个体报告的症状较少，除了打喷嚏，打喷嚏在接种疫苗后更常见（OR=1.24，CI[1.05-1.46]，p值=0.01）。我们还发现，接种疫苗后感染者的症状负担和持续时间减少。努力提高疫苗在高危人群中的有效性，并采取有针对性的感染控制措施，基金这项工作是由英国卫生部通过国家卫生研究所（NIHR）综合生物医学研究中心（BRC）奖给盖伊的支持，圣托马斯NHS基金会信托基金与伦敦国王学院和国王学院医院NHS基金会信托基金合作，并通过向ZOE Global提供赠款;英国伦敦国王学院的威康工程和物理科学研究理事会（EPSRC）医学工程中心（WT 203148/Z/16/Z）。研究人员还得到了慢性病研究基金会、医学研究理事会（MRC）、英国心脏基金会、英国研究与创新伦敦医学成像和人工智能中心的支持，（WT 213038/Z/18/Z和阿尔茨海默氏病协会（AS-JF-17-011），和马萨诸塞州病原体准备联盟（MassCPR）为了确定疫苗接种后SARS-CoV-2感染的风险因素和特征的现有证据，我们在PubMed中检索了2020年12月1日至5月18日期间发表的同行评议文章，使用关键词（“COVID-19”或“SARS-CoV-2”）AND（“Vaccine”或“vaccination”）AND（“infection”）AND（“risk factor*”或“characteristic*”），对2021年的2021年的2021年的2021年流行病学进行了分析。我们没有限制我们的搜索语言或出版物的类型。在识别的202篇文章中，我们没有发现关于接种疫苗后COVID-19感染的个体风险和保护因素的原始研究，也没有发现关于接种疫苗后，社区人群中症状的性质和持续时间的原始研究。
BackgroundCOVID-19 vaccines show excellent efficacy in clinical trials and real-world data, but some people still contract SARS-CoV-2 despite vaccination. This study sought to identify risk factors associated with SARS-CoV-2 infection post-vaccination and describe characteristics of post-vaccination illness.MethodsAmongst 1,102,192 vaccinated UK adults from the COVID Symptom Study, 2394 (0.2%) cases of post-vaccination SARS-CoV-2 infection were identified between 8th December 2020 and 1st May 2021. Using a control group of vaccinated individuals testing negative, we assessed the associations of age, frailty, comorbidity, area-level deprivation and lifestyle factors with infection. Illness profile post-vaccination was assessed using a second control group of unvaccinated cases.FindingsOlder adults with frailty (OR=2.78, 95% CI=[1.98-3.89], p-value<0.0001) and individuals living in most deprived areas (OR=1.22 vs. intermediate group, CI[1.04-1.43], p-value=0.01) had increased odds of post-vaccination infection. Risk was lower in individuals without obesity (OR=0.6, CI[0.44-0.82], p-value=0.001) and those reporting healthier diet (OR=0.73, CI[0.62-0.86], p-value<0.0001). Vaccination was associated with reduced odds of hospitalisation (OR=0.36, CI[0.28-0.46], p-value<0.0001), and high acute-symptom burden (OR=0.51, CI[0.42-0.61], p-value<0.0001). In older adults, risk of ≥28 days illness was lower following vaccination (OR=0.72, CI[0.51-1.00], p-value=0.05). Symptoms were reported less in positive-vaccinated vs. positive-unvaccinated individuals, except sneezing, which was more common post-vaccination (OR=1.24, CI[1.05-1.46], p-value=0.01).InterpretationOur findings suggest that older individuals with frailty and those living in most deprived areas are at increased risk of infection post-vaccination. We also showed reduced symptom burden and duration in those infected post-vaccination. Efforts to boost vaccine effectiveness in at-risk populations, and to targeted infection control measures, may still be appropriate to minimise SARS-CoV-2 infection.FundingThis work is supported by UK Department of Health via the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre (BRC) award to Guy’s & St Thomas’ NHS Foundation Trust in partnership with King’s College London and King’s College Hospital NHS Foundation Trust and via a grant to ZOE Global; the Wellcome Engineering and Physical Sciences Research Council (EPSRC) Centre for Medical Engineering at King’s College London (WT 203148/Z/16/Z). Investigators also received support from the Chronic Disease Research Foundation, the Medical Research Council (MRC), British Heart Foundation, the UK Research and Innovation London Medical Imaging & Artificial Intelligence Centre for Value Based Healthcare, the Wellcome Flagship Programme (WT213038/Z/18/Z and Alzheimer’s Society (AS-JF-17-011), and the Massachusetts Consortium on Pathogen Readiness (MassCPR).Research in contextEvidence before this studyTo identify existing evidence for risk factors and characteristics of SARS-CoV-2 infection post-vaccination, we searched PubMed for peer-reviewed articles published between December 1, 2020 and May 18, 2021 using keywords (“COVID-19” OR “SARS-CoV-2”) AND (“Vaccine” OR “vaccination”) AND (“infection”) AND (“risk factor*” OR “characteristic*”). We did not restrict our search by language or type of publication. Of 202 articles identified, we found no original studies on individual risk and protective factors for COVID-19 infection following vaccination nor on nature and duration of symptoms in vaccinated, community …
登录
查看更多内容
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
COVID-19 死亡率和长期护理：英国比较
DOI：
--
发表时间：
2020
期刊：
--
影响因子：
--
作者：
David Bell
通讯作者：
David Bell
影响因子：
13.2
作者：
Krueger, Karen M.;Ison, Michael G.;Ghossein, Cybele
通讯作者：
Ghossein, Cybele
DOI：
10.1001/jama.2020.6775
发表时间：
2020-01-01
期刊：
JAMA, Journal of the American Medical Association
影响因子：
--
作者：
Richardson, Safiya;Hirsch, Jamie S.;,
通讯作者：
,
PRISMA-7：一种病例发现工具，用于识别患有中度至重度残疾的老年人。
DOI：
--
发表时间：
2008
期刊：
Archives of gerontology and geriatrics (Print)
影响因子：
--
作者：
Michel Raîche;R. Hébert;M. Dubois
通讯作者：
M. Dubois