Vaccine effectiveness of one, two, and three doses of BNT162b2 and CoronaVac against COVID-19 in Hong Kong: a population-based observational study.
Vaccine effectiveness of one, two, and three doses of BNT162b2 and CoronaVac against COVID-19 in Hong Kong: a population-based observational study.
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DOI：
10.1016/s1473-3099(22)00345-0
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发表时间：
2022-10
影响因子：
56.3
通讯作者：
Cowling, Benjamin J.
中科院分区：
文献类型：
--
作者：
McMenamin, Martina E.;Nealon, Joshua;Lin, Yun;Wong, Jessica Y.;Cheung, Justin K.;Lau, Eric H. Y.;Wu, Peng;Leung, Gabriel M.;Cowling, Benjamin J.
香港一直保持SARS-CoV-2的低传播，直至2022年1月omicron（B.1.1.529）亚系BA.2开始出现重大社区流行。mRNA（BNT 162 b2 [Fosun Pharma-BioNTech]）和灭活CoronaVac（Sinovac，中国北京）疫苗均已广泛使用;然而，疫苗接种覆盖率较低，尤其是在70岁或以上的老年人中。我们的目的是评估疫苗在这一主要为初次感染人群中的有效性。在这项观察性研究中，我们使用了沿着人口普查信息和BNT 162 b2和CoronaVac的覆盖率数据，以及因COVID-19住院的患者中轻度或中度、重度或致命性和致命性疾病的个体水平病例数据。我们使用负二项模型，调整年龄，性别和日历日，以估计BNT 162 b2和CoronaVac疫苗的一剂，两剂和三剂的疫苗有效性，以及剂量和疫苗类型的相对有效性。在2020年12月31日至2022年3月16日期间，香港740万人口接种了1320万剂疫苗。我们分析了确诊的轻度或中度（n=5566）、重度或致命（n=8875）和致命（n=6866）COVID-19病例的数据。两剂疫苗均可在阳性检测后28天内预防严重疾病和死亡，与CoronaVac（69.9%[64.4 - 74.6]）相比，BNT 162 b2（疫苗有效性89.3%[95%CI 86.6 - 91.6]）在60岁或以上成人中的有效性更高。任一疫苗接种3剂均可提供极高水平的保护，防止严重或致命性结局（97.9%[97.3 - 98.4]）。第三剂BNT 162 b2或CoronaVac可提供针对严重COVID-19的实质性额外保护，应优先考虑，特别是在60岁以上的老年人和接受CoronaVac主要方案的高风险人群中。需要更长时间的随访，以评估不同疫苗平台和时间表的保护持续时间。中国疾病预防控制中心新型冠状病毒疫苗评价项目。
Hong Kong maintained low circulation of SARS-CoV-2 until a major community epidemic of the omicron (B.1.1.529) sublineage BA.2 began in January, 2022. Both mRNA (BNT162b2 [Fosun Pharma-BioNTech]) and inactivated CoronaVac (Sinovac, Beijing, China) vaccines are widely available; however, vaccination coverage has been low, particularly in older adults aged 70 years or older. We aimed to assess vaccine effectiveness in this predominantly infection-naive population. In this observational study, we used individual-level case data on mild or moderate, severe or fatal, and fatal disease in patients hospitalised with COVID-19 along with census information and coverage data of BNT162b2 and CoronaVac. We used a negative binomial model, adjusting for age, sex, and calendar day to estimate vaccine effectiveness of one, two, and three doses of both BNT162b2 and CoronaVac vaccines, and relative effectiveness by number of doses and vaccine type. Between Dec 31, 2020, and March 16, 2022, 13·2 million vaccine doses were administered in Hong Kong's 7·4-million population. We analysed data from confirmed cases with mild or moderate (n=5566), severe or fatal (n=8875), and fatal (n=6866) COVID-19. Two doses of either vaccine protected against severe disease and death within 28 days of a positive test, with higher effectiveness among adults aged 60 years or older with BNT162b2 (vaccine effectiveness 89·3% [95% CI 86·6–91·6]) compared with CoronaVac (69·9% [64·4–74·6]). Three doses of either vaccine offered very high levels of protection against severe or fatal outcomes (97·9% [97·3–98·4]). Third doses of either BNT162b2 or CoronaVac provide substantial additional protection against severe COVID-19 and should be prioritised, particularly in older adults older than 60 years and others in high-risk populations who received CoronaVac primary schedules. Longer follow-up is needed to assess duration of protection across different vaccine platforms and schedules. COVID-19 Vaccines Evaluation Program, Chinese Center for Disease Control and Prevention.