Interim findings from first-dose mass COVID-19 vaccination roll-out and COVID-19 hospital admissions in Scotland: a national prospective cohort study.
Interim findings from first-dose mass COVID-19 vaccination roll-out and COVID-19 hospital admissions in Scotland: a national prospective cohort study.
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DOI：
10.1016/s0140-6736(21)00677-2
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发表时间：
2021-05-01
期刊：
影响因子：
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通讯作者：
Sheikh A
中科院分区：
文献类型：
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作者：
Vasileiou E;Simpson CR;Shi T;Kerr S;Agrawal U;Akbari A;Bedston S;Beggs J;Bradley D;Chuter A;de Lusignan S;Docherty AB;Ford D;Hobbs FR;Joy M;Katikireddi SV;Marple J;McCowan C;McGagh D;McMenamin J;Moore E;Murray JL;Pan J;Ritchie L;Shah SA;Stock S;Torabi F;Tsang RS;Wood R;Woolhouse M;Robertson C;Sheikh A
BNT 162 b2 mRNA（Pfizer-BioNTech）和ChAdOx 1 nCoV-19（Oxford-AstraZeneca）COVID-19疫苗在3期临床试验中显示出对疾病的高疗效，目前正在英国和其他几个国家的国家疫苗接种计划中使用。研究这些疫苗的实际效果是一项迫切的要求。我们研究的目的是调查这些COVID-19疫苗第一剂的大规模推广与COVID-19住院之间的关联。我们使用COVID-19的早期大流行评估和加强监测-EAVE II数据库进行了一项前瞻性队列研究，该数据库包括联系疫苗接种，初级保健，实时逆转录PCR检测和苏格兰540万人（约占人口的99%）在940个全科诊所注册的住院患者记录。以前检测呈阳性的人被排除在分析之外。拟合了时间依赖性考克斯模型和具有反向倾向权重的泊松回归模型，以估计首次接种疫苗后对COVID-19住院的有效性（定义为1调整率比）。在2020年12月8日至2021年2月22日期间，共有1 331 993人在研究期间接种了疫苗。接种疫苗者的平均年龄为65.0岁（SD 16.2）。第一剂BNT 162 b2 mRNA疫苗与疫苗接种后28-34天减少COVID-19住院的91%（95%CI 85-94）的疫苗效应相关。ChAdOx 1疫苗在相同时间间隔的疫苗效应为88%（95% CI 75-94）。当将分析限制在80岁及以上人群时，联合疫苗对COVID-19住院的影响结果相似（接种后28-34天为83%，95%CI 72-89）。首批BNT 162 b2 mRNA和ChAdOx 1疫苗的大规模推广与苏格兰因COVID-19住院的风险大幅降低有关。仍然存在一些观察到的效应可能是由于残留混杂造成的可能性。英国研究和创新（医学研究理事会），研究和创新产业战略挑战基金，英国健康数据研究。
The BNT162b2 mRNA (Pfizer–BioNTech) and ChAdOx1 nCoV-19 (Oxford–AstraZeneca) COVID-19 vaccines have shown high efficacy against disease in phase 3 clinical trials and are now being used in national vaccination programmes in the UK and several other countries. Studying the real-world effects of these vaccines is an urgent requirement. The aim of our study was to investigate the association between the mass roll-out of the first doses of these COVID-19 vaccines and hospital admissions for COVID-19. We did a prospective cohort study using the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19—EAVE II—database comprising linked vaccination, primary care, real-time reverse transcription-PCR testing, and hospital admission patient records for 5·4 million people in Scotland (about 99% of the population) registered at 940 general practices. Individuals who had previously tested positive were excluded from the analysis. A time-dependent Cox model and Poisson regression models with inverse propensity weights were fitted to estimate effectiveness against COVID-19 hospital admission (defined as 1–adjusted rate ratio) following the first dose of vaccine. Between Dec 8, 2020, and Feb 22, 2021, a total of 1 331 993 people were vaccinated over the study period. The mean age of those vaccinated was 65·0 years (SD 16·2). The first dose of the BNT162b2 mRNA vaccine was associated with a vaccine effect of 91% (95% CI 85–94) for reduced COVID-19 hospital admission at 28–34 days post-vaccination. Vaccine effect at the same time interval for the ChAdOx1 vaccine was 88% (95% CI 75–94). Results of combined vaccine effects against hospital admission due to COVID-19 were similar when restricting the analysis to those aged 80 years and older (83%, 95% CI 72–89 at 28–34 days post-vaccination). Mass roll-out of the first doses of the BNT162b2 mRNA and ChAdOx1 vaccines was associated with substantial reductions in the risk of hospital admission due to COVID-19 in Scotland. There remains the possibility that some of the observed effects might have been due to residual confounding. UK Research and Innovation (Medical Research Council), Research and Innovation Industrial Strategy Challenge Fund, Health Data Research UK.