Covid-19 Rates by Time since Vaccination during Delta Variant Predominance.
Covid-19 Rates by Time since Vaccination during Delta Variant Predominance.
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DOI：
10.1056/evidoa2100057
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发表时间：
2022-01-10
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随着德尔塔变异病毒的出现，美国在2021年经历了新冠肺炎病例的快速增加。我们估计了突破性感染和死亡的风险，按接种疫苗的月份作为δ变体占优势期间免疫力减弱的代表。使用2021年1月3日至9月4日期间来自美国15个司法管辖区的Covid-19病例和死亡数据来估计按年龄组和疫苗产品分层的完全接种人群的每周风险率。2021年8月1日至9月4日期间的病例和死亡率按接种月份定义的四个队列列出。泊松模型用于估计调整后的比率比较早期队列7月率。在2021年8月1日至9月4日期间，1月至2月、3月至4月、5月至6月和7月队列的所有疫苗接种者每10万人周的病例率为168.8（95%置信区间[CI]，167.5至170.1）、123.5（95% CI，122.8至124.1）、83.6（95% CI，82.9至84.3）和63.1（95% CI，61.6至64.6）。对于BNT 162 b2（Pfizer-BioNTech）和mRNA-1273（Moderna）疫苗接种者，按年龄组观察到相似的趋势。Ad26.COV2.S（Janssen-约翰逊&约翰逊）疫苗的发生率更高;然而，趋势不一致。65岁或以上的BNT 162 b2疫苗接种者在今年早些时候接种疫苗的人中死亡率较高。对于mRNA-1273疫苗接受者而言，针对死亡的保护是持续的。在不同年龄组和疫苗类型中，6个月或更长时间（1月至2月）前接种疫苗的人感染COVID-19的可能性是2021年7月最近接种疫苗的人的3. 44倍（3. 36至3. 53倍），死于COVID-19的可能性是1. 70倍（1. 29至2. 23倍）。我们的研究表明，在三角洲占主导地位的时期，所有年龄段的SARS-CoV-2感染或老年人死亡的保护随着接种疫苗时间的增加而减弱。这些结果增加了支持美国加强疫苗建议的证据基础，特别是对于接种BNT 162 b2疫苗的老年人和Ad26.COV2.S疫苗的接受者。（由疾病控制和预防中心资助。
With the emergence of the delta variant, the United States experienced a rapid increase in Covid-19 cases in 2021. We estimated the risk of breakthrough infection and death by month of vaccination as a proxy for waning immunity during a period of delta variant predominance. Covid-19 case and death data from 15 U.S. jurisdictions during January 3 to September 4, 2021 were used to estimate weekly hazard rates among fully vaccinated persons, stratified by age group and vaccine product. Case and death rates during August 1 to September 4, 2021 were presented across four cohorts defined by month of vaccination. Poisson models were used to estimate adjusted rate ratios comparing the earlier cohorts to July rates. During August 1 to September 4, 2021, case rates per 100,000 person-weeks among all vaccine recipients for the January to February, March to April, May to June, and July cohorts were 168.8 (95% confidence interval [CI], 167.5 to 170.1), 123.5 (95% CI, 122.8 to 124.1), 83.6 (95% CI, 82.9 to 84.3), and 63.1 (95% CI, 61.6 to 64.6), respectively. Similar trends were observed by age group for BNT162b2 (Pfizer–BioNTech) and mRNA-1273 (Moderna) vaccine recipients. Rates for the Ad26.COV2.S (Janssen-Johnson & Johnson) vaccine were higher; however, trends were inconsistent. BNT162b2 vaccine recipients 65 years of age or older had higher death rates among those vaccinated earlier in the year. Protection against death was sustained for the mRNA-1273 vaccine recipients. Across age groups and vaccine types, people who were vaccinated 6 months ago or longer (January-February) were 3.44 (3.36 to 3.53) times more likely to be infected and 1.70 (1.29 to 2.23) times more likely to die from COVID-19 than people vaccinated recently in July 2021. Our study suggests that protection from SARS-CoV-2 infection among all ages or death among older adults waned with increasing time since vaccination during a period of delta predominance. These results add to the evidence base that supports U.S. booster recommendations, especially for older adults vaccinated with BNT162b2 and recipients of the Ad26.COV2.S vaccine. (Funded by the Centers for Disease Control and Prevention.)