Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant.
Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant.
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DOI：
10.1056/nejmoa2108891
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发表时间：
2021-08-12
期刊：
影响因子：
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通讯作者：
Ramsay M
中科院分区：
文献类型：
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作者：
Lopez Bernal J;Andrews N;Gower C;Gallagher E;Simmons R;Thelwall S;Stowe J;Tessier E;Groves N;Dabrera G;Myers R;Campbell CNJ;Amirthalingam G;Edmunds M;Zambon M;Brown KE;Hopkins S;Chand M;Ramsay M
严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 的 B.1.617.2 (delta) 变体是导致 2019 年冠状病毒病 (Covid-19) 的病毒，导致印度病例激增，目前已在全球范围内发现，其中英国病例显着增加。 BNT162b2 和 ChAdOx1 nCoV-19 疫苗针对该变种的有效性尚不清楚。我们使用测试阴性病例对照设计来评估在 Delta 变种开始传播期间，疫苗接种对 Delta 变种或主要菌株（B.1.1.7 或 α 变种）引起的症状性疾病的有效性。通过测序并根据刺突 (S) 基因状态来鉴定变体。英国所有有症状的 Covid-19 病例的数据被用来根据患者的疫苗接种状况估计携带任一变体的病例比例。 δ 变体患者接种一剂疫苗（BNT162b2 或 ChAdOx1 nCoV-19）后的有效性（30.7%；95% 置信区间 [CI]，25.2 至 35.7）明显低于 α 变体患者（48.7%；95% CI，45.5 至 51.7）；两种疫苗的结果相似。对于 BNT162b2 疫苗，在 α 变体患者中，两剂疫苗的有效率为 93.7%（95% CI，91.6 至 95.3），在 Delta 变体患者中，为 88.0%（95% CI，85.3 至 90.1）。对于 ChAdOx1 nCoV-19 疫苗，两剂疫苗的有效性在 α 变体患者中为 74.5%（95% CI，68.4 至 79.4），在 Delta 变体患者中为 67.0%（95% CI，61.3 至 71.8）。在接受两剂疫苗后，与α变体相比，δ变体的疫苗有效性仅存在适度差异。接受第一剂疫苗后，疫苗有效性的绝对差异更加明显。这一发现将支持在弱势群体中最大限度地提高两剂疫苗接种率的努力。 （由英格兰公共卫生部门资助。）
The B.1.617.2 (delta) variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19), has contributed to a surge in cases in India and has now been detected across the globe, including a notable increase in cases in the United Kingdom. The effectiveness of the BNT162b2 and ChAdOx1 nCoV-19 vaccines against this variant has been unclear. We used a test-negative case–control design to estimate the effectiveness of vaccination against symptomatic disease caused by the delta variant or the predominant strain (B.1.1.7, or alpha variant) over the period that the delta variant began circulating. Variants were identified with the use of sequencing and on the basis of the spike (S) gene status. Data on all symptomatic sequenced cases of Covid-19 in England were used to estimate the proportion of cases with either variant according to the patients’ vaccination status. Effectiveness after one dose of vaccine (BNT162b2 or ChAdOx1 nCoV-19) was notably lower among persons with the delta variant (30.7%; 95% confidence interval [CI], 25.2 to 35.7) than among those with the alpha variant (48.7%; 95% CI, 45.5 to 51.7); the results were similar for both vaccines. With the BNT162b2 vaccine, the effectiveness of two doses was 93.7% (95% CI, 91.6 to 95.3) among persons with the alpha variant and 88.0% (95% CI, 85.3 to 90.1) among those with the delta variant. With the ChAdOx1 nCoV-19 vaccine, the effectiveness of two doses was 74.5% (95% CI, 68.4 to 79.4) among persons with the alpha variant and 67.0% (95% CI, 61.3 to 71.8) among those with the delta variant. Only modest differences in vaccine effectiveness were noted with the delta variant as compared with the alpha variant after the receipt of two vaccine doses. Absolute differences in vaccine effectiveness were more marked after the receipt of the first dose. This finding would support efforts to maximize vaccine uptake with two doses among vulnerable populations. (Funded by Public Health England.)