Estimated US Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence Based on Blood Donations, July 2020-May 2021
Estimated US Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence Based on Blood Donations, July 2020-May 2021
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DOI：
10.1001/jama.2021.15161
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发表时间：
2021-09-02
影响因子：
120.7
通讯作者：
Busch, Michael P.
中科院分区：
文献类型：
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作者：
Jones, Jefferson M.;Stone, Mars;Busch, Michael P.
感染过SARS-CoV-2或接种过SARS-CoV-2疫苗的人群随后感染的风险降低，但在美国，因感染或接种过SARS-CoV-2抗体的人群比例尚不确定。目的评估美国人群中与感染和疫苗接种相关的SARS-CoV-2血清流行趋势。设计、环境和参与者在2020年7月至2021年5月期间每月进行的重复横断面研究中，来自美国所有50个州的17个献血组织；华盛顿特区;和波多黎各被划分为66个特定研究区域，代表了美国人口的74%。在每个研究区域，每月从中位数约2000名献血者中选择并检测样本；初步选取和检测了1 594 363个标本。献血截止日期为2021年5月31日。曝光日历时间。检测到SARS-CoV-2刺突抗体和核衣壳抗体的人群比例。根据献血者样本和一般人群之间的人口统计学差异，对血清阳性率进行加权。感染诱导的血清患病率定义为同时具有刺突抗体和核衣壳抗体的人群的患病率。联合感染和疫苗诱导的血清患病率定义为具有刺突抗体的人群的患病率。将血清阳性率估计值与COVID-19病例报告的累计发病率进行比较。结果1 443 519例标本中，女性733 052例（50.8%），16 ~ 29岁人群174 842例（12.1%），65岁及以上人群292 258例（20.2%），非西班牙裔黑人36 654例（2.5%），西班牙裔88 773例（6.1%）。总体感染诱导的SARS-CoV-2血清流行率估计值从2020年7月的3.5% （95% CI, 3.2%-3.8%）上升至2021年5月的20.2% (95% CI, 19.9%-20.6%)；2021年5月感染和疫苗联合诱导的血清患病率估计为83.3% （95% CI, 82.9%-83.7%）。到2021年5月，每例报告的COVID-19病例估计发生2.1例SARS-CoV-2感染（95% CI, 2.0-2.1）。根据2020年7月至2021年5月在美国的献血样本，疫苗和感染引起的SARS-CoV-2血清阳性率随着时间的推移而增加，并且随着年龄、种族和民族以及地理区域的变化而变化。尽管对人口差异进行了加权调整，但这些来自全国献血者样本的发现可能并不代表整个美国人口。
IMPORTANCE People who have been infected with or vaccinated against SARS-CoV-2 have reduced risk of subsequent infection, but the proportion of people in the US with SARS-CoV-2 antibodies from infection or vaccination is uncertain.OBJECTIVE To estimate trends in SARS-CoV-2 seroprevalence related to infection and vaccination in the US population.DESIGN, SETTING, AND PARTICIPANTS In a repeated cross-sectional study conducted each month during July 2020 through May 2021, 17 blood collection organizations with blood donations from all 50 US states; Washington, DC; and Puerto Rico were organized into 66 study-specific regions, representing a catchment of 74% of the US population. For each study region, specimens from a median of approximately 2000 blood donors were selected and tested each month; a total of 1 594 363 specimens were initially selected and tested. The final date of blood donation collection was May 31, 2021.EXPOSURE Calendar time.MAIN OUTCOMES AND MEASURES Proportion of persons with detectable SARS-CoV-2 spike and nucleocapsid antibodies. Seroprevalence was weighted for demographic differences between the blood donor sample and general population. Infection-induced seroprevalence was defined as the prevalence of the population with both spike and nucleocapsid antibodies. Combined infection- and vaccination-induced seroprevalence was defined as the prevalence of the population with spike antibodies. The seroprevalence estimates were compared with cumulative COVID-19 case report incidence rates.RESULTS Among 1 443 519 specimens included, 733 052 (50.8%) were from women, 174 842 (12.1%) were from persons aged 16 to 29 years, 292 258 (20.2%) were from persons aged 65 years and older, 36 654 (2.5%) were from non-Hispanic Black persons, and 88 773 (6.1%) were from Hispanic persons. The overall infection-induced SARS-CoV-2 seroprevalence estimate increased from 3.5% (95% CI, 3.2%-3.8%) in July 2020 to 20.2% (95% CI, 19.9%-20.6%) in May 2021; the combined infection- and vaccination-induced seroprevalence estimate in May 2021 was 83.3% (95% CI, 82.9%-83.7%). By May 2021, 2.1 SARS-CoV-2 infections (95% CI, 2.0-2.1) per reported COVID-19 case were estimated to have occurred.CONCLUSIONS AND RELEVANCE Based on a sample of blood donations in the US from July 2020 through May 2021, vaccine- and infection-induced SARS-CoV-2 seroprevalence increased over time and varied by age, race and ethnicity, and geographic region. Despite weighting to adjust for demographic differences, these findings from a national sample of blood donors may not be representative of the entire US population.