Prevention and Attenuation of Covid-19 with the BNT162b2 and mRNA-1273 Vaccines.
Prevention and Attenuation of Covid-19 with the BNT162b2 and mRNA-1273 Vaccines.
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DOI：
10.1056/nejmoa2107058
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发表时间：
2021-07-22
期刊：
影响因子：
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通讯作者：
Gaglani M
中科院分区：
文献类型：
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作者：
Thompson MG;Burgess JL;Naleway AL;Tyner H;Yoon SK;Meece J;Olsho LEW;Caban-Martinez AJ;Fowlkes AL;Lutrick K;Groom HC;Dunnigan K;Odean MJ;Hegmann K;Stefanski E;Edwards LJ;Schaefer-Solle N;Grant L;Ellingson K;Kuntz JL;Zunie T;Thiese MS;Ivacic L;Wesley MG;Mayo Lamberte J;Sun X;Smith ME;Phillips AL;Groover KD;Yoo YM;Gerald J;Brown RT;Herring MK;Joseph G;Beitel S;Morrill TC;Mak J;Rivers P;Poe BP;Lynch B;Zhou Y;Zhang J;Kelleher A;Li Y;Dickerson M;Hanson E;Guenther K;Tong S;Bateman A;Reisdorf E;Barnes J;Azziz-Baumgartner E;Hunt DR;Arvay ML;Kutty P;Fry AM;Gaglani M
关于双剂量信使RNA （mRNA）疫苗BNT162b2（辉瑞- biontech）和mRNA-1273 （Moderna）在预防严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）感染和在实际条件下减毒2019冠状病毒病（Covid-19）的有效性，信息有限。我们进行了一项前瞻性队列研究，涉及3975名卫生保健人员、急救人员和其他必要的一线工作人员。从2020年12月14日至2021年4月10日，参与者每周通过提供中鼻甲鼻拭子完成SARS-CoV-2检测，用于定性和定量逆转录-聚合酶链反应（RT-PCR）分析。计算疫苗有效性的公式为100%×（接种疫苗的参与者与未接种疫苗的参与者感染SARS-CoV-2的1 -危险比），并对接种倾向、研究地点、职业和当地病毒循环进行了调整。204名参与者（5%）检测到SARS-CoV-2，其中5名完全接种疫苗（剂量2后≥14天），11名部分接种疫苗（剂量1后≥14天，剂量2后<14天），156名未接种疫苗；排除32名接种状态不确定（第一次接种后<14天）的参与者。完全接种调整后的疫苗有效性为91%(95%可信区间[CI]， 76 - 97)，部分接种调整后的疫苗有效性为81%（95%可信区间[CI]， 64 - 90）。在SARS-CoV-2感染的参与者中，部分或完全接种疫苗的参与者的平均病毒RNA载量比未接种疫苗的参与者低40% （95% CI， 16至57）。此外，发热症状的风险降低了58%（相对风险，0.42;95% CI， 0.18至0.98），病程更短，卧床时间减少了2.3天（95% CI， 0.8至3.7）。经授权的mRNA疫苗在工作年龄成年人中预防SARS-CoV-2感染非常有效，并且疫苗在接种疫苗后仍发生突破性感染的人群中降低了病毒RNA载量、发热症状的风险和疾病持续时间。（由国家免疫和呼吸疾病中心以及疾病控制和预防中心资助。）
Information is limited regarding the effectiveness of the two-dose messenger RNA (mRNA) vaccines BNT162b2 (Pfizer–BioNTech) and mRNA-1273 (Moderna) in preventing infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and in attenuating coronavirus disease 2019 (Covid-19) when administered in real-world conditions. We conducted a prospective cohort study involving 3975 health care personnel, first responders, and other essential and frontline workers. From December 14, 2020, to April 10, 2021, the participants completed weekly SARS-CoV-2 testing by providing mid-turbinate nasal swabs for qualitative and quantitative reverse-transcriptase–polymerase-chain-reaction (RT-PCR) analysis. The formula for calculating vaccine effectiveness was 100%×(1−hazard ratio for SARS-CoV-2 infection in vaccinated vs. unvaccinated participants), with adjustments for the propensity to be vaccinated, study site, occupation, and local viral circulation. SARS-CoV-2 was detected in 204 participants (5%), of whom 5 were fully vaccinated (≥14 days after dose 2), 11 partially vaccinated (≥14 days after dose 1 and <14 days after dose 2), and 156 unvaccinated; the 32 participants with indeterminate vaccination status (<14 days after dose 1) were excluded. Adjusted vaccine effectiveness was 91% (95% confidence interval [CI], 76 to 97) with full vaccination and 81% (95% CI, 64 to 90) with partial vaccination. Among participants with SARS-CoV-2 infection, the mean viral RNA load was 40% lower (95% CI, 16 to 57) in partially or fully vaccinated participants than in unvaccinated participants. In addition, the risk of febrile symptoms was 58% lower (relative risk, 0.42; 95% CI, 0.18 to 0.98) and the duration of illness was shorter, with 2.3 fewer days spent sick in bed (95% CI, 0.8 to 3.7). Authorized mRNA vaccines were highly effective among working-age adults in preventing SARS-CoV-2 infection when administered in real-world conditions, and the vaccines attenuated the viral RNA load, risk of febrile symptoms, and duration of illness among those who had breakthrough infection despite vaccination. (Funded by the National Center for Immunization and Respiratory Diseases and the Centers for Disease Control and Prevention.)