Influence of age on the effectiveness and duration of protection of Vaxzevria and CoronaVac vaccines: A population-based study.
Influence of age on the effectiveness and duration of protection of Vaxzevria and CoronaVac vaccines: A population-based study.
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DOI：
10.1016/j.lana.2021.100154
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Barral-Netto M
中科院分区：
文献类型：
--
作者：
Cerqueira-Silva T;Oliveira VA;Boaventura VS;Pescarini JM;Júnior JB;Machado TM;Flores-Ortiz R;Penna GO;Ichihara MY;de Barros JV;Barreto ML;Werneck GL;Barral-Netto M
老龄化会影响 COVID-19 的严重程度和对疫苗接种的反应，但之前的疫苗有效性 (VE) 分析缺乏评估其在老年人群中的作用的能力。在这里，我们分析了年龄对病毒载体和灭活病毒疫苗有效性的影响，这是低收入和中等收入国家使用的主要平台。我们报告了一项对 2021 年 1 月 18 日至 7 月 24 日期间 75,919,840 名巴西疫苗接种者进行的回顾性纵向研究，评估了记录的严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染、与 COVID-19 相关的住院、入住 ICU 和死亡情况。根据社会人口统计特征调整的负二项式回归模型用于 VE 估计。全面疫苗接种的总体分析显示，Vaxzevria 的 VE 相对于住院、入住 ICU 和死亡分别为 91·4% (95%CI:90·1–92·5)、91·1% (95%CI:88·9–92·9) 和 92·3% (95%CI:90·5–93·7)，71·2% CoronaVac 分别为 (95%CI:70·0–72·4)、72·2% (95%CI:70·2–74·0) 和 73·7% (95%CI:72·1–75·2)。所有结果的 VE 随着年龄的增长而逐渐降低。在年龄 <60 岁的完全接种 Vaxzevria 疫苗的个体中，VE 抗死亡率为 96.5% (95%CI:82.1–99.3)，而 ≥90 岁的个体为 68·5% (95%CI:40·0–83·4)。在完全接种 CoronaVac 疫苗的个体中，60 岁以下人群的 VE 抗死亡率为 84.8% (95%CI:77.1–89.9)，而 80–89 岁疫苗接种者的 VE 抗死亡率为 63.5% (95%CI: 58.7–67.7) 和 48·6%； (95%CI:35·0–59·3) 对于年龄 ≥90 岁的个体。疫苗接种后所有结果的每日累积发病率曲线显示，从年轻到老年，风险增加。与≥90岁的人相比，60岁以下的人在同一时期内接种疫苗的住院率没有增加。尽管这两种疫苗都能有效预防感染、住院和死亡； Vaxzevria 和 CoronaVac 对 79 岁以下个体的严重后果表现出高效能。我们的结果强化了这样的观点：老年人应仔细考虑加强剂量。这项研究得到了“Fazer o bem faz bem”计划捐赠的部分支持。
Aging influences COVID-19 severity and response to vaccination, but previous vaccine effectiveness (VE) analyzes lack the power to evaluate its role in subgroups within the elderly age group. Here we analyzed the impact of age on viral vector and inactivated virus vaccines' effectiveness, the main platforms used in low- and middle-income countries. We report a retrospective longitudinal study of 75,919,840 Brazilian vaccinees from January 18 to July 24, 2021, evaluating documented infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19-related hospitalisation, ICU admission, and death. Negative binomial regression models adjusted for sociodemographic characteristics were used for VE estimation. The overall analyzes of full vaccination showed VE against hospitalisation, ICU admission, and death of 91·4% (95%CI:90·1–92·5), 91·1% (95%CI:88·9–92·9) and 92·3% (95%CI:90·5–93·7) for Vaxzevria and 71·2% (95%CI:70·0–72·4), 72·2% (95%CI:70·2–74·0) and 73·7% (95%CI:72·1–75·2) for CoronaVac, respectively. VE for all outcomes is progressively lower with age. In fully-Vaxzevria-vaccinated individuals aged <60 years, VE against death was 96.5% (95%CI:82.1–99.3) versus 68·5% (95%CI:40·0–83·4) in those ≥90 years. Among fully-CoronaVac-vaccinated individuals, VE against death was 84.8% (95%CI:77.1–89.9) in those <60 years compared to 63.5 (95%CI 58.7–67.7) for vaccinees aged 80–89 years and 48·6%; (95%CI:35·0–59·3) for individuals aged ≥90 years. Post-vaccination daily cumulative incidence curves for all outcomes showed increased risk from younger to elder decades of life. There was no increase in the incidence of hospitalisation for individuals <60 years vaccinated during the same period as those aged ≥90 years. Although both vaccines have been effective in protecting against infection, hospitalization and death; Vaxzevria and CoronaVac demonstrated high effectiveness against severe outcomes for individuals up to 79 years of age. Our results reinforce the idea that booster doses should be carefully considered in elders. This study was partially supported by a donation from the "Fazer o bem faz bem" program.
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发表时间：
2021-08
期刊：
The Lancet. Child & adolescent health
影响因子：
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10.1093/cid/ciab079
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10.1016/s0140-6736(21)00677-2
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2021-05-01
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Lancet (London, England)
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