Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study.
Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study.
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DOI：
10.1136/bmj.n1088
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发表时间：
2021-05-13
期刊：
影响因子：
--
通讯作者：
Ramsay M
中科院分区：
文献类型：
--
作者：
Lopez Bernal J;Andrews N;Gower C;Robertson C;Stowe J;Tessier E;Simmons R;Cottrell S;Roberts R;O'Doherty M;Brown K;Cameron C;Stockton D;McMenamin J;Ramsay M
评估Pfizer-BioNTech BNT 162 b2和Oxford-AstraZeneca ChAdOx 1-S疫苗对确诊的COVID-19症状（包括关注的英国变体B.1.1.7）、住院和死亡的真实的世界有效性。试验阴性病例对照研究。在英格兰进行新冠肺炎社区测试。2020年12月8日至2021年2月19日期间，156930名70岁及以上的成年人报告了新冠肺炎症状，并成功与国家免疫管理系统的疫苗接种数据相关联。接种BNT 162 b2或ChAdOx 1-S。主要结局是聚合酶链反应证实的症状性SARS-CoV-2感染、因covid-19住院和因covid-19死亡。在2021年1月4日之前接种BNT 162 b2疫苗的80岁及以上参与者在接种疫苗后的前9天内检测出covid-19阳性的几率更高（比值比高达1.48，95%置信区间1.23至1.77），表明最初目标人群的潜在感染风险更高。因此，将疫苗有效性与接种后基线期进行比较。疫苗接种后10 - 13天观察到疫苗效应，达到70%的疫苗有效性（95%置信区间59%-78%），然后达到稳定。从第二次接种后14天起，与基线风险增加相比，发现疫苗接种有效性为89%（85%至93%）。年龄在70岁及以上的参与者从1月4日（ChAdOx 1-S交付开始时）接种疫苗，与未接种疫苗的个体具有相似的covid-19潜在风险。对于BNT 162 b2，疫苗有效性在接种后28至34天达到61%（51%至69%），然后达到稳定水平。使用ChAdOx 1-S，在接种后14至20天观察到效果，从28至34天达到60%（41%至73%）的有效性，从第35天起增加到73%（27%至90%）。除了对症状性疾病的保护外，在接受一剂BNT 162 b2的患者中观察到急诊入院风险降低了43%（33%至52%），死亡风险降低了51%（37%至62%）。接受一剂ChAdOx 1-S的参与者的急诊入院风险进一步降低了37%（3%至59%）。随访不足以评估ChAdOx 1-S对死亡率的影响。结合对症状性疾病的作用，单剂疫苗在预防Covid-19住院方面的有效率约为80%，单剂BNT 162 b2在预防Covid-19死亡方面的有效率为85%。接种一剂BNT 162 b2或ChAdOx 1-S疫苗与老年人中有症状的covid-19显著减少相关，并进一步保护其免受严重疾病的侵害。两种疫苗都表现出类似的效果。在随访期间（>6周）维持保护。第二剂量的BNT 162 b2与针对症状性疾病的进一步保护相关。发现疫苗对B.1.1.7变体的明显作用。
To estimate the real world effectiveness of the Pfizer-BioNTech BNT162b2 and Oxford-AstraZeneca ChAdOx1-S vaccines against confirmed covid-19 symptoms (including the UK variant of concern B.1.1.7), admissions to hospital, and deaths. Test negative case-control study. Community testing for covid-19 in England. 156 930 adults aged 70 years and older who reported symptoms of covid-19 between 8 December 2020 and 19 February 2021 and were successfully linked to vaccination data in the National Immunisation Management System. Vaccination with BNT162b2 or ChAdOx1-S. Primary outcomes were polymerase chain reaction confirmed symptomatic SARS-CoV-2 infections, admissions to hospital for covid-19, and deaths with covid-19. Participants aged 80 years and older vaccinated with BNT162b2 before 4 January 2021 had a higher odds of testing positive for covid-19 in the first nine days after vaccination (odds ratio up to 1.48, 95% confidence interval 1.23 to 1.77), indicating that those initially targeted had a higher underlying risk of infection. Vaccine effectiveness was therefore compared with the baseline post-vaccination period. Vaccine effects were noted 10 to 13 days after vaccination, reaching a vaccine effectiveness of 70% (95% confidence interval 59% to 78%), then plateauing. From 14 days after the second dose a vaccination effectiveness of 89% (85% to 93%) was found compared with the increased baseline risk. Participants aged 70 years and older vaccinated from 4 January (when ChAdOx1-S delivery commenced) had a similar underlying risk of covid-19 to unvaccinated individuals. With BNT162b2, vaccine effectiveness reached 61% (51% to 69%) from 28 to 34 days after vaccination, then plateaued. With ChAdOx1-S, effects were seen from 14 to 20 days after vaccination, reaching an effectiveness of 60% (41% to 73%) from 28 to 34 days, increasing to 73% (27% to 90%) from day 35 onwards. On top of the protection against symptomatic disease, a further 43% (33% to 52%) reduced risk of emergency hospital admission and 51% (37% to 62%) reduced risk of death was observed in those who had received one dose of BNT162b2. Participants who had received one dose of ChAdOx1-S had a further 37% (3% to 59%) reduced risk of emergency hospital admission. Follow-up was insufficient to assess the effect of ChAdOx1-S on mortality. Combined with the effect against symptomatic disease, a single dose of either vaccine was about 80% effective at preventing admission to hospital with covid-19 and a single dose of BNT162b2 was 85% effective at preventing death with covid-19. Vaccination with either one dose of BNT162b2 or ChAdOx1-S was associated with a significant reduction in symptomatic covid-19 in older adults, and with further protection against severe disease. Both vaccines showed similar effects. Protection was maintained for the duration of follow-up (>6 weeks). A second dose of BNT162b2 was associated with further protection against symptomatic disease. A clear effect of the vaccines against the B.1.1.7 variant was found.
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影响因子：
19
作者：
Singanayagam, Anika;Patel, Monika;Gopal, Robin
通讯作者：
Gopal, Robin
DOI：
10.1016/s0140-6736(20)32661-1
发表时间：
2021-01-09
期刊：
Lancet (London, England)
影响因子：
--
作者：
Voysey M;Clemens SAC;Madhi SA;Weckx LY;Folegatti PM;Aley PK;Angus B;Baillie VL;Barnabas SL;Bhorat QE;Bibi S;Briner C;Cicconi P;Collins AM;Colin-Jones R;Cutland CL;Darton TC;Dheda K;Duncan CJA;Emary KRW;Ewer KJ;Fairlie L;Faust SN;Feng S;Ferreira DM;Finn A;Goodman AL;Green CM;Green CA;Heath PT;Hill C;Hill H;Hirsch I;Hodgson SHC;Izu A;Jackson S;Jenkin D;Joe CCD;Kerridge S;Koen A;Kwatra G;Lazarus R;Lawrie AM;Lelliott A;Libri V;Lillie PJ;Mallory R;Mendes AVA;Milan EP;Minassian AM;McGregor A;Morrison H;Mujadidi YF;Nana A;O'Reilly PJ;Padayachee SD;Pittella A;Plested E;Pollock KM;Ramasamy MN;Rhead S;Schwarzbold AV;Singh N;Smith A;Song R;Snape MD;Sprinz E;Sutherland RK;Tarrant R;Thomson EC;Török ME;Toshner M;Turner DPJ;Vekemans J;Villafana TL;Watson MEE;Williams CJ;Douglas AD;Hill AVS;Lambe T;Gilbert SC;Pollard AJ;Oxford COVID Vaccine Trial Group
通讯作者：
Oxford COVID Vaccine Trial Group
BNT162B2 mRNA COVID-19疫苗的安全性和功效。
DOI：
10.1056/nejmoa2034577
发表时间：
2020-12-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Polack FP;Thomas SJ;Kitchin N;Absalon J;Gurtman A;Lockhart S;Perez JL;Pérez Marc G;Moreira ED;Zerbini C;Bailey R;Swanson KA;Roychoudhury S;Koury K;Li P;Kalina WV;Cooper D;Frenck RW Jr;Hammitt LL;Türeci Ö;Nell H;Schaefer A;Ünal S;Tresnan DB;Mather S;Dormitzer PR;Şahin U;Jansen KU;Gruber WC;C4591001 Clinical Trial Group
通讯作者：
C4591001 Clinical Trial Group
影响因子：
19
作者：
Pebody, Richard;Djennad, Abdelmajid;Zambon, Maria
通讯作者：
Zambon, Maria
影响因子：
5.5
作者：
Schwartz LM;Halloran ME;Rowhani-Rahbar A;Neuzil KM;Victor JC
通讯作者：
Victor JC