Effectiveness of BNT162b2 mRNA COVID-19 vaccine against SARS-CoV-2 variant Beta (B.1.351) among persons identified through contact tracing in Israel: A prospective cohort study.
Effectiveness of BNT162b2 mRNA COVID-19 vaccine against SARS-CoV-2 variant Beta (B.1.351) among persons identified through contact tracing in Israel: A prospective cohort study.
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DOI：
10.1016/j.eclinm.2021.101190
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发表时间：
2021-12
影响因子：
15.1
通讯作者：
Alroy-Preis S
中科院分区：
文献类型：
--
作者：
Singer SR;Angulo FJ;Swerdlow DL;McLaughlin JM;Hazan I;Ginish N;Anis E;Mendelson E;Mor O;Zuckerman NS;Erster O;Southern J;Pan K;Mircus G;Lipsitch M;Haas EJ;Jodar L;Levy Y;Alroy-Preis S
SARS-CoV-2变种Beta(B.1.351)在南非成为主要毒株并在国际上传播后，被指定为令人担忧的变种(VOC)。BNT162b2显示，与其他菌株相比，针对Beta的中和抗体水平较低，这引发了人们对Beta引起的感染疫苗有效性的担忧。我们估计了BNT162b2疫苗对以色列贝塔感染的有效性(VE)，以色列是一个疫苗接种率很高的国家。卫生部通过强制报告SARS-CoV-2病例和疫苗接种样本的全基因组测序(WGS)确定了贝塔病例--突破性感染、再感染、到达的国际旅行者和选定的其他感染者。对初发贝塔病例接触者的暴露事件进行队列分析。对从接触者中收集的可用聚合酶链式反应阳性标本进行WGS。通过比较未接种和完全接种(第二次接种后7天后的≥)接触者以及未接种和部分接种(第二次接种后7天后)接触者之间的感染风险，确定了对确认和可能的贝塔感染具有95%可信区间(CI)的VE估计。截至2021年6月27日，卫生部确认了310例贝塔病例。在研究期间(2020年12月11日-2021年3月25日)，确认了164例非制度化的初级贝塔病例，其中552名接触者年龄为16岁的≥。343/552(62%)的接触者接受了访谈和检测。343名接触者中有71名(21%)为阳性。71例阳性标本中有7例(10%)进行了WGS检查，均为Beta。在感染SARS-CoV-2的接触者中，48/71(68%)有症状，10/71(14%)住院，2/71(3%)死亡。完全接种VE对确诊或可能的Beta感染的抵抗率为72%(95%CI-5-97%；p=0.04)，对有症状的或可能的Beta感染的抵抗率为100%(95%CI为19-100%；p=0.01)。在部分接种疫苗的接触者中，没有证据表明有保护作用。在一项前瞻性观察研究中，两种剂量的BNT162b2对确诊的和可能的Beta感染有效。截至2021年6月底，Beta的引入没有中断对以色列大流行的控制。以色列卫生部和辉瑞制药公司。
SARS-CoV-2 variant Beta (B.1.351) was designated as a Variant of Concern (VoC) after becoming the dominant strain in South Africa and spreading internationally. BNT162b2 showed lower levels of neutralizing antibodies against Beta than against other strains raising concerns about effectiveness of vaccines against infections caused by Beta. We estimated BNT162b2 vaccine effectiveness (VE) against Beta infections in Israel, a country with high vaccine uptake. The Ministry of Health (MoH) identified Beta cases through mandatory reporting of SARS-CoV-2 cases and whole genome sequencing (WGS) of specimens from vaccination-breakthrough infections, reinfections, arriving international travelers, and a selection of other infected persons. A cohort analysis was conducted of exposure events of contacts of primary Beta cases. WGS was conducted on available PCR-positive specimens collected from contacts. VE estimates with 95% confidence intervals (CIs) against confirmed and probable Beta infections were determined by comparing infection risk between unvaccinated and fully-vaccinated (≥7 days after the second dose) contacts, and between unvaccinated and partially-vaccinated (<7 days after the second dose) contacts. MoH identified 310 Beta cases through Jun 27, 2021. During the study period (Dec 11, 2020 – Mar 25, 2021), 164 non-institutionalized primary Beta cases, with 552 contacts aged ≥16 years, were identified. 343/552 (62%) contacts were interviewed and tested. 71/343 (21%) contacts were PCR-positive. WGS was performed on 7/71 (10%) PCR-positive specimens; all were Beta. Among SARS-CoV-2-infected contacts, 48/71 (68%) were symptomatic, 10/71 (14%) hospitalized, and 2/71 (3%) died. Fully-vaccinated VE against confirmed or probable Beta infections was 72% (95% CI -5 – 97%; p=0·04) and against symptomatic confirmed or probable Beta infections was 100% (95% CI 19 – 100%; p=0·01). There was no evidence of protection in partially-vaccinated contacts. In a prospective observational study, two doses of BNT162b2 were effective against confirmed and probable Beta infections. Through the end of June 2021, introductions of Beta did not interrupt control of the pandemic in Israel. Israel Ministry of Health and Pfizer.
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