Effectiveness of BNT162b2 and ChAdOx1 nCoV-19 COVID-19 vaccination at preventing hospitalisations in people aged at least 80 years: a test-negative, case-control study.
Effectiveness of BNT162b2 and ChAdOx1 nCoV-19 COVID-19 vaccination at preventing hospitalisations in people aged at least 80 years: a test-negative, case-control study.
复制标题
DOI：
10.1016/s1473-3099(21)00330-3
复制
发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Finn A
中科院分区：
文献类型：
--
作者：
Hyams C;Marlow R;Maseko Z;King J;Ward L;Fox K;Heath R;Tuner A;Friedrich Z;Morrison L;Ruffino G;Antico R;Adegbite D;Szasz-Benczur Z;Garcia Gonzalez M;Oliver J;Danon L;Finn A
2020年12月8日，英国开始部署第一个授权使用的SARS-CoV-2疫苗（BNT 162 b2 mRNA疫苗），随后于2021年1月4日部署了腺病毒载体疫苗ChAdOx 1 nCoV-19。护理之家的居民和工作人员，一线卫生保健工作者和80岁及以上的成年人首先接种疫苗。然而，关于这些疫苗对患有多种合并症的老年人的有效性的数据很少。在对两种COVID-19疫苗的实施后评估中，我们旨在确定一剂疫苗在减少高龄人群中COVID-19相关入院方面的有效性。这项前瞻性试验阴性病例对照研究纳入了在英国布里斯托的两个NHS信托机构住院的年龄至少80岁的成人，他们有呼吸道疾病的体征和症状。在接种疫苗前出现症状的患者或在入院后接种疫苗的患者被排除在外，入院前10天以上开始出现症状的患者也被排除在外。我们进行了逻辑回归分析，控制时间（周），性别，多重剥夺指数，和护理居住状态，并使用条件逻辑模型调整多重剥夺指数和护理居住状态，进行时间和性别匹配的敏感性分析。本研究在ISRCTN注册，编号39557。在2020年12月18日至2021年2月26日期间，有466名成年人符合条件（144名测试阳性，322名测试阴性）。135名SARS-CoV-2感染者中有18名（13%）和269名对照者中有90名（34%）接受了一剂BNT 162 b2。调整后的疫苗有效性为71.4%（95% CI 46.5 - 90.6）。36名COVID-19感染者中有9人（25%）和90名对照者中有53人（59%）接受了一剂ChAdOx 1 nCoV-19。调整后的疫苗有效性为80.4%（95% CI 36.4 - 94.5）。当BNT 162 b2有效性分析仅限于ChAdOx 1 nCoV-19涵盖的时期时，估计值为79.3%（95% CI 47.0 - 92.5）。一剂BNT 162 b2或ChAdOx 1 nCoV-19导致年龄至少80岁的人群中COVID-19相关住院的风险大幅降低。辉瑞制药
On Dec 8, 2020, deployment of the first SARS-CoV-2 vaccination authorised for UK use (BNT162b2 mRNA vaccine) began, followed by an adenoviral vector vaccine ChAdOx1 nCoV-19 on Jan 4, 2021. Care home residents and staff, frontline health-care workers, and adults aged 80 years and older were vaccinated first. However, few data exist regarding the effectiveness of these vaccines in older people with many comorbidities. In this post-implementation evaluation of two COVID-19 vaccines, we aimed to determine the effectiveness of one dose in reducing COVID-19-related admissions to hospital in people of advanced age. This prospective test-negative case-control study included adults aged at least 80 years who were admitted to hospital in two NHS trusts in Bristol, UK with signs and symptoms of respiratory disease. Patients who developed symptoms before receiving their vaccine or those who received their vaccine after admission to hospital were excluded, as were those with symptoms that started more than 10 days before hospital admission. We did logistic regression analysis, controlling for time (week), sex, index of multiple deprivations, and care residency status, and sensitivity analyses matched for time and sex using a conditional logistic model adjusting for index of multiple deprivations and care residency status. This study is registered with ISRCTN, number 39557. Between Dec 18, 2020, and Feb 26, 2021, 466 adults were eligible (144 test-positive and 322 test-negative). 18 (13%) of 135 people with SARS-CoV-2 infection and 90 (34%) of 269 controls received one dose of BNT162b2. The adjusted vaccine effectiveness was 71·4% (95% CI 46·5–90·6). Nine (25%) of 36 people with COVID-19 infection and 53 (59%) of 90 controls received one dose of ChAdOx1 nCoV-19. The adjusted vaccine effectiveness was 80·4% (95% CI 36·4–94·5). When BNT162b2 effectiveness analysis was restricted to the period covered by ChAdOx1 nCoV-19, the estimate was 79·3% (95% CI 47·0–92·5). One dose of either BNT162b2 or ChAdOx1 nCoV-19 resulted in substantial risk reductions of COVID-19-related hospitalisation in people aged at least 80 years. Pfizer.