Predicting the Public Health Impact of Bivalent Vaccines and Nirmatrelvir-Ritonavir Against Coronavirus Disease 2019.
Predicting the Public Health Impact of Bivalent Vaccines and Nirmatrelvir-Ritonavir Against Coronavirus Disease 2019.
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DOI：
10.1093/ofid/ofad415
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发表时间：
2023-09
影响因子：
4.2
通讯作者：
中科院分区：
文献类型：
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作者：
在美国，2019冠状病毒病（COVID-19）双价疫苗和口服药物nirmatrelvir-ritonavir （Paxlovid）的吸收率仍然很低。评估在关键风险群体中更多地采用这些干预措施对公共卫生的影响，可以进一步指导公共卫生资源和政策，并确定通过这些干预措施可避免的严重COVID-19比例。该建模研究使用了加州公共卫生部关于2022年7月23日至2023年1月23日COVID-19病例、住院、死亡和疫苗管理的个人数据。我们使用准泊松回归模型校准了最近的历史数据来预测未来的COVID-19结局，并模拟了不同风险群体在急性疾病期间增加双价COVID-19疫苗和尼马特韦-利托那韦的吸收（覆盖率高达70%）的影响。危险组根据年龄（≥50岁，≥65岁，≥75岁）和疫苗接种状况（每个人，仅限初级系列，以前接种过疫苗）定义。我们预测了避免的COVID-19病例数、住院人数、死亡人数和需要治疗的人数（NNT）。该模型预测，在所有符合条件的人群中增加双价COVID-19增强剂和尼马特韦-利托那韦（覆盖率高达70%）的摄入，可分别避免约15.7%（95%不确定区间[UI]， 11.2%-20.7%; NNT: 17310）和23.5% （95% UI, 13.1%-30.0%; NNT: 67）的COVID-19相关死亡总数。仅在65岁以上的高危人群中，增加双价增强剂和尼马特韦-利托那韦的摄入，估计可分别避免与covid -19相关的总死亡人数的11.9% （95% UI, 8.4%-15.1%; NNT: 2757）和22.8% （95% UI, 12.7%-29.2%; NNT: 50）。这些发现表明，优先在老年群体（≥65岁）中使用双价增强剂和尼马特韦-利托那韦将是最有效的（基于NNT），但不能解决严重COVID-19的全部负担。这项与加州公共卫生部合作的建模研究发现，优先考虑在老年群体中额外接种二价疫苗和nirmatrelvir-ritonavir，将有效减少严重COVID-19病例的数量，但无法解决全部负担。
Uptake of coronavirus disease 2019 (COVID-19) bivalent vaccines and the oral medication nirmatrelvir-ritonavir (Paxlovid) has remained low across the United States. Assessing the public health impact of increasing uptake of these interventions in key risk groups can guide further public health resources and policy and determine what proportion of severe COVID-19 is avertable with these interventions. This modeling study used person-level data from the California Department of Public Health on COVID-19 cases, hospitalizations, deaths, and vaccine administration from 23 July 2022 to 23 January 2023. We used a quasi-Poisson regression model calibrated to recent historical data to predict future COVID-19 outcomes and modeled the impact of increasing uptake (up to 70% coverage) of bivalent COVID-19 vaccines and nirmatrelvir-ritonavir during acute illness in different risk groups. Risk groups were defined by age (≥50, ≥65, ≥75 years) and vaccination status (everyone, primary series only, previously vaccinated). We predicted the number of averted COVID-19 cases, hospitalizations, and deaths and number needed to treat (NNT). The model predicted that increased uptake of bivalent COVID-19 boosters and nirmatrelvir-ritonavir (up to 70% coverage) in all eligible persons could avert an estimated 15.7% (95% uncertainty interval [UI], 11.2%–20.7%; NNT: 17 310) and 23.5% (95% UI, 13.1%–30.0%; NNT: 67) of total COVID-19–related deaths, respectively. In the high-risk group of persons ≥65 years old alone, increased uptake of bivalent boosters and nirmatrelvir-ritonavir could avert an estimated 11.9% (95% UI, 8.4%–15.1%; NNT: 2757) and 22.8% (95% UI, 12.7%–29.2%; NNT: 50) of total COVID-19–related deaths, respectively. These findings suggest that prioritizing uptake of bivalent boosters and nirmatrelvir-ritonavir among older age groups (≥65 years) would be most effective (based on NNT) but would not address the entire burden of severe COVID-19. This modeling study, in collaboration with the California Department of Public Health, found prioritizing additional uptake of bivalent vaccines and nirmatrelvir-ritonavir among older age-groups would effectively reduce the number of severe COVID-19 cases but would not address the entire burden.
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影响因子：
56.3
作者：
Bobrovitz, Niklas;Ware, Harriet;Ma, Xiaomeng;Li, Zihan;Hosseini, Reza;Cao, Christian;Selemon, Anabel;Whelan, Mairead;Premji, Zahra;Issa, Hanane;Cheng, Brianna;Abu Raddad, Laith J.;Buckeridge, David L.;Van Kerkhove, Maria D.;Piechotta, Vanessa;Higdon, Melissa M.;Wilder-Smith, Annelies;Bergeri, Isabel;Feikin, Daniel R.;Arora, Rahul K.;Patel, Minal K.;Subissi, Lorenzo
通讯作者：
Subissi, Lorenzo
影响因子：
13.8
作者：
Madewell, Zachary J.;Yang, Yang;Longini, Ira M., Jr.;Halloran, M. Elizabeth;Dean, Natalie E.
通讯作者：
Dean, Natalie E.
DOI：
10.1056/nejmoa2119451
发表时间：
2022-04-21
期刊：
The New England journal of medicine
影响因子：
--
作者：
Andrews N;Stowe J;Kirsebom F;Toffa S;Rickeard T;Gallagher E;Gower C;Kall M;Groves N;O'Connell AM;Simons D;Blomquist PB;Zaidi A;Nash S;Iwani Binti Abdul Aziz N;Thelwall S;Dabrera G;Myers R;Amirthalingam G;Gharbia S;Barrett JC;Elson R;Ladhani SN;Ferguson N;Zambon M;Campbell CNJ;Brown K;Hopkins S;Chand M;Ramsay M;Lopez Bernal J
通讯作者：
Lopez Bernal J
影响因子：
39.2
作者：
Dryden-Peterson, Scott;Kim, Andy;Woolley, Ann E.
通讯作者：
Woolley, Ann E.
DOI：
10.15585/mmwr.mm7107e2
发表时间：
2022-02-18
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Ferdinands JM;Rao S;Dixon BE;Mitchell PK;DeSilva MB;Irving SA;Lewis N;Natarajan K;Stenehjem E;Grannis SJ;Han J;McEvoy C;Ong TC;Naleway AL;Reese SE;Embi PJ;Dascomb K;Klein NP;Griggs EP;Konatham D;Kharbanda AB;Yang DH;Fadel WF;Grisel N;Goddard K;Patel P;Liao IC;Birch R;Valvi NR;Reynolds S;Arndorfer J;Zerbo O;Dickerson M;Murthy K;Williams J;Bozio CH;Blanton L;Verani JR;Schrag SJ;Dalton AF;Wondimu MH;Link-Gelles R;Azziz-Baumgartner E;Barron MA;Gaglani M;Thompson MG;Fireman B
通讯作者：
Fireman B