Waning Immunity after the BNT162b2 Vaccine in Israel.
Waning Immunity after the BNT162b2 Vaccine in Israel.
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DOI：
10.1056/nejmoa2114228
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发表时间：
2021-12-09
期刊：
影响因子：
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通讯作者：
Huppert A
中科院分区：
文献类型：
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作者：
Goldberg Y;Mandel M;Bar-On YM;Bodenheimer O;Freedman L;Haas EJ;Milo R;Alroy-Preis S;Ash N;Huppert A
2020年12月，以色列通过接种BNT 162 b2疫苗开始了针对2019冠状病毒病（COVID-19）的大规模疫苗接种运动，从而大幅遏制了疫情。在一段时间几乎没有严重急性呼吸系统综合征冠状病毒2型（SARS-CoV-2）感染病例后，2021年6月中旬开始重新爆发新冠肺炎疫情。再次出现的可能原因是针对delta（B.1.617.2）变体的疫苗有效性降低和免疫力减弱。在以色列，疫苗对德尔塔变体的免疫力减弱的程度尚不清楚。我们使用了2021年7月11日至31日期间从以色列国家数据库收集的确诊感染和严重疾病的数据，这些数据适用于2021年6月之前已完全接种疫苗的所有以色列居民。我们使用泊松回归模型比较了不同时间段接种疫苗的人群中确诊的SARS-CoV-2感染率和严重的Covid-19感染率，并根据年龄组进行分层，并对可能的混杂因素进行了调整。在60岁或60岁以上的人群中，在2021年1月完全接种疫苗的人群中，7月11日至31日期间的感染率高于2个月后即3月完全接种疫苗的人群（率比为1.6; 95%置信区间[CI]为1.3至2.0）。在40至59岁的人群中，2月（首次合格时）完全接种疫苗的人群与2个月后的4月相比，感染率为1.7（95% CI，1.4至2.1）。在16至39岁的人群中，3月（首次合格时）完全接种疫苗的人群与2个月后的5月相比，感染率为1.6（95% CI，1.3至2.0）。在首次符合资格的月份接受全面疫苗注射的人士，与在三月份接受全面疫苗注射的人士比较，（95% CI，1.1 - 2.9），60岁或以上的人和2.2（95% CI，0.6至7.7）;由于人数较少，无法计算16至39岁人群的比率。这些发现表明，在接种第二剂疫苗后几个月，所有年龄组对SARS-CoV-2 δ变体的免疫力都有所减弱。
In December 2020, Israel began a mass vaccination campaign against coronavirus disease 2019 (Covid-19) by administering the BNT162b2 vaccine, which led to a sharp curtailing of the outbreak. After a period with almost no cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, a resurgent Covid-19 outbreak began in mid-June 2021. Possible reasons for the resurgence were reduced vaccine effectiveness against the delta (B.1.617.2) variant and waning immunity. The extent of waning immunity of the vaccine against the delta variant in Israel is unclear. We used data on confirmed infection and severe disease collected from an Israeli national database for the period of July 11 to 31, 2021, for all Israeli residents who had been fully vaccinated before June 2021. We used a Poisson regression model to compare rates of confirmed SARS-CoV-2 infection and severe Covid-19 among persons vaccinated during different time periods, with stratification according to age group and with adjustment for possible confounding factors. Among persons 60 years of age or older, the rate of infection in the July 11–31 period was higher among persons who became fully vaccinated in January 2021 (when they were first eligible) than among those fully vaccinated 2 months later, in March (rate ratio, 1.6; 95% confidence interval [CI], 1.3 to 2.0). Among persons 40 to 59 years of age, the rate ratio for infection among those fully vaccinated in February (when they were first eligible), as compared with 2 months later, in April, was 1.7 (95% CI, 1.4 to 2.1). Among persons 16 to 39 years of age, the rate ratio for infection among those fully vaccinated in March (when they were first eligible), as compared with 2 months later, in May, was 1.6 (95% CI, 1.3 to 2.0). The rate ratio for severe disease among persons fully vaccinated in the month when they were first eligible, as compared with those fully vaccinated in March, was 1.8 (95% CI, 1.1 to 2.9) among persons 60 years of age or older and 2.2 (95% CI, 0.6 to 7.7) among those 40 to 59 years of age; owing to small numbers, the rate ratio could not be calculated among persons 16 to 39 years of age. These findings indicate that immunity against the delta variant of SARS-CoV-2 waned in all age groups a few months after receipt of the second dose of vaccine.