Duration of Protection against Mild and Severe Disease by Covid-19 Vaccines.
Duration of Protection against Mild and Severe Disease by Covid-19 Vaccines.
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COVID-19疫苗对轻度和重度疾病的保护持续时间。
DOI：
10.1056/nejmoa2115481
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发表时间：
2022-01-27
期刊：
影响因子：
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通讯作者：
Lopez Bernal J
中科院分区：
文献类型：
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作者：
Andrews N;Tessier E;Stowe J;Gower C;Kirsebom F;Simmons R;Gallagher E;Thelwall S;Groves N;Dabrera G;Myers R;Campbell CNJ;Amirthalingam G;Edmunds M;Zambon M;Brown K;Hopkins S;Chand M;Ladhani SN;Ramsay M;Lopez Bernal J
自2020年12月起，英国开始使用针对严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）（导致2019冠状病毒病（Covid-19）的病毒）的疫苗。真实世界的数据表明，这些疫苗对新冠肺炎及其相关的严重疾病和死亡非常有效。自接受第二剂ChAdOx 1-S（ChAdOx 1 nCoV-19）和BNT 162 b2疫苗以来，疫苗有效性可能会随着时间的推移而减弱。我们使用测试阴性病例对照设计来评估疫苗对英格兰有症状的Covid-19以及相关住院和死亡的有效性。根据受试者年龄和共存疾病状态以及自接受第二剂疫苗以来的时间评估ChAdOx 1-S和BNT 162 b2疫苗的有效性，以分别研究B.1.1.7（α）和B.1.617.2（δ）变体的有效性减弱。针对有症状的Covid-19 δ变体的疫苗有效性在接受第二剂疫苗后的最初几周达到峰值，然后在20周内下降，ChAdOx 1-S疫苗为44.3%（95%置信区间[CI]，43.2至45.4），BNT 162 b2疫苗为66.3%（95% CI，65.7至66.9）。65岁或以上的人比40至64岁的人疫苗有效性的减弱更大。在接种后20周或更长时间，疫苗有效性下降较少，为80.0%，（95% CI，76.8至82.7），ChAdOx 1-S疫苗组为91.7%，（95% CI，90.2至93.0），死亡率分别为84.8%（95% CI，76.2至90.3）和91.9%（95% CI，88.5至94.3）。与健康成人相比，在65岁或65岁以上的临床极端脆弱人群和40至64岁的有基础疾病的人群中观察到疫苗对住院治疗的有效性下降更大。我们观察到，在接种两剂ChAdOx 1-S或BNT 162 b2疫苗后20周或更长时间，疫苗对Covid-19相关住院和死亡的有效性下降有限。在老年人和临床风险组中，衰退程度更大。
Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19), have been used since December 2020 in the United Kingdom. Real-world data have shown the vaccines to be highly effective against Covid-19 and related severe disease and death. Vaccine effectiveness may wane over time since the receipt of the second dose of the ChAdOx1-S (ChAdOx1 nCoV-19) and BNT162b2 vaccines. We used a test-negative case–control design to estimate vaccine effectiveness against symptomatic Covid-19 and related hospitalization and death in England. Effectiveness of the ChAdOx1-S and BNT162b2 vaccines was assessed according to participant age and status with regard to coexisting conditions and over time since receipt of the second vaccine dose to investigate waning of effectiveness separately for the B.1.1.7 (alpha) and B.1.617.2 (delta) variants. Vaccine effectiveness against symptomatic Covid-19 with the delta variant peaked in the early weeks after receipt of the second dose and then decreased by 20 weeks to 44.3% (95% confidence interval [CI], 43.2 to 45.4) with the ChAdOx1-S vaccine and to 66.3% (95% CI, 65.7 to 66.9) with the BNT162b2 vaccine. Waning of vaccine effectiveness was greater in persons 65 years of age or older than in those 40 to 64 years of age. At 20 weeks or more after vaccination, vaccine effectiveness decreased less against both hospitalization, to 80.0% (95% CI, 76.8 to 82.7) with the ChAdOx1-S vaccine and 91.7% (95% CI, 90.2 to 93.0) with the BNT162b2 vaccine, and death, to 84.8% (95% CI, 76.2 to 90.3) and 91.9% (95% CI, 88.5 to 94.3), respectively. Greater waning in vaccine effectiveness against hospitalization was observed in persons 65 years of age or older in a clinically extremely vulnerable group and in persons 40 to 64 years of age with underlying medical conditions than in healthy adults. We observed limited waning in vaccine effectiveness against Covid-19–related hospitalization and death at 20 weeks or more after vaccination with two doses of the ChAdOx1-S or BNT162b2 vaccine. Waning was greater in older adults and in those in a clinical risk group.