A global epidemiological analysis of COVID-19 vaccine types and clinical outcomes.

A global epidemiological analysis of COVID-19 vaccine types and clinical outcomes.
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DOI:
10.1016/j.ijid.2022.09.014
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发表时间:
2022-11
影响因子:
8.4
通讯作者:
Michelow, Ian C.
Michelow, Ian C.
中科院分区:
医学2区
文献类型:
--
作者:
Alhinai, Zaid;Park, Sangshin;Choe, Young -June;Michelow, Ian C.

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使用真实世界的汇总数据比较基于信使 RNA (mRNA) 和腺病毒载体的疫苗 (ADVV) 与灭活病毒疫苗 (IVV)。我们对 2021 年上半年 41 个符合条件的国家公开的流行病学、临床、病毒学、疫苗相关和其他公共卫生数据进行了纵向分析。使用重复测量相关分析和混合效应模型来分析疫苗接种覆盖率和临床结果之间的关系,以调整潜在的中介和混杂因素。使用 mRNA 和/或 ADVV (n = 31) 与 IVV 以及其他疫苗类型 (n = 10) 的国家具有不同的年龄分布(分别为 42.4 岁 vs 33.9 岁;P 值 = 0.0006)、人均国内生产总值(分别为 38,606 美元 vs 20,422 美元;P <0.0001)和人口规模分布(分别为 8,655,541 与 5,139,162;P 值 = 0.36)。调整国家差异、非药物干预措施的严格性以及主要 SARS-CoV-2 变异类型后,随着时间的推移,接受 mRNA 和/或 ADVV 的人群的病例率和死亡率显着降低(每次分析 P <0.001)。随着时间的推移,接种 IVV 疫苗的人群的病例率和死亡率显着升高(每次分析 P <0.05)。 IVV 在现实世界中的有效性可能不如 mRNA 和/或 ADVV,需要进行前瞻性比较研究来严格评估 IVV 在当代 SARS-CoV-2 变体背景下的作用。
To compare messenger RNA (mRNA)–based and adenovirus-vectored vaccines (ADVVs) with inactivated virus vaccines (IVVs) using real-world aggregate data. We performed longitudinal analyses of publicly accessible epidemiological, clinical, virological, vaccine-related, and other public health data from 41 eligible countries during the first half of 2021. The relationships between vaccination coverage and clinical outcomes were analyzed using repeated measures correlation analyses and mixed-effects modeling to adjust for potential mediating and confounding factors. Countries that used mRNA and/or ADVV (n = 31) vs IVV, among other vaccine types (n = 10), had different distributions of age (42.4 vs 33.9 years, respectively; P-value = 0.0006), gross domestic product per capita ($ 38,606 vs $ 20,422, respectively; P <0.0001), and population sizes (8,655,541 vs 5,139,162, respectively; P-value = 0.36). After adjustment for country differences, the stringency of nonpharmaceutical interventions, and dominant SARS-CoV-2 variant types, populations that received mRNA and/or ADVV had significantly lower rates of cases and deaths over time (P <0.001 for each analysis). Populations vaccinated with IVV, among others, had significantly higher rates of cases and deaths over time (P <0.05 for each analysis). The real-world effectiveness of IVV may be inferior to mRNA and/or ADVV, and prospective comparative studies are needed to critically evaluate the role of IVV in the context of contemporary SARS-CoV-2 variants.
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