PDF(Pubmed)
Abstract：
UNASSIGNED: The fight against SARS-CoV-2 has been a major task worldwide since it was first identified in December 2019. An imperative preventive measure is the availability of efficacious vaccines while there is also a significant interest in the protective effect of a previous SARS-CoV-2 infection on a subsequent infection (natural protection rate).
UNASSIGNED: In order to compare protection rates after infection and vaccination, researchers consider different effect measures such as 1 minus hazard ratio, 1 minus odds ratio, or 1 minus risk ratio. These measures differ in a setting with competing risks. Nevertheless, as there is no unique definition, these metrics are frequently used in studies examining protection rate. Comparison of protection rates via vaccination and natural infection poses several challenges. For instance many publications consider the epidemiological definition, that a reinfection after a SARS-CoV-2 infection is only possible after 90 days, whereas there is no such constraint after vaccination. Furthermore, death is more prominent as a competing event during the first 90 days after infection compared to vaccination. In this work we discuss the statistical issues that arise when investigating protection rates comparing vaccination with infection. We explore different aspects of effect measures and provide insights drawn from different analyses, distinguishing between the first and the second 90 days post-infection or vaccination.
UNASSIGNED: In this study, we have access to real-world data of almost two million people from Stockholm County, Sweden. For the main analysis, data of over 52.000 people is considered. The infected group is younger, includes more men, and is less morbid compared to the vaccinated group. After the first 90 days, these differences increased. Analysis of the second 90 days shows differences between analysis approaches and between age groups. There are age-related differences in mortality. Considering the outcome SARS-CoV-2 infection, the effect of vaccination versus infection varies by age, showing a disadvantage for the vaccinated in the younger population, while no significant difference was found in the elderly.
UNASSIGNED: To compare the effects of immunization through infection or vaccination, we emphasize consideration of several investigations. It is crucial to examine two observation periods: The first and second 90-day intervals following infection or vaccination. Additionally, methods to address imbalances are essential and need to be used. This approach supports fair comparisons, allows for more comprehensive conclusions and helps prevent biased interpretations.
UNASSIGNED: In order to compare protection rates after infection and vaccination, researchers consider different effect measures such as 1 minus hazard ratio, 1 minus odds ratio, or 1 minus risk ratio. These measures differ in a setting with competing risks. Nevertheless, as there is no unique definition, these metrics are frequently used in studies examining protection rate. Comparison of protection rates via vaccination and natural infection poses several challenges. For instance many publications consider the epidemiological definition, that a reinfection after a SARS-CoV-2 infection is only possible after 90 days, whereas there is no such constraint after vaccination. Furthermore, death is more prominent as a competing event during the first 90 days after infection compared to vaccination. In this work we discuss the statistical issues that arise when investigating protection rates comparing vaccination with infection. We explore different aspects of effect measures and provide insights drawn from different analyses, distinguishing between the first and the second 90 days post-infection or vaccination.
UNASSIGNED: In this study, we have access to real-world data of almost two million people from Stockholm County, Sweden. For the main analysis, data of over 52.000 people is considered. The infected group is younger, includes more men, and is less morbid compared to the vaccinated group. After the first 90 days, these differences increased. Analysis of the second 90 days shows differences between analysis approaches and between age groups. There are age-related differences in mortality. Considering the outcome SARS-CoV-2 infection, the effect of vaccination versus infection varies by age, showing a disadvantage for the vaccinated in the younger population, while no significant difference was found in the elderly.
UNASSIGNED: To compare the effects of immunization through infection or vaccination, we emphasize consideration of several investigations. It is crucial to examine two observation periods: The first and second 90-day intervals following infection or vaccination. Additionally, methods to address imbalances are essential and need to be used. This approach supports fair comparisons, allows for more comprehensive conclusions and helps prevent biased interpretations.
摘要：
自2019年12月首次确定以来，抗击SARS-CoV-2一直是全球的一项主要任务。必要的预防措施是有效疫苗的可用性，同时对先前的SARS-CoV-2感染对随后的感染的保护作用（自然保护率）也有很大的兴趣。
■为了比较感染和接种疫苗后的保护率，研究人员考虑不同的影响措施，如1减去危险比，1减去赔率比，或1减去风险比。这些措施在具有竞争风险的环境中有所不同。然而，因为没有唯一的定义，这些指标在检查保护率的研究中经常使用。通过疫苗接种和自然感染的保护率的比较提出了几个挑战。例如，许多出版物考虑流行病学定义，SARS-CoV-2感染后的再感染只有在90天后才有可能，而接种疫苗后没有这样的限制。此外，与接种疫苗相比,在感染后的前90天,死亡作为竞争事件更为突出.在这项工作中，我们讨论了将疫苗接种与感染进行比较时调查保护率时出现的统计问题。我们探讨了效果措施的不同方面，并提供了从不同分析中得出的见解，区分感染或疫苗接种后第90天和第90天。
■在这项研究中，我们可以访问来自斯德哥尔摩县的近200万人的真实数据，瑞典。对于主要分析，超过52.000人的数据被考虑。受感染的群体更年轻，包括更多的男人,并且与接种组相比病态较少。90天后，这些差异增加了。第二个90天的分析显示了分析方法之间和年龄组之间的差异。死亡率存在年龄相关差异。考虑到SARS-CoV-2感染的结果，疫苗接种对感染的影响因年龄而异，显示出年轻人接种疫苗的劣势，而在老年人中没有发现显着差异。
■为了比较通过感染或接种疫苗进行免疫接种的效果，我们强调考虑几项调查。检查两个观察期至关重要：感染或接种疫苗后的第一和第二个90天间隔。此外,解决失衡的方法至关重要，需要使用。这种方法支持公平的比较，允许更全面的结论，并有助于防止有偏见的解释。
■为了比较感染和接种疫苗后的保护率，研究人员考虑不同的影响措施，如1减去危险比，1减去赔率比，或1减去风险比。这些措施在具有竞争风险的环境中有所不同。然而，因为没有唯一的定义，这些指标在检查保护率的研究中经常使用。通过疫苗接种和自然感染的保护率的比较提出了几个挑战。例如，许多出版物考虑流行病学定义，SARS-CoV-2感染后的再感染只有在90天后才有可能，而接种疫苗后没有这样的限制。此外，与接种疫苗相比,在感染后的前90天,死亡作为竞争事件更为突出.在这项工作中，我们讨论了将疫苗接种与感染进行比较时调查保护率时出现的统计问题。我们探讨了效果措施的不同方面，并提供了从不同分析中得出的见解，区分感染或疫苗接种后第90天和第90天。
■在这项研究中，我们可以访问来自斯德哥尔摩县的近200万人的真实数据，瑞典。对于主要分析，超过52.000人的数据被考虑。受感染的群体更年轻，包括更多的男人,并且与接种组相比病态较少。90天后，这些差异增加了。第二个90天的分析显示了分析方法之间和年龄组之间的差异。死亡率存在年龄相关差异。考虑到SARS-CoV-2感染的结果，疫苗接种对感染的影响因年龄而异，显示出年轻人接种疫苗的劣势，而在老年人中没有发现显着差异。
■为了比较通过感染或接种疫苗进行免疫接种的效果，我们强调考虑几项调查。检查两个观察期至关重要：感染或接种疫苗后的第一和第二个90天间隔。此外,解决失衡的方法至关重要，需要使用。这种方法支持公平的比较，允许更全面的结论，并有助于防止有偏见的解释。
