■2019年冠状病毒病(COVID-19)疫苗接种对COVID-19的有效性随着时间的推移而减弱。这项研究旨在通过将第一剂COVID-19加强剂与完全疫苗接种进行比较来综合其临床有效性。
■PubMed的研究,WebofScience,Embase,并在2021年1月1日至2022年9月10日期间检索临床试验数据库.如果研究包括从未或目前没有感染过SARS-CoV-2,没有免疫力或免疫抑制受损的一般成年参与者,并且没有严重的疾病。SARS-CoV-2的S和S亚基抗体的血清转化率和抗体滴度,频率,特异性T细胞和B细胞的表型,以及涉及确诊感染的临床事件,入住重症监护病房(ICU),比较首次加强剂量COVID-19疫苗接种组和完全疫苗接种组的死亡情况。使用DerSimoian和Laird随机效应模型来估计临床感兴趣的结果的合并风险比(RR)和相应的95%置信区间(CI)。虽然定性描述主要用于比较COVID-19疫苗接种组和完全疫苗接种组的首次加强剂量之间的免疫原性。敏感性分析用于处理异质性。
■在确定的10173条记录中,包括10项研究进行分析。第一剂COVID-19加强疫苗可以诱导针对各种SAS-CoV-2片段的抗体的更高的血清转化率,针对各种SARS-CoV-2变体的更高的中和抗体滴度,和强大的细胞免疫反应相比,完全接种疫苗。SARS-CoV-2感染的风险,进入ICU的风险,非加强组的死亡风险均高于加强组,RR为9.45(95%CI3.22-27.79;总评估人口12,422,454与8,441,368;I2=100%),14.75(95%CI4.07-53.46;总评估人口12,048,224与7,291,644;I2=91%),和13.63(95%CI4.72-39.36;总评估人口12,385,960与8,297,037;I2=85%),分别。
■同质或异质加强COVID-19疫苗接种可引起对SARS-CoV-2的强烈体液和细胞免疫反应。此外,除了两种剂量外,它还能显著降低SARS-CoV-2感染和严重COVID-19临床事件的风险.需要进一步的研究来调查首次加强剂量的COVID-19疫苗的长期临床有效性,并比较同质和异质加强COVID-19疫苗接种之间的有效性。
■https://inplasy.com/inplasy-2022-11-0114/,标识符:INPLASY2022110114。
The effectiveness of full Coronavirus Disease 2019 (COVID-19) vaccination against COVID-19 wanes over time. This study aimed to synthesize the clinical effectiveness of the first dose of COVID-19
booster by comparing it to the full vaccination.
Studies in PubMed, Web of Science, Embase, and clinical trials databases were searched from 1 January 2021 to 10 September 2022. Studies were eligible if they comprised general adult participants who were not ever or currently infected with SARS-CoV-2, did not have impaired immunity or immunosuppression, and did not have severe diseases. The seroconversion rate of antibodies to S and S subunits and antibody titers of SARS-CoV-2, frequency, phenotype of specific T and B cells, and clinical events involving confirmed infection, admission to the intensive care unit (ICU), and death were compared between the first booster dose of COVID-19 vaccination group and full vaccination group. The DerSimonian and Laird random effects models were used to estimate the pooled risk ratios (RRs) and corresponding 95% confidence intervals (CIs) for the outcomes of clinical interest. While a qualitative description was mainly used to compare the immunogenicity between the first
booster dose of COVID-19 vaccination group and full vaccination group. Sensitivity analysis was used to deal with heterogenicity.
Of the 10,173 records identified, 10 studies were included for analysis. The first dose COVID-19
booster vaccine could induce higher seroconversion rates of antibodies against various SAS-CoV-2 fragments, higher neutralization antibody titers against various SARS-CoV-2 variants, and robust cellular immune response compared to the full vaccination. The risk of SARS-CoV-2 infection, the risk of admission to the ICU, and the risk of death were all higher in the non-booster group than those in the
booster group, with RRs of 9.45 (95% CI 3.22-27.79; total evaluated population 12,422,454 vs. 8,441,368; I2 = 100%), 14.75 (95% CI 4.07-53.46; total evaluated population 12,048,224 vs. 7,291,644; I2 = 91%), and 13.63 (95% CI 4.72-39.36; total evaluated population 12,385,960 vs. 8,297,037; I2 = 85%), respectively.
A homogenous or heterogeneous
booster COVID-19 vaccination could elicit strong humoral and cellular immune responses to SARS-CoV-2. Furthermore, it could significantly reduce the risk of SARS-CoV-2 infection and severe COVID-19 clinical events on top of two doses. Future studies are needed to investigate the long-term clinical effectiveness of the first booster dose of the COVID-19 vaccine and compare the effectiveness between homogenous and heterogeneous booster COVID-19 vaccination.
https://inplasy.com/inplasy-2022-11-0114/, identifier: INPLASY2022110114.