■在新兴的SARS-CoV-2变体或谱系以及新疫苗的背景下,准确监测COVID-19疫苗有效性(CVE)是为疫苗接种活动提供信息的关键。
为了评估2022年秋季和冬季至2023年施用的COVID-19疫苗对有症状的SARS-CoV-2感染(尤其是所有循环病毒和XBB谱系)的有效性在欧洲60岁或以上的人群中,并比较所使用的暴露组和参考组的不同CVE方法。
■这项病例对照研究从VEBIS(疫苗有效性,负担和影响研究),一项多中心研究,从11个欧洲地点收集COVID-19和流感数据:克罗地亚;法国;德国;匈牙利;爱尔兰;葡萄牙;荷兰;罗马尼亚;西班牙,国家;西班牙,纳瓦拉地区;和瑞典。参与者是年龄在60岁或以上,有急性呼吸道感染症状的初级保健患者,他们是在2022年9月至2023年8月COVID-19疫苗接种活动开始后在11个地点招募的。病例和对照被定义为阳性和阴性的患者,分别,逆转录-聚合酶链反应(RT-PCR)检测结果。
■接触的是COVID-19疫苗。暴露组由在2022年秋季和冬季至2023年疫苗接种运动期间以及症状发作前14天或更长时间接受COVID-19疫苗的患者组成。参考组包括在2022年至2023年运动(季节性CVE)之前或之前6个月未接种疫苗的患者,那些从未接种过疫苗的人(绝对CVE),以及在运动前至少6个月或更长时间接种了主要系列疫苗的人(相对CVE)。对于第二助推器的相对CVE,将在运动期间接受第二次加强治疗的患者与运动前6个月或更长时间接受一次加强治疗的患者进行比较.
■结果经RT-PCR确认,医疗护理,有症状的SARS-CoV-2感染。生成了四个CVE估计值:季节性,绝对,相对,和第二助推器的亲戚。CVE使用逻辑回归估计,调整研究地点,症状发作日期,年龄,慢性疾病,和性爱。
■共包括9308名初级保健患者,1687例(1035名女性;中位[IQR]年龄,71[65-79]岁)和7621名对照(4619名女性[61%];中位[IQR]年龄,71[65-78]年)。接种疫苗后14至89天内,季节性CVE为29%(95%CI,14%-42%),绝对CVE为39%(95%CI,6%-60%),相对CVE为31%(95%CI,15%至44%),与所有SARS-CoV-2变体相比,第二助推器的相对CVE为34%(95%CI,18%-47%)。在相同的时间间隔内,季节性CVE为44%(95%CI,-10%至75%),绝对CVE为52%(95%CI,-23%至82%),相对CVE为47%(95%CI,-8%至77%),在高XBB循环期间,第二助推器的相对CVE为46%(95%CI,-13%至77%)。自接种疫苗以来,估计随着时间的推移而下降,疫苗接种后180天没有保护。
■在这项针对年长欧洲人的病例对照研究中,所有CVE方法都表明,2022年至2023年秋季和冬季施用的COVID-19疫苗可提供至少3个月的预防症状,医疗护理,实验室确诊的SARS-CoV-2感染。应使用CVE季节性方法持续监测新的COVID-19疫苗对新出现的SARS-CoV-2变体的有效性。
UNASSIGNED: In the context of emerging SARS-CoV-2 variants or lineages and new vaccines, it is key to accurately monitor COVID-19 vaccine effectiveness (CVE) to inform vaccination campaigns.
UNASSIGNED: To estimate the effectiveness of COVID-19 vaccines administered in autumn and winter 2022 to 2023 against symptomatic SARS-CoV-2 infection (with all circulating viruses and XBB lineage in particular) among people aged 60 years or older in Europe, and to compare different CVE approaches across the exposed and reference groups used.
UNASSIGNED: This case-control study obtained data from VEBIS (Vaccine Effectiveness, Burden and Impact Studies), a multicenter study that collects COVID-19 and influenza data from 11 European sites: Croatia; France; Germany; Hungary; Ireland; Portugal; the Netherlands; Romania; Spain, national; Spain, Navarre region; and Sweden. Participants were primary care patients aged 60 years or older with acute respiratory infection symptoms who were recruited at the 11 sites after the start of the COVID-19 vaccination campaign from September 2022 to August 2023. Cases and controls were defined as patients with positive and negative, respectively, reverse transcription-polymerase chain reaction (RT-PCR) test results.
UNASSIGNED: The exposure was COVID-19 vaccination. The exposure group consisted of patients who received a COVID-19 vaccine during the autumn and winter 2022 to 2023 vaccination campaign and 14 days or more before symptom onset. Reference group included patients who were not vaccinated during or in the 6 months before the 2022 to 2023 campaign (seasonal CVE), those who were never vaccinated (absolute CVE), and those who were vaccinated with at least the primary series 6 months or more before the campaign (relative CVE). For relative CVE of second boosters, patients receiving their second booster during the campaign were compared with those receiving 1 booster 6 months or more before the campaign.
UNASSIGNED: The outcome was RT-PCR-confirmed, medically attended, symptomatic SARS-CoV-2 infection. Four CVE estimates were generated: seasonal, absolute, relative, and relative of second boosters. CVE was estimated using logistic regression, adjusting for study site, symptom onset date, age, chronic condition, and sex.
UNASSIGNED: A total of 9308 primary care patients were included, with 1687 cases (1035 females; median [IQR] age, 71 [65-79] years) and 7621 controls (4619 females [61%]; median [IQR] age, 71 [65-78] years). Within 14 to 89 days after vaccination, seasonal CVE was 29% (95% CI, 14%-42%), absolute CVE was 39% (95% CI, 6%-60%), relative CVE was 31% (95% CI, 15% to 44%), and relative CVE of second boosters was 34% (95% CI, 18%-47%) against all SARS-CoV-2 variants. In the same interval, seasonal CVE was 44% (95% CI, -10% to 75%), absolute CVE was 52% (95% CI, -23% to 82%), relative CVE was 47% (95% CI, -8% to 77%), and relative CVE of second boosters was 46% (95% CI, -13% to 77%) during a period of high XBB circulation. Estimates decreased with time since vaccination, with no protection from 180 days after vaccination.
UNASSIGNED: In this case-control study among older Europeans, all CVE approaches suggested that COVID-19 vaccines administered in autumn and winter 2022 to 2023 offered at least 3 months of protection against symptomatic, medically attended, laboratory-confirmed SARS-CoV-2 infection. The effectiveness of new COVID-19 vaccines against emerging SARS-CoV-2 variants should be continually monitored using CVE seasonal approaches.