■COVID-19二价疫苗(BV)的快速发展涵盖了原始病毒株和变异株。然而,BV的有效性在很大程度上是未知的。因此,我们对BV的有效性进行了系统评价和荟萃分析.
■文献研究是通过PubMed进行的,科克伦图书馆,Embase,和WebofScience直到2023年11月4日。随机对照试验和观察性研究均被纳入考虑。使用随机效应模型计算集合估计值。在队列和病例对照研究中,使用纽卡斯尔-渥太华量表(NOS)评估偏倚的风险。
■共审查了1,174篇文章,纳入了22项符合条件的研究。所有纳入的研究均为观察性研究(15项队列研究,7个病例对照研究)。参与者总数为39,673,160,作为干预组接种BV的人数为11,585,182。主要涉及两种mRNABVs,包括祖先菌株和BA.1或BA.4-5变体。Meta分析结果显示,与单价疫苗(MV)相比,BV在COVID-19相关感染/有症状感染中的相对有效性(rVE),疾病,住院治疗,死亡率为30.90%[95%置信区间(CI),8.43-53.37],39.83%(95%CI,27.34-52.32),59.70%(95%CI,44.08-75.32),和72.23%(95%CI,62.08-82.38),分别。对于50岁及以上的人来说,与MV相比,BV提供了额外的49.69%(95%CI,41.44-57.94)有效保护。在omicronXBB变异株的优势期,与MV相比,BV提供了额外的47.63%(95%CI,27.45-67.82)有效保护。
■我们的研究结果表明,BV在预防COVID-19相关感染方面的作用,有症状的感染,疾病,住院治疗,与MV相比,死亡人数更高。特别是对于50岁以上的人和Omicron变体XBB优势阶段,BV提供卓越的保护。因此,BV可能在预防和控制冠状病毒变体中具有更广泛的应用。
UNASSIGNED: The rapid development of COVID-19 bivalent vaccines (BVs) has encompassed both the original virus strains and the variant strain. However, the effectiveness of BVs is largely unknown. Therefore, we conducted a systematic review and meta-analysis of the effectiveness of BVs.
UNASSIGNED: Literature research was conducted through PubMed, Cochrane Library, Embase, and Web of Science up until November 4, 2023. Both randomized control trials and observational studies were considered for inclusion. Pooled estimates were calculated using a random effects model. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias in cohort and case-control studies.
UNASSIGNED: A total of 1,174 articles were reviewed and 22 eligible studies were included. All included studies were observational (15 cohort studies, 7 case-control studies). The total number of participants was 39,673,160, and the number of people vaccinated with BVs as an intervention group was 11,585,182. Two mRNA BVs were mainly involved, including the ancestral strain and the BA.1 or BA.4-5 variants. Meta-analysis results showed, compared with the monovalent vaccines (MVs), the relative effectiveness (rVE) of the BVs in COVID-19-associated infections/symptomatic infections, illnesses, hospitalizations, and deaths was 30.90% [95% confidence interval (CI), 8.43-53.37], 39.83% (95% CI, 27.34-52.32), 59.70% (95% CI, 44.08-75.32), and 72.23% (95% CI, 62.08-82.38), respectively. For those aged 50 years and older, BVs provided an additional 49.69% (95% CI, 41.44-57.94) effective protection compared with MVs. During the dominance period of the omicron XBB variant strain, BVs provided an additional 47.63% (95% CI, 27.45-67.82) effective protection compared with MVs.
UNASSIGNED: Our findings show that the rVE of BVs in preventing COVID-19-associated infections, symptomatic infections, illnesses, hospitalizations, and deaths is higher compared to MVs. Particularly for people over 50 years of age and during the Omicron variant XBB dominance phase, BVs provided superior protection. Therefore, BVs may have a broader application in the prevention and control of coronaviruses variant.