■在现实世界中,改良的安卡拉牛痘(MVA)疫苗对水痘的有效性数据有限。
■我们使用Cox比例风险回归进行了回顾性队列分析,以评估疫苗接种与实验室确认的痘发病率之间的关联。研究对象包括在西雅图性健康诊所看到的所有与男性发生性关系的男性,华盛顿,2020年1月1日至2022年12月31日。根据公共卫生疫苗登记和监测数据,确定受试者接种疫苗和诊断为水痘。分析根据人口因素进行了调整,人类免疫缺陷病毒(HIV)状态,和性危险行为。
■在0剂量的患者中,每100人年的水痘发生率为8.83,3.32在1剂量的患者中,2剂MVA疫苗的患者为0.78。天花诊断与年龄30-39和40-51岁显著相关,艾滋病毒阳性,梅毒诊断在前一年,>去年有10个性伴侣,去年还去了诊所.在调整这些因素的多变量模型中,1剂疫苗有效率为81%,2剂疫苗有效率为83%.
■这些数据支持MVA疫苗(包括单剂量疫苗)在预防水痘疾病方面的有效性,并强调了在流行病早期基于风险因素的免疫优先排序的适当性。MVA疫苗诱导免疫的持久性是未知的,高危人群应接受2剂MVA。
UNASSIGNED: Data on modified Vaccinia Ankara (MVA) vaccine effectiveness against mpox in real-world settings are limited.
UNASSIGNED: We performed a retrospective cohort analysis using Cox proportional hazards regression to estimate the association between vaccination and laboratory-confirmed mpox incidence. Study subjects included all men who have sex with men seen in a sexual health clinic in Seattle, Washington, between 1 January 2020 and 31 December 2022. Subjects\' receipt of vaccine and diagnosis with mpox were ascertained from public health vaccine registry and surveillance data. Analyses were adjusted for demographic factors, human immunodeficiency virus (HIV) status, and sexual risk behaviors.
UNASSIGNED: The incidence of mpox per 100 person-years was 8.83 among patients with 0 doses, 3.32 among patients with 1 dose, and 0.78 among patients with 2 doses of MVA vaccine. Mpox diagnosis was significantly associated with age category 30-39 and 40-51 years, HIV positivity, syphilis diagnosis in the prior year, >10 sex partners in the last year, and having a clinic visit in the last year. In the multivariate model adjusting for these factors, vaccine effectiveness was 81% for 1 dose and 83% for 2 doses.
UNASSIGNED: These data support the effectiveness of the MVA vaccine-including a single dose of the vaccine-in preventing mpox disease and highlight the appropriateness of risk factor-based prioritization of immunization early in the epidemic. The durability of MVA vaccine-induced immunity is unknown, and at-risk persons should receive 2 doses of MVA.