Effectiveness of Severe Acute Respiratory Syndrome Coronavirus 2 Messenger RNA Vaccines for Preventing Coronavirus Disease 2019 Hospitalizations in the United States

중증 급성 호흡기 증후군 코로나바이러스 2 메신저 RNA 백신의 효과로 미국에서 코로나바이러스 질병 2019 입원 예방

Published on
Journal: Clinical Infectious Diseases: An Official Publicat
[키워드]
[저자] Mark W Tenforde, Manish M Patel, Adit A Ginde, David J Douin, H Keipp Talbot, Jonathan D Casey, Nicholas M Mohr, Anne Zepeski, Manjusha Gaglani, Tresa McNeal, Shekhar Ghamande, Nathan I Shapiro, Kevin W Gibbs, D Clark Files, David N Hager, Arber Shehu, Matthew E Prekker, Heidi L Erickson, Matthew C Exline, Michelle N Gong, Amira Mohamed, Daniel J Henning, Jay S Steingrub, Ithan D Peltan, Samuel M Brown, Emily T Martin, Arnold S Monto, Akram Khan, Catherine L Hough, Laurence W Busse, Caitlin C Ten Lohuis, Abhijit Duggal, Jennifer G Wilson, Alexandra June Gordon, Nida Qadir, Steven Y Chang, Christopher Mallow, Hayley B Gershengorn, Hilary M Babcock, Jennie H Kwon, Natasha Halasa, James D Chappell, Adam S Lauring, Carlos G Grijalva, Todd W Rice, Ian D Jones, William B Stubblefield, Adrienne Baughman, Kelsey N Womack, Christopher J Lindsell, Kimberly W Hart, Yuwei Zhu, Samantha M Olson, Meagan Stephenson, Stephanie J Schrag, Miwako Kobayashi, Jennifer R Verani, Wesley H Self, Influenza and Other Viruses in the Acutely Ill (IVY) Network
[Category] COVID19(2023년), SARS, 변종,
PMC URL    [DOI] 10.1093/cid/ciab687    
[Article Type] Multicenter Study
[Source] PMC

Abstract
Background: As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination coverage increases in the United States, there is a need to understand the real-world effectiveness against severe coronavirus disease 2019 (COVID-19) and among people at increased risk for poor outcomes.
Methods: In a multicenter case-control analysis of US adults hospitalized March 11-May 5, 2021, we evaluated vaccine effectiveness to prevent COVID-19 hospitalizations by comparing odds of prior vaccination with a messenger RNA (mRNA) vaccine (Pfizer-BioNTech or Moderna) between cases hospitalized with COVID-19 and hospital-based controls who tested negative for SARS-CoV-2.
Results: Among 1212 participants, including 593 cases and 619 controls, median age was 58 years, 22.8% were Black, 13.9% were Hispanic, and 21.0% had immunosuppression. SARS-CoV-2 lineage B0.1.1.7 (Alpha) was the most common variant (67.9% of viruses with lineage determined). Full vaccination (receipt of 2 vaccine doses ≥14 days before illness onset) had been received by 8.2% of cases and 36.4% of controls. Overall vaccine effectiveness was 87.1% (95% confidence interval [CI], 80.7-91.3). Vaccine effectiveness was similar for Pfizer-BioNTech and Moderna vaccines, and highest in adults aged 18-49 years (97.4%; 95% CI, 79.3-9.7). Among 45 patients with vaccine-breakthrough COVID hospitalizations, 44 (97.8%) were ≥50 years old and 20 (44.4%) had immunosuppression. Vaccine effectiveness was lower among patients with immunosuppression (62.9%; 95% CI,20.8-82.6) than without immunosuppression (91.3%; 95% CI, 85.6-94.8).
Conclusion: During March-May 2021, SARS-CoV-2 mRNA vaccines were highly effective for preventing COVID-19 hospitalizations among US adults. SARS-CoV-2 vaccination was beneficial for patients with immunosuppression, but effectiveness was lower in the immunosuppressed population.
Keywords: COVID-19; hospitalized; immunocompromised; mRNA vaccines; vaccine effectiveness.

All Keywords
【저자키워드】 COVID-19, Hospitalized, mRNA vaccines, Immunocompromised, vaccine effectiveness, 【초록키워드】 coronavirus disease, SARS-CoV-2, Coronavirus disease 2019, Vaccine, coronavirus, vaccination, Vaccines, mRNA vaccine, variant, Immunosuppression, severe acute respiratory syndrome Coronavirus, virus, mRNA vaccines, COVID, vaccine dose, outcomes, Adults, Coverage, mRNA, hospitalizations, Patient, Lineage, Effectiveness, Control, Immunocompromised, Case-control, COVID-19 hospitalization, United States, multicenter, Pfizer-BioNTech, SARS-CoV-2 vaccination, Moderna, Hispanic, Analysis, Immunosuppressed, black, Messenger RNA, acute respiratory syndrome, Participants, 95% CI, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, 95% confidence interval, increased risk, severe coronavirus disease, median age, receipt, illness onset, SARS-CoV-2 lineage, The United States, Prevent, controls, effective, highest, tested, evaluated, increases in, adults hospitalized, with COVID-19, 【제목키워드】 coronavirus 2, RNA, respiratory, messenger, the United State, Preventing,
{{{ 추상적인 }}} {{ 배경: }} 미국에서 중증급성호흡기증후군 코로나바이러스 2(SARS-CoV-2) 예방접종 범위가 증가함에 따라 중증 코로나바이러스 감염증 2019(COVID-19) 및 나쁜 결과에 대한 위험이 증가된 사람들 사이에서. {{ 방법: }} 2021년 3월 11일부터 5월 5일까지 입원한 미국 성인에 대한 다기관 사례 대조 분석에서 우리는 이전 예방 접종과 메신저 RNA(mRNA) 백신( Pfizer-BioNTech 또는 Moderna) COVID-19로 입원한 사례와 SARS-CoV-2에 대해 음성 판정을 받은 병원 기반 대조군 사이. {{ 결과: }} 593건의 사례와 619명의 대조군을 포함한 1212명의 참가자 중 중앙 연령은 58세, 22.8%가 흑인, 13.9%가 히스패닉, 21.0%가 면역 억제를 가지고 있었습니다. SARS-CoV-2 계통 B0.1.1.7(알파)은 가장 일반적인 변이체였습니다(계통이 결정된 바이러스의 67.9%). 전체 백신 접종(질병 발병 14일 이상 전에 2회 백신 접종)은 사례의 8.2%와 대조군의 36.4%에서 받았습니다. 전체 백신 효과는 87.1%(95% 신뢰 구간[CI], 80.7-91.3)였습니다. 백신 효과는 Pfizer-BioNTech 및 Moderna 백신과 유사했으며 18-49세 성인에서 가장 높았습니다(97.4%; 95% CI, 79.3-9.7). 백신으로 인한 코로나19로 입원한 환자 45명 중 50세 이상 환자는 44명(97.8%), 면역억제 환자는 20명(44.4%)이었다. 면역억제군(62.9%; 95% CI, 20.8-82.6)이 면역억제군이 없는 환자(91.3%, 95% CI, 85.6-94.8)보다 백신 효과가 더 낮았습니다. {{ 결론: }} 2021년 3월-5월 동안 SARS-CoV-2 mRNA 백신은 미국 성인의 COVID-19 입원 예방에 매우 효과적이었습니다. SARS-CoV-2 예방 접종은 면역 억제 환자에게 유익했지만 면역 억제 인구에서는 효과가 더 낮았습니다. {{ 키워드: }} 코로나19; 입원; 면역저하; mRNA 백신; 백신 효과.