Effects of Previous Infection and Vaccination on Symptomatic Omicron Infections,The New England Journal of Medicine

当前位置： X-MOL 学术 › N. Engl. J. Med. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Effects of Previous Infection and Vaccination on Symptomatic Omicron Infections
The New England Journal of Medicine ( IF 158.5 ) Pub Date : 2022-06-15 , DOI: 10.1056/nejmoa2203965
Heba N Altarawneh ₁ , Hiam Chemaitelly ₁ , Houssein H Ayoub ₁ , Patrick Tang ₁ , Mohammad R Hasan ₁ , Hadi M Yassine ₁ , Hebah A Al-Khatib ₁ , Maria K Smatti ₁ , Peter Coyle ₁ , Zaina Al-Kanaani ₁ , Einas Al-Kuwari ₁ , Andrew Jeremijenko ₁ , Anvar H Kaleeckal ₁ , Ali N Latif ₁ , Riyazuddin M Shaik ₁ , Hanan F Abdul-Rahim ₁ , Gheyath K Nasrallah ₁ , Mohamed G Al-Kuwari ₁ , Adeel A Butt ₁ , Hamad E Al-Romaihi ₁ , Mohamed H Al-Thani ₁ , Abdullatif Al-Khal ₁ , Roberto Bertollini ₁ , Laith J Abu-Raddad ₁

Affiliation

Background

The protection conferred by natural immunity, vaccination, and both against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with the BA.1 or BA.2 sublineages of the omicron (B.1.1.529) variant is unclear.

Methods

We conducted a national, matched, test-negative, case–control study in Qatar from December 23, 2021, through February 21, 2022, to evaluate the effectiveness of vaccination with BNT162b2 (Pfizer–BioNTech) or mRNA-1273 (Moderna), natural immunity due to previous infection with variants other than omicron, and hybrid immunity (previous infection and vaccination) against symptomatic omicron infection and against severe, critical, or fatal coronavirus disease 2019 (Covid-19).

Results

The effectiveness of previous infection alone against symptomatic BA.2 infection was 46.1% (95% confidence interval [CI], 39.5 to 51.9). The effectiveness of vaccination with two doses of BNT162b2 and no previous infection was negligible (−1.1%; 95% CI, −7.1 to 4.6), but nearly all persons had received their second dose more than 6 months earlier. The effectiveness of three doses of BNT162b2 and no previous infection was 52.2% (95% CI, 48.1 to 55.9). The effectiveness of previous infection and two doses of BNT162b2 was 55.1% (95% CI, 50.9 to 58.9), and the effectiveness of previous infection and three doses of BNT162b2 was 77.3% (95% CI, 72.4 to 81.4). Previous infection alone, BNT162b2 vaccination alone, and hybrid immunity all showed strong effectiveness (>70%) against severe, critical, or fatal Covid-19 due to BA.2 infection. Similar results were observed in analyses of effectiveness against BA.1 infection and of vaccination with mRNA-1273.

Conclusions

No discernable differences in protection against symptomatic BA.1 and BA.2 infection were seen with previous infection, vaccination, and hybrid immunity. Vaccination enhanced protection among persons who had had a previous infection. Hybrid immunity resulting from previous infection and recent booster vaccination conferred the strongest protection. (Funded by Weill Cornell Medicine–Qatar and others.)

中文翻译：

既往感染和疫苗接种对有症状的 Omicron 感染的影响

背景

自然免疫、疫苗接种以及两者针对 omicron (B.1.1.529) 变种的 BA.1 或 BA.2 亚系感染的有症状的严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 所提供的保护作用尚不清楚。

方法

我们于 2021 年 12 月 23 日至 2022 年 2 月 21 日在卡塔尔进行了一项全国性匹配、检测阴性病例对照研究，以评估 BNT162b2 (Pfizer-BioNTech) 或 mRNA-1273 (Moderna) 疫苗接种的有效性，由于既往感染 omicron 以外的变种而产生的自然免疫力，以及针对有症状的 omicron 感染和严重、危重或致命的 2019 年冠状病毒病 (Covid-19) 的混合免疫（既往感染和疫苗接种）。

结果

仅先前感染对有症状的 BA.2 感染的有效性为 46.1%（95% 置信区间 [CI]，39.5 至 51.9）。接种两剂 BNT162b2 且既往没有感染的疫苗接种效果可以忽略不计（-1.1%；95% CI，-7.1 至 4.6），但几乎所有的人都在 6 个多月前接受了第二剂疫苗。三种剂量的 BNT162b2 且既往无感染的有效性为 52.2%（95% CI，48.1 至 55.9）。既往感染和两剂 BNT162b2 的有效性为 55.1%（95% CI，50.9 至 58.9），既往感染和三剂 BNT162b2 的有效性为 77.3%（95% CI，72.4 至 81.4）。单独既往感染、单独接种 BNT162b2 疫苗以及混合免疫都对 BA.2 感染引起的严重、危重或致命 Covid-19 表现出很强的有效性 (>70%)。在针对 BA.1 感染和 mRNA-1273 疫苗接种的有效性分析中观察到了类似的结果。