ABSTRACT

Knowing vaccine effectiveness (VE) against variants of concern (VOCs) in the real-world setting is essential for public health decision-making. A systematic landscape of the VE against a series of clinical outcomes caused by the VOCs in the real-world setting is needed. We systematically searched for studies that evaluated VE against VOCs in the real-world setting and collected individual data. We identified 113 studies meeting the eligibility criteria. We found full vaccination provided strong protection against each clinical outcome with summary VE ranging from 86.8% to 96.0% Alpha, moderate protection against infection caused by Beta, Gamma and Delta with summary VE ranging from 70.9% to 72.8%, strong protection against severe disease caused by Delta with summary VE ranging from 84.9% to 90.3%, limited protection with summary VE of 23.5% (95% CI, 17.0–29.5) against infection and moderate protection with summary VE ranging from 56.5% to 82.4% against severe diseases caused by Omicron. Booster vaccination can provide a substantial improvement in protection against Delta and Omicron, but not as much as the Delta. The meta-regression analysis showed that the VE against the Omicron wanned over time, and the VE against hospitalization declined relatively slowly, compared to against infection. Those findings supported the need for public health measures, increasing booster vaccination coverage in response to current and new infectious waves driven by variants and developing broadly protective vaccines to confront virus evolution.

摘要

了解现实环境中针对关注变体 (VOC) 的疫苗有效性 (VE) 对于公共卫生决策至关重要。需要针对现实世界环境中 VOC 引起的一系列临床结果对 VE 进行系统的描述。我们系统地搜索了在现实环境中评估 VE 针对 VOC 的研究，并收集了个人数据。我们确定了 113 项符合资格标准的研究。我们发现完全疫苗接种对每种临床结果提供了强有力的保护，总结 VE 范围从 86.8% 到 96.0% Alpha，对由 Beta、Gamma 和 Delta 引起的感染提供中度保护，总结 VE 范围从 70.9% 到 72.8%，对严重疾病的强保护由 Delta 引起，摘要 VE 范围从 84.9% 到 90.3%，摘要 VE 为 23 的有限保护。5% (95% CI, 17.0–29.5) 抗感染和中度保护​​，总结 VE 范围从 56.5% 到 82.4% 抗 Omicron 引起的严重疾病。加强疫苗接种可以显着改善对 Delta 和 Omicron 的保护，但不如 Delta。元回归分析表明，针对 Omicron 的 VE 随着时间的推移而减弱，与针对感染的 VE 相比，针对住院的 VE 下降相对缓慢。这些发现支持了采取公共卫生措施的必要性，增加加强疫苗接种的覆盖率以应对由变体驱动的当前和新的感染波，并开发广泛的保护性疫苗以应对病毒进化。加强疫苗接种可以显着改善对 Delta 和 Omicron 的保护，但不如 Delta。元回归分析表明，针对 Omicron 的 VE 随着时间的推移而减弱，与针对感染的 VE 相比，针对住院的 VE 下降相对缓慢。这些发现支持了采取公共卫生措施的必要性，增加加强疫苗接种的覆盖率以应对由变体驱动的当前和新的感染波，并开发广泛的保护性疫苗以应对病毒进化。加强疫苗接种可以显着改善对 Delta 和 Omicron 的保护，但不如 Delta。元回归分析表明，针对 Omicron 的 VE 随着时间的推移而减弱，与针对感染的 VE 相比，针对住院的 VE 下降相对缓慢。这些发现支持了采取公共卫生措施的必要性，增加加强疫苗接种的覆盖率以应对由变体驱动的当前和新的感染波，并开发广泛的保护性疫苗以应对病毒进化。