Effectiveness of SARS-CoV-2 primary vaccines and boosters in patients with type 2 diabetes mellitus in Hungary (HUN-VE 4 Study).

IF 3.7 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

BMJ Open Diabetes Research & Care Pub Date : 2024-01-24 DOI:10.1136/bmjdrc-2023-003777

Gergő A Molnár, Zoltán Vokó, Gábor Sütő, György Rokszin, Dávid Nagy, György Surján, Orsolya Surján, Péter Nagy, István Kenessey, András Wéber, Mihály Pálosi, Cecília Müller, Miklós Kásler, István Wittmann, Zoltan Kiss

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Abstract

Introduction: Type 2 diabetes mellitus is a risk factor for severe COVID-19 infection and is associated with increased risk of complications. The present study aimed to investigate effectiveness and persistence of different COVID vaccines in persons with or without diabetes during the Delta wave in Hungary.

Research design and methods: Data sources were the national COVID-19 registry data from the National Public Health Center and the National Health Insurance Fund on the total Hungarian population. The adjusted incidence rate ratios and corresponding 95% CIs were derived from a mixed-effect negative binomial regression model.

Results: A population of 672 240 cases with type 2 diabetes and a control group of 2 974 102 non-diabetic persons free from chronic diseases participated. Unvaccinated elderly persons with diabetes had 2.68 (95% CI 2.47 to 2.91) times higher COVID-19-related mortality rate as the 'healthy' controls. Primary immunization effectively equalized the risk of COVID-19 mortality between the two groups. Vaccine effectiveness declined over time, but the booster restored the effectiveness against mortality to over 90%. The adjusted vaccine effectiveness of the primary Pfizer-BioNTech against infection in the 14-120 days of postvaccination period was 71.6 (95% CI 66.3 to 76.1)% in patients aged 65-100 years with type 2 diabetes and 64.52 (95% CI 59.2 to 69.2)% in the controls. Overall, the effectiveness tended to be higher in individuals with diabetes than in controls. The booster vaccines could restore vaccine effectiveness to over 80% concerning risk of infection (eg, patients with diabetes aged 65-100 years: 89.1 (88.1-89.9)% with Pfizer-on-Pfizer, controls 65-100 years old: 86.9 (85.8-88.0)% with Pfizer-on-Pfizer, or patients with diabetes aged 65-100 years: 88.3 (87.2-89.2)% with Pfizer-on-Sinopharm, controls 65-100 years old: 87.8 (86.8-88.7)% with Pfizer-on-Sinopharm).

Conclusions: Our data suggest that people with type 2 diabetes may have even higher health gain when getting vaccinated as compared with non-diabetic persons, eliminating the marked, COVID-19-related excess risk of this population. Boosters could restore protection.

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匈牙利 2 型糖尿病患者接种 SARS-CoV-2 初次疫苗和强化疫苗的效果（HUN-VE 4 研究）。

导言：2 型糖尿病是严重 COVID-19 感染的一个风险因素，与并发症风险的增加有关。本研究旨在调查不同 COVID 疫苗在匈牙利德尔塔波期间对糖尿病患者或非糖尿病患者的有效性和持续性：数据来源是国家公共卫生中心和国家健康保险基金对匈牙利总人口进行的全国 COVID-19 登记数据。通过混合效应负二项回归模型得出调整后的发病率比和相应的 95% CI：参与调查的人群包括 672 240 名 2 型糖尿病患者和 2 974 102 名无慢性疾病的非糖尿病患者。未接种疫苗的老年糖尿病患者与 COVID-19 相关的死亡率是 "健康 "对照组的 2.68 倍（95% CI 2.47 至 2.91）。初级免疫接种有效地平衡了两组人群的 COVID-19 死亡风险。随着时间的推移，疫苗的有效性有所下降，但加强免疫可使疫苗的有效性恢复到 90% 以上。在接种后的14-120天内，调整后的辉瑞生物技术公司初级疫苗对65-100岁2型糖尿病患者的感染有效率为71.6%（95% CI 66.3-76.1），对对照组的有效率为64.52%（95% CI 59.2-69.2）。总体而言，糖尿病患者的有效性往往高于对照组。加强型疫苗可将疫苗有效性恢复到 80% 以上，从而降低感染风险（例如，65-100 岁的糖尿病患者：89.1（88.1-89.9）%；65-100 岁对照组：86.9（85.8-88.0）%；65-100 岁糖尿病患者：88.3（87.2-89.9）%：结论：我们的数据表明，2 型糖尿病患者使用辉瑞-新诺明的比例为 88.3 (87.2-89.2)%，65-100 岁对照组使用辉瑞-新诺明的比例为 87.8 (86.8-88.7)%：我们的数据表明，与非糖尿病患者相比，2 型糖尿病患者接种疫苗后可能会获得更高的健康收益，从而消除该人群与 COVID-19 相关的明显超额风险。增强剂可恢复保护。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

9.30

自引率

2.40%

发文量

123

审稿时长

18 weeks

期刊介绍： BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.