MVA-BN vaccine effectiveness: A systematic review of real-world evidence in outbreak settings

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2024-10-16 DOI:10.1016/j.vaccine.2024.126409

Lauren M.K. Mason , Estefania Betancur , Margarita Riera-Montes , Florian Lienert , Suzanne Scheele

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引用次数: 0

Abstract

Background: Mpox is a disease endemic to Central and West Africa. It caused outbreaks in non-endemic countries, mainly in 2022. The endemic Democratic Republic of Congo is currently experiencing its largest outbreak yet. The vaccine Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN) is approved for active immunization against mpox and smallpox. Since the outbreak in 2022, real-world studies have assessed MVA-BN's vaccine effectiveness (VE) against mpox, and this systematic literature review aims to summarize the most current evidence.

Methods: Medline (via PubMed), Embase, and LILACS were searched, as well as grey literature sources and publications' bibliographies to identify observational studies published between 1/Jan/2022 and 28/Feb/2024 that estimate the VE of MVA-BN against mpox or provide risk measures that allow calculation of these VE estimates. Data were presented descriptively in tables and text; the methodological quality of included records was assessed using NHLBI/NIH quality assessment tools.

Results: The literature search identified 16 records that fit the inclusion criteria. The studies took place in high-income countries and were heterogeneous in design, setting, and definition of at-risk populations. MVA-BN VE estimates against mpox infection were assessed. Where the study population was exclusively or primarily those receiving pre-exposure prophylactic vaccination, the adjusted VE estimates ranged from 35 % to 86 % (n = 8 studies) for one dose and from 66 % to 90 % (n = 5) for two doses. Where only post-exposure prophylactic vaccination was assessed, adjusted VE estimates were reported for one dose only at 78 % and 89 % (n = 2). Additionally, MVA-BN reduced the risk of mpox-related hospitalization in one study and the severity of mpox clinical manifestations in two studies.

Conclusions: Despite heterogeneity in study design, setting, and at-risk populations, the reported VE estimates against mpox infection demonstrated the effectiveness of one or two doses of MVA-BN in the context of an outbreak across multiple countries.

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MVA-BN 疫苗的有效性：疫情爆发环境下真实世界证据的系统性审查

背景介绍麻腮风是一种流行于中非和西非的疾病。它主要于 2022 年在非流行国家爆发。流行的刚果民主共和国目前正在经历迄今为止最大规模的疫情爆发。改良型安卡拉-巴伐利亚-北欧（MVA-BN）疫苗已被批准用于天花和麻痘的主动免疫。自2022年疫情爆发以来，对MVA-BN的天花疫苗有效性（VE）进行了真实世界研究评估，本系统文献综述旨在总结最新证据：方法：对 Medline（通过 PubMed）、Embase 和 LILACS 以及灰色文献来源和出版物书目进行了检索，以确定在 2022 年 1 月 1 日至 2024 年 2 月 28 日期间发表的观察性研究，这些研究估计了 MVA-BN 对天花的 VE，或提供了可计算这些 VE 估计值的风险度量。数据以表格和文本的形式描述；采用 NHLBI/NIH 质量评估工具对纳入记录的方法学质量进行评估：文献检索发现了 16 条符合纳入标准的记录。这些研究发生在高收入国家，在设计、环境和高危人群定义方面存在差异。评估了针对 mpox 感染的 MVA-BN VE 估计值。如果研究人群完全或主要是那些接受暴露前预防接种的人，那么调整后的 VE 估计值为：接种一剂疫苗从 35% 到 86%（8 项研究）不等，接种两剂疫苗从 66% 到 90%（5 项研究）不等。在仅评估暴露后预防接种的情况下，仅报告了一剂疫苗的调整 VE 估计值为 78 % 和 89 %（n = 2）。此外，在一项研究中，MVA-BN 降低了与水痘相关的住院风险，在两项研究中降低了水痘临床表现的严重程度：结论：尽管在研究设计、环境和高危人群方面存在差异，但所报告的针对天花感染的VE估计值表明，在多个国家爆发疫情的情况下，服用一到两剂MVA-BN是有效的。

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

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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