BNT162b2 和 CoronaVac 对儿童和青少年 COVID-19 相关严重后果的疗效：巴西全国性队列研究

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2024-11-26 DOI:10.1016/j.vaccine.2024.126550

Eliandra da Silveira de Lima , Marcos Otávio Brum Antunes , Jesuely Spieckert de Souza , Marcus H. Jones , Renato T. Stein , Leonardo A. Pinto , Frederico Friedrich , Marcelo Comerlato Scotta

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引用次数: 0

摘要

导言：来自大国的全国性数据库可提供有关 COVID-19 疫苗有效性 (VE) 的真实证据。本研究旨在评估BNT162b2和CoronaVac在巴西COVID-19大流行的Omicron波期间对学龄儿童和青少年COVID-19相关严重后果的VE。方法一项基于人群的全国性队列研究比较了 2022 年学龄儿童（5-11 岁）和青少年（12-17 岁）中因 COVID-19 相关严重急性呼吸系统综合征（SARS）住院、需要侵入性呼吸支持和死亡的发病风险比 (IRR)，并按疫苗接种情况（无、一剂或两剂）进行了分层。这一时期包括学龄儿童的流行病学周 (EW) 10 至 34，以及青少年的流行病学周 1 至 22。所有因实验室确诊为 COVID-19 相关的 SARS 而住院治疗的患者数据均从 OpenDATASUS 中提取，其中包括临床结果和疫苗接种情况等个人数据。疫苗接种覆盖率是通过巴西卫生部 "Vacinômetro COVID-19 "仪表盘的数据估算得出的。结果对19,219,424名学龄儿童和22,580,918名青少年的合格人群进行了评估。在学龄儿童中，接种一剂和两剂疫苗后，因 SARS 住院、接受侵入性呼吸支持治疗和死亡的 VE 分别为 61 % 和 58 %、62 % 和 74 %，以及 81 % 和 88 %（所有 p 均为 0.01）。在青少年中，服用一剂和两剂后，针对相同结果的 VE 分别为 55 % 和 72 %、60 % 和 78 %，以及 83 % 和 80 %（所有 p 均为 0.05）。结论COVID-19疫苗可有效预防学龄儿童和青少年的严重后果，即使只接种一剂疫苗也能降低死亡率。在学龄儿童中，CoronaVac的效果并不比BNT162b2差。

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Effectiveness of BNT162b2 and CoronaVac against COVID-19-related severe outcomes among children and adolescents: A Brazilian nationwide cohort study

Introduction

Nationwide databases from large countries may provide real-world evidence about COVID-19 vaccine effectiveness (VE). This study sought to assess the VE of BNT162b2 and CoronaVac against COVID-19-related severe outcomes in school-aged children and adolescents during the Omicron wave of the COVID-19 pandemic in Brazil.

Methods

A nationwide population-based cohort study compared the incidence risk ratios (IRRs) of hospitalization due to COVID-19-associated severe acute respiratory syndrome (SARS), need for invasive ventilatory support, and death among school-aged children (age 5 to 11 years) and adolescents (age 12 to 17 years), stratified by vaccination status (none, one, or two doses), in 2022. The period included epidemiological weeks (EW) 10 to 34 for school-aged children and EW 1 to EW 22 for adolescents. Data from all individuals hospitalized due to laboratory-confirmed COVID-19-related SARS were extracted from OpenDATASUS, where individual data including clinical outcomes and vaccination status are available. Vaccine coverage was estimated using data from the Brazilian Ministry of Health “Vacinômetro COVID-19” dashboard.

Results

An eligible population of 19,219,424 school-aged children and 22,580,918 adolescents was assessed. For school-aged children, the VE against hospitalization for SARS, invasive ventilatory support, and death after one and two doses was 61 % and 58 %, 62 % and 74 %, and 81 % and 88 %, respectively (all p < 0.01). Among adolescents, the VE against the same outcomes after one and two doses was 55 % and 72 %, 60 % and 78 %, and 83 % and 80 %, respectively (all p < 0.05). CoronaVac was noninferior to BNT162b2 considering all outcomes among fully vaccinated school-aged children, a group that could have received either of the two vaccines.

Conclusions

COVID-19 vaccines are effective against severe outcomes in school-aged children and adolescents and are protective against mortality even after a single dose. CoronaVac was not inferior to BNT162b2 in school-aged children.

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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

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.