COVID-19疫苗抗感染有效性轨迹估计

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-03-29 DOI:10.1016/j.vaccine.2025.127067

Jialiang Jiang , Kwok Fai Lam , Eric Ho Yin Lau , Guosheng Yin , Yun Lin , Benjamin John Cowling

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引用次数: 0

摘要

这项在香港进行的大规模队列研究考察了各种COVID-19疫苗和剂量方案对欧米克隆BA.1/BA的时变保护作用。2变种。采用创新的药代动力学/药效学模型来估计疫苗有效性随时间的变化轨迹。结果表明，CoronaVac单次最大保护作用为0.120，comirty单次最大保护作用为0.171。第二剂和第三剂的保护效果峰值分别为0.348和0.522。在4次给药方案中，CoronaVac的最大保护有效性为0.548，稳定在0.487，而Comirnaty的最大有效性为0.784，在给药最后一次给药6个月后稳定在0.714。疫苗的有效性表现出先上升后下降的模式，在接种后约1-2个月达到峰值。随着病毒进化的继续，了解免疫力下降对于优化疫苗接种策略和政策至关重要。这项现实世界的研究捕获了可能与有限随访的临床试验不同的不断变化的动态，为指导疫苗接种工作的优化提供了必要的证据。随着病毒形势的演变，对疫苗有效性的持续监测仍然至关重要。目的探讨不同COVID-19疫苗和给药方案对Omicron BA.1/BA感染的时变保护作用。2个在香港。方法利用香港2022年1月至2022年5月的疫苗接种记录、COVID-19确诊病例和人口普查数据，综合分析不同COVID-19疫苗和给药方案对欧米克隆ba1和ba2感染的保护作用随时间变化的情况。采用4参数药代动力学/药效学模型来估计疫苗有效性随时间的变化轨迹。结果在620万成人中，冠状病毒单剂疫苗的最大保护效果为0.120，社区疫苗的最大保护效果为0.171。在第二次和第三次剂量中，CoronaVac和Comirnaty的峰值有效性分别为0.348和0.522。值得注意的是，4剂方案导致CoronaVac和Comirnaty的最大保护作用分别为0.548和0.785，在最后一次剂量后6个月分别稳定在0.487和0.714。疫苗有效性呈现先上升后下降的模式，在接种后1-2个月左右达到峰值，强调了持续接种疫苗策略的重要性。结论：了解疫苗保护作用随着时间的推移而减弱的过程，对于制定最佳的疫苗接种策略、加强接种计划和公共卫生政策至关重要。这项现实世界的研究可以捕捉到可能不同于临床试验的变化动态，临床试验的随访期更有限，并且可以为指导疫苗接种策略的优化提供关键证据。随着病毒进化的继续，对疫苗有效性的持续监测仍然至关重要。

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Estimation of trajectory of COVID-19 vaccines effectiveness against infection

This large-scale cohort study conducted in Hong Kong examined the time-varying protective effects of various COVID-19 vaccines and dosing regimens against the Omicron BA.1/BA.2 variants. An innovative pharmacokinetic/pharmacodynamic model was employed to estimate the trajectory of vaccine effectiveness over time. Results indicated that the maximum protection for a single dose reached 0.120 for CoronaVac and 0.171 for Comirnaty. The peak protective effectiveness for the second and third doses were observed at 0.348 and 0.522, respectively. In a 4-dose regimen, CoronaVac demonstrated a maximum protective effectiveness of 0.548, stabilizing at 0.487, while Comirnaty achieved a maximum effectiveness of 0.784, stabilizing at 0.714 six months after the administration of the last dose. The vaccine effectiveness exhibited a rising and then declining pattern, peaking approximately 1–2 months post-vaccination. Understanding waning immunity is crucial for optimizing vaccination strategies and policies as viral evolution continues. This real-world study captured changing dynamics that may differ from clinical trials with limited follow-up, providing essential evidence to guide the optimization of vaccination efforts. Ongoing monitoring of vaccine effectiveness remains critical as the viral landscape evolves.

Objectives

This study aims to investigate the time-varying protective effects of various COVID-19 vaccines and dosing regimens against infections caused by the Omicron BA.1/BA.2 in Hong Kong.

Methods

This territory-wide cohort study from Hong Kong combined vaccination records, confirmed COVID-19 cases, and census data from January 2022 to May 2022 to comprehensively analyze the time-varying protective effects of different COVID-19 vaccines and dosing regimens against Omicron BA.1 and BA.2 infections. A 4-parameter pharmacokinetic/pharmacodynamic model was used to estimate the trajectory of vaccine effectiveness over time.

Results

Among 6.2 million adults, the maximum protective effectiveness for a single vaccine dose reached 0.120 for CoronaVac and 0.171 for Comirnaty. For the second and third doses, peak effectiveness were observed at 0.348 for CoronaVac and 0.522 for Comirnaty. Notably, a 4-dose regimen resulted in maximum protections of 0.548 for CoronaVac and 0.785 for Comirnaty, which stabilized at 0.487 and 0.714, respectively, six months following the last doses. The vaccine effectiveness exhibited a rising then declining pattern, peaking around 1–2 months post-vaccination, underscoring the importance of ongoing vaccination strategies.

Conclusions

Understanding the waning of vaccine protection over time is critical for informing optimal vaccination strategies, booster schedules, and public health policies. This real-world study can capture changing dynamics that may differ from clinical trials which have more limited follow-up periods, and can provide crucial evidence to guide optimization of vaccination strategies. Ongoing monitoring of vaccine effectiveness remains crucial as the viral evolution continues.

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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.