Diya Surie, Wesley H Self, Katharine A Yuengling, Adam S Lauring, Yuwei Zhu, Basmah Safdar, Adit A Ginde, Samantha J Simon, Ithan D Peltan, Samuel M Brown, Manjusha Gaglani, Shekhar Ghamande, Cristie Columbus, Nicholas M Mohr, Kevin W Gibbs, David N Hager, Matthew Prekker, Michelle N Gong, Amira Mohamed, Nicholas J Johnson, Jay S Steingrub, Akram Khan, Abhijit Duggal, Alexandra J Gordon, Nida Qadir, Steven Y Chang, Christopher Mallow, Jamie R Felzer, Jennie H Kwon, Matthew C Exline, Ivana A Vaughn, Mayur Ramesh, Leigh Papalambros, Jarrod M Mosier, Estelle S Harris, Adrienne Baughman, Sydney A Cornelison, Paul W Blair, Cassandra A Johnson, Nathaniel M Lewis, Sascha Ellington, Carlos G Grijalva, H Keipp Talbot, Jonathan D Casey, Natasha Halasa, James D Chappell, Rachel E Rutkowski, Kevin C Ma, Fatimah S Dawood
{"title":"美国60岁及以上成年人2个季节RSV疫苗预防住院的有效性","authors":"Diya Surie, Wesley H Self, Katharine A Yuengling, Adam S Lauring, Yuwei Zhu, Basmah Safdar, Adit A Ginde, Samantha J Simon, Ithan D Peltan, Samuel M Brown, Manjusha Gaglani, Shekhar Ghamande, Cristie Columbus, Nicholas M Mohr, Kevin W Gibbs, David N Hager, Matthew Prekker, Michelle N Gong, Amira Mohamed, Nicholas J Johnson, Jay S Steingrub, Akram Khan, Abhijit Duggal, Alexandra J Gordon, Nida Qadir, Steven Y Chang, Christopher Mallow, Jamie R Felzer, Jennie H Kwon, Matthew C Exline, Ivana A Vaughn, Mayur Ramesh, Leigh Papalambros, Jarrod M Mosier, Estelle S Harris, Adrienne Baughman, Sydney A Cornelison, Paul W Blair, Cassandra A Johnson, Nathaniel M Lewis, Sascha Ellington, Carlos G Grijalva, H Keipp Talbot, Jonathan D Casey, Natasha Halasa, James D Chappell, Rachel E Rutkowski, Kevin C Ma, Fatimah S Dawood","doi":"10.1001/jama.2025.15896","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>Respiratory syncytial virus (RSV) vaccines for adults aged 60 years or older became available in 2023. One dose is recommended for all adults aged 75 years or older and those aged 60 to 74 years at increased risk of severe RSV; however, duration of protection is unknown.</p><p><strong>Objective: </strong>To evaluate RSV vaccine effectiveness against RSV-associated hospitalization among adults aged 60 years or older during 2 RSV seasons.</p><p><strong>Design, setting, and participants: </strong>A total of 6958 adults aged 60 years or older were included in this test-negative, case-control study if they were hospitalized with acute respiratory illness at any of 26 hospitals in 20 US states during the October 1, 2023, to March 31, 2024, or October 1, 2024, to April 30, 2025, RSV seasons and had respiratory virus testing within 10 days of illness onset. Case patients tested positive for RSV only; control patients tested negative for RSV, SARS-CoV-2, and influenza. Demographic and clinical data were obtained through patient interview and electronic health records.</p><p><strong>Exposures: </strong>Receipt of 1 RSV vaccine dose at least 14 days before illness onset.</p><p><strong>Main outcomes and measures: </strong>Multivariable logistic regression was used to compare the odds of RSV vaccination among hospitalized cases and controls. Models were adjusted for age, sex, race and ethnicity, geographic region, and calendar month and year. Vaccine effectiveness was estimated as (1 - adjusted odds ratio) × 100%. Analyses were stratified by timing of RSV vaccine receipt (same vs prior season) relative to illness onset.</p><p><strong>Results: </strong>Of 6958 adults aged 60 years or older, 821 (11.8%) were RSV cases and 6137 (88.2%) were controls. A total of 1438 patients were Black (20.1%) and 4314 were White (62.0%); 3534 were female (50.8%). Median age was 72 years (IQR, 66-80 years) and 1829 adults (26.3%) were immunocompromised. A total of 63 cases (7.7%) and 966 controls (15.7%) were vaccinated. Estimated vaccine effectiveness against RSV-associated hospitalization was 58% (95% CI, 45%-68%) during 2 seasons and 69% (95% CI, 52%-81%) for same-season vaccination vs 48% (95% CI, 27%-63%; P = .06) for prior-season vaccination. Estimated vaccine effectiveness during 2 seasons was significantly lower among immunocompromised adults (30%; 95% CI, -9% to 55%) than immunocompetent adults (67%; 95% CI, 53%-77%; P = .02) and among those with cardiovascular disease (56%; 95% CI, 32%-72%) vs without (80%; 95% CI, 62%-90%; P = .03).</p><p><strong>Conclusions and relevance: </strong>Respiratory syncytial virus vaccines prevented RSV-associated hospitalization during 2 seasons, although effectiveness was lower in patients with immunocompromise and cardiovascular disease than in those without these conditions. Ongoing monitoring is needed to determine the optimal RSV revaccination interval.</p>","PeriodicalId":54909,"journal":{"name":"Jama-Journal of the American Medical Association","volume":" ","pages":""},"PeriodicalIF":55.0000,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398767/pdf/","citationCount":"0","resultStr":"{\"title\":\"RSV Vaccine Effectiveness Against Hospitalization Among US Adults Aged 60 Years or Older During 2 Seasons.\",\"authors\":\"Diya Surie, Wesley H Self, Katharine A Yuengling, Adam S Lauring, Yuwei Zhu, Basmah Safdar, Adit A Ginde, Samantha J Simon, Ithan D Peltan, Samuel M Brown, Manjusha Gaglani, Shekhar Ghamande, Cristie Columbus, Nicholas M Mohr, Kevin W Gibbs, David N Hager, Matthew Prekker, Michelle N Gong, Amira Mohamed, Nicholas J Johnson, Jay S Steingrub, Akram Khan, Abhijit Duggal, Alexandra J Gordon, Nida Qadir, Steven Y Chang, Christopher Mallow, Jamie R Felzer, Jennie H Kwon, Matthew C Exline, Ivana A Vaughn, Mayur Ramesh, Leigh Papalambros, Jarrod M Mosier, Estelle S Harris, Adrienne Baughman, Sydney A Cornelison, Paul W Blair, Cassandra A Johnson, Nathaniel M Lewis, Sascha Ellington, Carlos G Grijalva, H Keipp Talbot, Jonathan D Casey, Natasha Halasa, James D Chappell, Rachel E Rutkowski, Kevin C Ma, Fatimah S Dawood\",\"doi\":\"10.1001/jama.2025.15896\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>Respiratory syncytial virus (RSV) vaccines for adults aged 60 years or older became available in 2023. One dose is recommended for all adults aged 75 years or older and those aged 60 to 74 years at increased risk of severe RSV; however, duration of protection is unknown.</p><p><strong>Objective: </strong>To evaluate RSV vaccine effectiveness against RSV-associated hospitalization among adults aged 60 years or older during 2 RSV seasons.</p><p><strong>Design, setting, and participants: </strong>A total of 6958 adults aged 60 years or older were included in this test-negative, case-control study if they were hospitalized with acute respiratory illness at any of 26 hospitals in 20 US states during the October 1, 2023, to March 31, 2024, or October 1, 2024, to April 30, 2025, RSV seasons and had respiratory virus testing within 10 days of illness onset. Case patients tested positive for RSV only; control patients tested negative for RSV, SARS-CoV-2, and influenza. Demographic and clinical data were obtained through patient interview and electronic health records.</p><p><strong>Exposures: </strong>Receipt of 1 RSV vaccine dose at least 14 days before illness onset.</p><p><strong>Main outcomes and measures: </strong>Multivariable logistic regression was used to compare the odds of RSV vaccination among hospitalized cases and controls. Models were adjusted for age, sex, race and ethnicity, geographic region, and calendar month and year. Vaccine effectiveness was estimated as (1 - adjusted odds ratio) × 100%. Analyses were stratified by timing of RSV vaccine receipt (same vs prior season) relative to illness onset.</p><p><strong>Results: </strong>Of 6958 adults aged 60 years or older, 821 (11.8%) were RSV cases and 6137 (88.2%) were controls. A total of 1438 patients were Black (20.1%) and 4314 were White (62.0%); 3534 were female (50.8%). Median age was 72 years (IQR, 66-80 years) and 1829 adults (26.3%) were immunocompromised. A total of 63 cases (7.7%) and 966 controls (15.7%) were vaccinated. Estimated vaccine effectiveness against RSV-associated hospitalization was 58% (95% CI, 45%-68%) during 2 seasons and 69% (95% CI, 52%-81%) for same-season vaccination vs 48% (95% CI, 27%-63%; P = .06) for prior-season vaccination. Estimated vaccine effectiveness during 2 seasons was significantly lower among immunocompromised adults (30%; 95% CI, -9% to 55%) than immunocompetent adults (67%; 95% CI, 53%-77%; P = .02) and among those with cardiovascular disease (56%; 95% CI, 32%-72%) vs without (80%; 95% CI, 62%-90%; P = .03).</p><p><strong>Conclusions and relevance: </strong>Respiratory syncytial virus vaccines prevented RSV-associated hospitalization during 2 seasons, although effectiveness was lower in patients with immunocompromise and cardiovascular disease than in those without these conditions. Ongoing monitoring is needed to determine the optimal RSV revaccination interval.</p>\",\"PeriodicalId\":54909,\"journal\":{\"name\":\"Jama-Journal of the American Medical Association\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":55.0000,\"publicationDate\":\"2025-08-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398767/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Jama-Journal of the American Medical Association\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1001/jama.2025.15896\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jama-Journal of the American Medical Association","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1001/jama.2025.15896","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
重要性：适用于60岁及以上成人的呼吸道合胞病毒（RSV）疫苗将于2023年上市。建议所有75岁或以上的成年人以及60至74岁严重呼吸道合胞病毒风险增加的人服用一剂；然而，保护的持续时间是未知的。目的：评价RSV疫苗对2个RSV季节60岁及以上成人RSV相关住院的有效性。设计、环境和参与者：在2023年10月1日至2024年3月31日或2024年10月1日至2025年4月30日RSV季节期间，在美国20个州的26家医院中的任何一家因急性呼吸道疾病住院并在发病后10天内进行呼吸道病毒检测的60岁或60岁以上的成年人共6958人被纳入这项检测阴性的病例对照研究。仅RSV检测呈阳性的病例；对照患者RSV、SARS-CoV-2和流感检测呈阴性。通过患者访谈和电子健康记录获得人口统计和临床数据。接触：在发病前至少14天接种1剂RSV疫苗。主要结局和措施：采用多变量logistic回归比较住院病例和对照组之间RSV疫苗接种的几率。模型根据年龄、性别、种族和民族、地理区域和日历月份和年份进行了调整。疫苗有效性估计为（1校正优势比）× 100%。根据接种RSV疫苗的时间（同一季节与前一季节）与发病的关系对分析进行分层。结果：6958例60岁及以上老年人中，RSV病例821例（11.8%），对照组6137例（88.2%）。黑人1438例（20.1%），白人4314例（62.0%）；女性3534例（50.8%）。中位年龄为72岁（IQR， 66-80岁），1829名成年人（26.3%）免疫功能低下。共有63例（7.7%）和966例（15.7%）对照组接种了疫苗。2个季节疫苗对rsv相关住院的有效性估计为58% (95% CI, 45%-68%)，同一季节疫苗接种的有效性为69% (95% CI, 52%-81%)，而同期疫苗接种的有效性为48% (95% CI, 27%-63%; P =。06)季节前接种疫苗。免疫功能低下的成年人在2个季节的疫苗有效性估计（30%;95% CI， -9%至55%）显著低于免疫功能正常的成年人(67%;95% CI, 53%-77%; P =。02)和有心血管疾病者（56%;95% CI, 32%-72%） vs无心血管疾病者（80%;95% CI, 62%-90%; P = .03）。结论和相关性：呼吸道合胞病毒疫苗在2个季节内预防了rsv相关的住院治疗，尽管免疫功能低下和心血管疾病患者的有效性低于无这些疾病的患者。需要持续监测以确定最佳的RSV再接种间隔。
RSV Vaccine Effectiveness Against Hospitalization Among US Adults Aged 60 Years or Older During 2 Seasons.
Importance: Respiratory syncytial virus (RSV) vaccines for adults aged 60 years or older became available in 2023. One dose is recommended for all adults aged 75 years or older and those aged 60 to 74 years at increased risk of severe RSV; however, duration of protection is unknown.
Objective: To evaluate RSV vaccine effectiveness against RSV-associated hospitalization among adults aged 60 years or older during 2 RSV seasons.
Design, setting, and participants: A total of 6958 adults aged 60 years or older were included in this test-negative, case-control study if they were hospitalized with acute respiratory illness at any of 26 hospitals in 20 US states during the October 1, 2023, to March 31, 2024, or October 1, 2024, to April 30, 2025, RSV seasons and had respiratory virus testing within 10 days of illness onset. Case patients tested positive for RSV only; control patients tested negative for RSV, SARS-CoV-2, and influenza. Demographic and clinical data were obtained through patient interview and electronic health records.
Exposures: Receipt of 1 RSV vaccine dose at least 14 days before illness onset.
Main outcomes and measures: Multivariable logistic regression was used to compare the odds of RSV vaccination among hospitalized cases and controls. Models were adjusted for age, sex, race and ethnicity, geographic region, and calendar month and year. Vaccine effectiveness was estimated as (1 - adjusted odds ratio) × 100%. Analyses were stratified by timing of RSV vaccine receipt (same vs prior season) relative to illness onset.
Results: Of 6958 adults aged 60 years or older, 821 (11.8%) were RSV cases and 6137 (88.2%) were controls. A total of 1438 patients were Black (20.1%) and 4314 were White (62.0%); 3534 were female (50.8%). Median age was 72 years (IQR, 66-80 years) and 1829 adults (26.3%) were immunocompromised. A total of 63 cases (7.7%) and 966 controls (15.7%) were vaccinated. Estimated vaccine effectiveness against RSV-associated hospitalization was 58% (95% CI, 45%-68%) during 2 seasons and 69% (95% CI, 52%-81%) for same-season vaccination vs 48% (95% CI, 27%-63%; P = .06) for prior-season vaccination. Estimated vaccine effectiveness during 2 seasons was significantly lower among immunocompromised adults (30%; 95% CI, -9% to 55%) than immunocompetent adults (67%; 95% CI, 53%-77%; P = .02) and among those with cardiovascular disease (56%; 95% CI, 32%-72%) vs without (80%; 95% CI, 62%-90%; P = .03).
Conclusions and relevance: Respiratory syncytial virus vaccines prevented RSV-associated hospitalization during 2 seasons, although effectiveness was lower in patients with immunocompromise and cardiovascular disease than in those without these conditions. Ongoing monitoring is needed to determine the optimal RSV revaccination interval.
期刊介绍：
JAMA (Journal of the American Medical Association) is an international peer-reviewed general medical journal. It has been published continuously since 1883. JAMA is a member of the JAMA Network, which is a consortium of peer-reviewed general medical and specialty publications.
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