Effectiveness of BNT162b2 and mRNA-1273 covid-19 vaccines against symptomatic SARS-CoV-2 infection and severe covid-19 outcomes in Ontario, Canada: test negative design study

被引：287

作者：

Chung, Hannah ^{[1
]}

He, Siyi ^{[1
]}

Nasreen, Sharifa ^{[1
]}

Sundaram, Maria E. ^{[1
,2
]}

Buchan, Sarah A. ^{[1
,2
,3
,4
]}

Wilson, Sarah E. ^{[1
,2
,3
,4
]}

Chen, Branson ^{[1
]}

Calzavara, Andrew ^{[1
]}

Fell, Deshayne B. ^{[1
,5
,6
]}

Austin, Peter C. ^{[1
,7
]}

Wilson, Kumanan ^{[5
,8
,9
]}

Schwartz, Kevin L. ^{[1
,2
,3
]}

Brown, Kevin A. ^{[1
,2
,3
]}

Gubbay, Jonathan B. ^{[3
,10
]}

Basta, Nicole E. ^{[11
]}

Mahmud, Salaheddin M. ^{[12
]}

Righolt, Christiaan H. ^{[12
]}

Svenson, Lawrence W. ^{[13
,14
,15
,16
]}

MacDonald, Shannon E. ^{[15
,17
]}

Janjua, Naveed Z. ^{[18
,19
]}

Tadrous, Mina ^{[1
,20
,21
]}

Kwong, Jeffrey C. ^{[1
,2
,3
,4
,22
,23
]}

机构：

[1] ICES, Toronto, ON, Canada

[2] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada

[3] Publ Hlth Ontario, Toronto, ON, Canada

[4] Univ Toronto, Ctr Vaccine Preventable Dis, Toronto, ON, Canada

[5] Univ Ottawa, Sch Epidemiol & Publ Hlth, Ottawa, ON, Canada

[6] Childrens Hosp, Eastern Ontario Res Inst, Ottawa, ON, Canada

[7] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada

[8] Bruyere & Ottawa Hosp Res Inst, Ottawa, ON, Canada

[9] Univ Ottawa, Dept Med, Ottawa, ON, Canada

[10] Univ Toronto, Dept Lab Med & Pathobiol, Toronto, ON, Canada

[11] McGill Univ, Sch Populat & Global Hlth, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ, Canada

[12] Univ Manitoba, Dept Community Hlth Sci, Vaccine & Drug Evaluat Ctr, Winnipeg, MB, Canada

[13] Alberta Hlth, Analyt & Performance Reporting Branch, Edmonton, AB, Canada

[14] Univ Alberta, Fac Med & Dent, Div Prevent Med, Edmonton, AB, Canada

[15] Univ Alberta, Sch Publ Hlth, Edmonton, AB, Canada

[16] Univ Calgary, Cumming Sch Med, Dept Community Hlth Sci, Calgary, AB, Canada

[17] Univ Alberta, Fac Nursing, Edmonton, AB, Canada

[18] British Columbia Ctr Dis Control, Vancouver, BC, Canada

[19] Univ British Columbia, Sch Populat & Publ Hlth, Vancouver, BC, Canada

[20] Womens Coll Hosp, Toronto, ON, Canada

[21] Univ Toronto, Leslie Dan Fac Pharm, Toronto, ON, Canada

[22] Univ Toronto, Dept Family & Community Med, Toronto, ON, Canada

[23] Univ Hlth Network, Toronto, ON, Canada

来源：

BMJ-BRITISH MEDICAL JOURNAL | 2021年 / 374卷

基金：

加拿大健康研究院;

关键词：

WORKERS;

D O I：

10.1136/bmj.n1943

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVE To estimate the effectiveness of mRNA covid-19 vaccines against symptomatic infection and severe outcomes (hospital admission or death). DESIGN Test negative design study. SETTING Ontario, Canada between 14 December 2020 and 19 April 2021. PARTICIPANTS 324 033 community dwelling people aged >= 16 years who had symptoms of covid-19 and were tested for SARS-CoV-2. INTERVENTIONS BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine. MAIN OUTCOME MEASURES Laboratory confirmed SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR) and hospital admissions and deaths associated with SARS-CoV-2 infection. Multivariable logistic regression was adjusted for personal and clinical characteristics associated with SARS-CoV-2 and vaccine receipt to estimate vaccine effectiveness against symptomatic infection and severe outcomes. RESULTS Of 324 033 people with symptoms, 53 270 (16.4%) were positive for SARS-CoV-2 and 21 272 (6.6%) received at least one dose of vaccine. Among participants who tested positive, 2479 (4.7%) were admitted to hospital or died. Vaccine effectiveness against symptomatic infection observed >= 14 days after one dose was 60% (95% confidence interval 57% to 64%), increasing from 48% (41% to 54%) at 14-20 days after one dose to 71% (63% to 78%) at 35-41 days. Vaccine effectiveness observed >= 7 days after two doses was 91% (89% to 93%). Vaccine effectiveness against hospital admission or death observed >= 14 days after one dose was 70% (60% to 77%), increasing from 62% (44% to 75%) at 14-20 days to 91% (73% to 97%) at >= 35 days, whereas vaccine effectiveness observed >= 7 days after two doses was 98% (88% to 100%). For adults aged >= 70 years, vaccine effectiveness estimates were observed to be lower for intervals shortly after one dose but were comparable to those for younger people for all intervals after 28 days. After two doses, high vaccine effectiveness was observed against variants with the E484K mutation. CONCLUSIONS Two doses of mRNA covid-19 vaccines were observed to be highly effective against symptomatic infection and severe outcomes. Vaccine effectiveness of one dose was observed to be lower, particularly for older adults shortly after the first dose.

引用

页数：12

共 42 条

[1] Prevention of Coronavirus Disease 2019 (COVID-19) by mRNA-Based Vaccines Within the General Population of California [J].

Andrejko, Kristin L. ;

Pry, Jake ;

Myers, Jennifer F. ;

Jewell, Nicholas P. ;

Openshaw, John ;

Watt, James ;

Jain, Seema ;

Lewnard, Joseph A. .

CLINICAL INFECTIOUS DISEASES, 2022, 74 (08) :1382-1389

[2] Association Between Vaccination With BNT162b2 and Incidence of Symptomatic and Asymptomatic SARS-CoV-2 Infections Among Health Care Workers [J].

Angel, Yoel ;

Spitzer, Avishay ;

Henig, Oryan ;

Saiag, Esther ;

Sprecher, Eli ;

Padova, Hagit ;

Ben-Ami, Ronen .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2021, 325 (24) :2457-2465

[3]

[Anonymous], 2021, ICES COVID 19 DASHB

[4]

[Anonymous], 2021, COVID 19 VACC SURV R

[5]

[Anonymous], 2021, Evaluation of COVID-19 vaccine effectiveness: interim guidance

[6]

[Anonymous], UNDERLYING MED CONDI, P2021

[7]

[Anonymous], 2021, UPDATES PHOS VARIANT

[8]

[Anonymous], 2021, ONTARIOS COVID 19 VA

[9]

[Anonymous], 2021, EXT 2 DOS

[10]

Aran D., 2021, ESTIMATING REAL WORL, DOI DOI 10.1101/2021.02.05.21251139

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