Analysis of COVID-19 Incidence and Severity Among Adults Vaccinated With 2-Dose mRNA COVID-19 or Inactivated SARS-CoV-2 Vaccines With and Without Boosters in Singapore.

Autor:	Ng OT; National Centre for Infectious Diseases, Singapore.; Tan Tock Seng Hospital, Singapore.; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore., Marimuthu K; National Centre for Infectious Diseases, Singapore.; Tan Tock Seng Hospital, Singapore.; Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore., Lim N; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore., Lim ZQ; National Centre for Infectious Diseases, Singapore.; Tan Tock Seng Hospital, Singapore., Thevasagayam NM; National Centre for Infectious Diseases, Singapore.; Tan Tock Seng Hospital, Singapore., Koh V; National Centre for Infectious Diseases, Singapore.; Tan Tock Seng Hospital, Singapore., Chiew CJ; Communicable Diseases Division, Ministry of Health, Singapore., Ma S; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.; Public Health Group, Ministry of Health, Singapore., Koh M; Ministry of Health, Singapore., Low PY; Ministry of Health, Singapore., Tan SB; National Medical Research Council, Ministry of Health, Singapore.; SingHealth, Singapore.; Duke-National University of Singapore Medical School, Singapore., Ho J; Bioinformatics Institute, Agency for Science Technology and Research, Singapore.; GISAID Global Data Science Initiative, Munich, Germany., Maurer-Stroh S; National Centre for Infectious Diseases, Singapore.; Bioinformatics Institute, Agency for Science Technology and Research, Singapore.; Infectious Diseases Labs, Agency for Science Technology and Research, Singapore.; Department of Biological Sciences, National University of Singapore, Singapore., Lee VJM; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.; Communicable Diseases Division, Ministry of Health, Singapore., Leo YS; National Centre for Infectious Diseases, Singapore.; Tan Tock Seng Hospital, Singapore.; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.; Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore., Tan KB; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.; Ministry of Health, Singapore.; Centre for Regulatory Excellence, Duke-National University of Singapore Medical School, Singapore., Cook AR; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore., Tan CC; Office of Healthcare Transformation, Ministry of Health, Singapore.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2022 Aug 01; Vol. 5 (8), pp. e2228900. Date of Electronic Publication: 2022 Aug 01.
DOI:	10.1001/jamanetworkopen.2022.28900
Abstrakt:	Importance: Assessing booster effectiveness of COVID-19 mRNA vaccine and inactivated SARS-CoV-2 vaccine over longer time intervals and in response to any further SARS-CoV-2 variants is crucial in determining optimal COVID-19 vaccination strategies. Objective: To determine levels of protection against severe COVID-19 and confirmed SARS-CoV-2 infection by types and combinations of vaccine boosters in Singapore during the Omicron wave. Design, Setting, and Participants: This cohort study included Singapore residents aged 30 years or more vaccinated with either at least 2 doses of mRNA COVID-19 vaccines (ie, Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273) or inactivated SARS-CoV-2 vaccines (Sinovac CoronaVac or Sinopharm BBIBP-CorV) as of March 10, 2022. Individuals with a known SARS-CoV-2 infection prior to December 27, 2021, an infection on or before the date of their second vaccine dose, or with reinfection cases were excluded. Exposures: Two or 3 doses of Pfizer-BioNTech BNT162b2, Moderna mRNA-1273, Sinovac CoronaVac, or Sinopharm BBIBP-CorV. Main Outcomes and Measures: Notified infections from December 27, 2021, to March 10, 2022, adjusted for age, sex, race, housing status, and calendar days. Estimated booster effectiveness, defined as the relative incidence-rate reduction of severe disease (supplemental oxygen, intensive care, or death) or confirmed infection following 3-dose vaccination compared with 5 months after second mRNA dose, was determined using binomial regression. Results: Among 2 441 581 eligible individuals (1 279 047 [52.4%] women, 846 110 (34.7%) aged 60 years and older), there were 319 943 (13.1%) confirmed SARS-CoV-2 infections, of which 1513 (0.4%) were severe COVID-19 cases. mRNA booster effectiveness against confirmed infection 15 to 60 days after boosting was estimated to range from 31.7% to 41.3% for the 4 boosting combinations (homologous BNT162b2, homologous mRNA-1273, 2-dose BNT162b2/mRNA-1273 booster, and 2-dose mRNA-1273/BNT162b2 booster). Five months and more after boosting, estimated booster effectiveness against confirmed infection waned, ranging from -2.8% to 14.6%. Against severe COVID-19, estimated mRNA booster effectiveness was 87.4% (95% CI, 83.3%-90.5%) 15 to 60 days after boosting and 87.2% (95% CI, 84.2%-89.7%) 5 to 6 months after boosting, with no significant difference comparing vaccine combinations. Booster effectiveness against severe COVID-19 15 days to 330 days after 3-dose inactivated COVID-19 vaccination, regardless of combination, was estimated to be 69.6% (95% CI, 48.7%-81.9%). Conclusions and Relevance: Booster mRNA vaccine protection against severe COVID-19 was estimated to be durable over 6 months. Three-dose inactivated SARS-CoV-2 vaccination provided greater protection than 2-dose but weaker protection compared with 3-dose mRNA.
Databáze:	MEDLINE
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