Vaccine Effectiveness of JYNNEOS against Mpox Disease in the United States.

Autor:	Deputy NP; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Deckert J; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Chard AN; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Sandberg N; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Moulia DL; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Barkley E; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Dalton AF; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Sweet C; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Cohn AC; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Little DR; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Cohen AL; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Sandmann D; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Payne DC; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Gerhart JL; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.)., Feldstein LR; From the Mpox Emergency Response Team, Centers for Disease Control and Prevention, Atlanta (N.P.D., A.N.C., D.L.M., A.F.D., A.C.C., A.L.C., D.C.P., L.R.F.); the Public Health Service Commissioned Corps, Rockville, MD (N.P.D., A.N.C., A.C.C., A.L.C., L.R.F.); and Epic Research, Epic Systems, Verona, WI (J.D., N.S., E.B., C.S., D.R.L., D.S., J.L.G.).
Jazyk:	angličtina
Zdroj:	The New England journal of medicine [N Engl J Med] 2023 Jun 29; Vol. 388 (26), pp. 2434-2443. Date of Electronic Publication: 2023 May 18.
DOI:	10.1056/NEJMoa2215201
Abstrakt:	Background: In the United States, more than 30,000 cases of mpox (formerly known as monkeypox) had occurred as of March 1, 2023, in an outbreak disproportionately affecting transgender persons and gay, bisexual, and other men who have sex with men. In 2019, the JYNNEOS vaccine was approved for subcutaneous administration (0.5 ml per dose) to prevent mpox infection. On August 9, 2022, an emergency use authorization was issued for intradermal administration (0.1 ml per dose); however, real-world effectiveness data are limited for either route. Methods: We conducted a case-control study based on data from Cosmos, a nationwide Epic electronic health record (EHR) database, to assess the effectiveness of JYNNEOS vaccination in preventing medically attended mpox disease among adults. Case patients had an mpox diagnosis code or positive orthopoxvirus or mpox virus laboratory result, and control patients had an incident diagnosis of human immunodeficiency virus (HIV) infection or a new or refill order for preexposure prophylaxis against HIV infection between August 15, 2022, and November 19, 2022. Odds ratios and 95% confidence intervals were estimated from conditional logistic-regression models, adjusted for confounders; vaccine effectiveness was calculated as (1 - odds ratio for vaccination in case patients vs. controls) × 100. Results: Among 2193 case patients and 8319 control patients, 25 case patients and 335 control patients received two doses (full vaccination), among whom the estimated adjusted vaccine effectiveness was 66.0% (95% confidence interval [CI], 47.4 to 78.1), and 146 case patients and 1000 control patients received one dose (partial vaccination), among whom the estimated adjusted vaccine effectiveness was 35.8% (95% CI, 22.1 to 47.1). Conclusions: In this study using nationwide EHR data, patients with mpox were less likely to have received one or two doses of JYNNEOS vaccine than control patients. The findings suggest that JYNNEOS vaccine was effective in preventing mpox disease, and a two-dose series appeared to provide better protection. (Funded by the Centers for Disease Control and Prevention and Epic Research.). (Copyright © 2023 Massachusetts Medical Society.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu