Effectiveness of a Fourth COVID-19 mRNA Vaccine Dose Against the Omicron Variant in Solid Organ Transplant Recipients.

Autor:	Naylor KL; ICES, Toronto, ON, Canada.; Department of Epidemiology & Biostatistics, Western University, London, ON, Canada.; Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada., Knoll GA; ICES, Toronto, ON, Canada.; Department of Medicine (Nephrology), University of Ottawa and the Ottawa Hospital Research Institute, Ottawa, ON, Canada., Smith G; ICES, Toronto, ON, Canada.; Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada., McArthur E; ICES, Toronto, ON, Canada.; Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada., Kwong JC; ICES, Toronto, ON, Canada.; Public Health Ontario, Toronto, ON, Canada.; Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada., Dixon SN; ICES, Toronto, ON, Canada.; Department of Epidemiology & Biostatistics, Western University, London, ON, Canada.; Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada., Treleaven D; Trillium Gift of Life Network, Ontario Health, Toronto, ON, Canada.; Division of Nephrology, McMaster University, Hamilton, ON, Canada., Kim SJ; ICES, Toronto, ON, Canada.; Division of Nephrology, University Health Network, University of Toronto, Toronto, ON, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2024 Jan 01; Vol. 108 (1), pp. 294-302. Date of Electronic Publication: 2023 Dec 13.
DOI:	10.1097/TP.0000000000004766
Abstrakt:	Background: The effectiveness of booster doses of COVID-19 vaccines in solid organ transplant recipients is unclear. We conducted a population-based matched cohort study using linked administrative healthcare databases from Ontario, Canada to estimate the marginal vaccine effectiveness of a fourth versus third dose of the BNT162b2 and mRNA-1273 vaccines against clinically important outcomes (ie, hospitalization or death) and infection during the era of the Omicron variant. Methods: We matched 3120 solid organ transplant recipients with a third COVID-19 vaccine dose (reference) to 3120 recipients with a fourth dose. Recipients were matched on the third dose date (±7 d). We used a multivariable Cox proportional hazards model to estimate the marginal vaccine effectiveness with outcomes occurring between December 21, 2021 and April 30, 2022. Results: The cumulative incidence of COVID-19-related hospitalization or death was 2.8% (95% confidence interval [CI], 2.0-3.7) in the third dose group compared with 1.1% (95% CI, 0.59-1.8) in the fourth dose group after 84 d of follow-up (P < 0.001). The adjusted marginal vaccine effectiveness was 70% (95% CI, 47-83) against clinically important outcomes and 39% (95% CI, 21-52) against SARS-CoV-2 infection. Conclusions: Compared with a third dose, a fourth dose of the COVID-19 vaccine was associated with improved protection against hospitalization, death, and SARS-CoV-2 infection during the Omicron era. Results highlight the importance of a booster COVID-19 vaccine dose in solid organ transplant recipients. Competing Interests: G.A.K. has received investigator-initiated research grants from the Canadian Institutes of Health Research. The other authors declare no conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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