How effective is the BNT162b2 mRNA vaccine against SARS-CoV-2 transmission and infection? A national programme analysis in Monaco, July 2021 to September 2022.

Autor: Althaus T; Directorate of Health Affairs, Monaco, Monaco. talthaus@gouv.mc., Overton CE; Department of Mathematical Sciences, University of Liverpool, Liverpool, UK.; United Kingdom Health Security Agency, London, UK., Devaux I; World Health Organization Regional Office for Europe, Copenhagen, Denmark., House T; Department of Mathematics, University of Manchester, Manchester, UK., Lapouze A; Directorate of Health Affairs, Monaco, Monaco., Troel A; Digital Service Department, Monaco, Monaco., Vanzo B; Digital Service Department, Monaco, Monaco., Laroche M; Directorate of Health Affairs, Monaco, Monaco., Bordero A; Directorate of Health Affairs, Monaco, Monaco., Jorgensen P; World Health Organization Regional Office for Europe, Copenhagen, Denmark., Pebody R; World Health Organization Regional Office for Europe, Copenhagen, Denmark., Voiglio EJ; Directorate of Health Affairs, Monaco, Monaco.
Jazyk: angličtina
Zdroj: BMC medicine [BMC Med] 2024 Jun 05; Vol. 22 (1), pp. 227. Date of Electronic Publication: 2024 Jun 05.
DOI: 10.1186/s12916-024-03444-6
Abstrakt: Background: We quantified SARS-CoV-2 dynamics in different community settings and the direct and indirect effect of the BNT162b2 mRNA vaccine in Monaco for different variants of concern (VOC).
Methods: Between July 2021 and September 2022, we prospectively investigated 20,443 contacts from 6320 index cases using data from the Monaco COVID-19 Public Health Programme. We calculated secondary attack rates (SARs) in households (n = 13,877), schools (n = 2508) and occupational (n = 6499) settings. We used binomial regression with a complementary log-log link function to measure adjusted hazard ratios (aHR) and vaccine effectiveness (aVE) for index cases to infect contacts and contacts to be infected in households.
Results: In households, the SAR was 55% (95% CI 54-57) and 50% (48-51) among unvaccinated and vaccinated contacts, respectively. The SAR was 32% (28-36) and 12% (10-13) in workplaces, and 7% (6-9) and 6% (3-10) in schools, among unvaccinated and vaccinated contacts respectively. In household, the aHR was lower in contacts than in index cases (aHR 0.68 [0.55-0.83] and 0.93 [0.74-1.1] for delta; aHR 0.73 [0.66-0.81] and 0.89 [0.80-0.99] for omicron BA.1&2, respectively). Vaccination had no significant effect on either direct or indirect aVE for omicron BA.4&5. The direct aVE in contacts was 32% (17, 45) and 27% (19, 34), and for index cases the indirect aVE was 7% (- 17, 26) and 11% (1, 20) for delta and omicron BA.1&2, respectively. The greatest aVE was in contacts with a previous SARS-CoV-2 infection and a single vaccine dose during the omicron BA.1&2 period (45% [27, 59]), while the lowest were found in contacts with either three vaccine doses (aVE - 24% [- 63, 6]) or one single dose and a previous SARS-CoV-2 infection (aVE - 36% [- 198, 38]) during the omicron BA.4&5 period.
Conclusions: Protection conferred by the BNT162b2 mRNA vaccine against transmission and infection was low for delta and omicron BA.1&2, regardless of the number of vaccine doses and previous SARS-CoV-2 infection. There was no significant vaccine effect for omicron BA.4&5. Health authorities carrying out vaccination campaigns should bear in mind that the current generation of COVID-19 vaccines may not represent an effective tool in protecting individuals from either transmitting or acquiring SARS-CoV-2 infection.
(© 2024. The Author(s).)
Databáze: MEDLINE
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