NEJM:加州医护人员接种SARS-CoV-2疫苗后感染情况调查

2021-03-25 MedSci原创 MedSci原创

疫苗的效力在试验环境之外保持不变。这些数据强调了持续的公共卫生缓解措施(佩戴口罩、保持社交距离、每日症状筛查和定期检测)的重要性,即使在疫苗接种率较高的地区也是如此,直到达到普遍的群体免疫力为止。

新英格兰杂志发表通讯文章介绍了加州医护人员接种SARS-CoV-2疫苗后感染情况调查。

截至2020年11月的mRNA疫苗第三阶段临床试验的数据显示,在第二剂mRNA-1273疫苗(Moderna)接种后14天,预防有症状的SARS-CoV-2感染的有效率为94.1%;在第二剂BNT162b2疫苗(辉瑞)接种后7天的有效率为95%。自这些试验结果公布以来,COVID-19的全国性激增已被注意到,传染性增强的SARS-CoV-2变种已经出现,FDA已批准这两种mRNA疫苗的紧急使用,美国各地已开始接种疫苗。

自疫苗接种活动开始以来,已有报道称接种了一剂或两剂疫苗的人中出现了感染新冠肺炎。加州大学圣地亚哥分校和加州大学洛杉矶分校的医疗系统于2020年12月16日开始为医护人员接种疫苗。12月2日,除了确定对有症状的人进行检测的低门槛外,加州大学圣地亚哥分校还要求无症状的医护人员每周接受鼻拭子PCR检测。12月26日,加州大学洛杉矶分校启动了一项针对无症状医护人员的选择性鼻拭子PCR检测项目。该计划允许在接种疫苗后增加对无症状SARS-CoV-2感染的检测。

从2020年12月16日到2021年2月9日,共有36659名医护人员接种了第一剂疫苗,其中28184人(77%)接种了第二剂疫苗。在接种疫苗的医护人员中,379人在接种疫苗后至少1天检测出SARS-CoV-2呈阳性,其中大多数人(71%)在第一针接种后的头两周内检测呈阳性。在接种两种疫苗后,37名医护人员检测呈阳性;其中22名在第二次接种后1至7天检测结果呈阳性。只有8名医护人员在第二次接种后8至14天检测呈阳性,7名在第二次接种后15天或更长时间检测呈阳性。截至2月9日,加州大学圣地亚哥分校共有5455名医护人员和加州大学洛杉矶分校的9535名医护人员在两周或更长时间前接受了第二剂疫苗;这些发现对应的阳性率为0.05%。

接种疫苗后SARS-CoV-2检测呈阳性的绝对风险在加州大学圣地亚哥分校的医护人员中为1.19%,在加州大学洛杉矶分校的医护人员中为0.97%;这些比率高于mRNA-1273疫苗和BNT162b2疫苗试验中报告的风险。风险升高的可能解释包括该机构对无症状和有症状的人进行定期检测,在疫苗接种活动期间,南加州地区感染人数激增,以及两国人口特征的差异。与临床试验的参与者相比,医护人员更年轻,接触SARS-CoV-2的总体风险更高。此外,两个初始疫苗试验的报告截止日期都早在这一激增之前,BNT162b2疫苗试验中没有包括对无症状人群的检测,并且在第二剂疫苗接种之前,在mRNA-1273疫苗试验中只对无症状人群进行了一次筛查

在接种第二剂疫苗后14天阳性结果明显较少的情况令人鼓舞,这表明这些疫苗的效力在试验环境之外保持不变。这些数据强调了持续的公共卫生缓解措施(佩戴口罩、保持社交距离、每日症状筛查和定期检测)的重要性,即使在疫苗接种率较高的地区也是如此,直到达到普遍的群体免疫力为止。

原文出处:

SARS-CoV-2 Infection after Vaccination in Health Care Workers in California. N Engl J Med. 2021 Mar 23. doi: 10.1056/NEJMc2101927. Online ahead of print.

 

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    2021-03-27 小刀医生
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    2021-08-30 hukaixun
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    2021-03-25 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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    2021-03-25 ms1000001818983804

    学习了

    0

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    2021-03-25 oYyzo

    真不错

    0

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