基于一起新型冠状病毒感染聚集性疫情的新冠灭活疫苗保护效果研究  

Protective effect of COVID-19 inactivated vaccine based on a cluster epidemic of COVID-19

作　　者：李杰[1] 李慧 曾意茹 周丽君[2] 吴莹[3] 夏茄翔 LI Jie;LI Hui;ZENG Yiru;ZHOU Lijun;WU Ying;XIA Jiaxiang(Meishan Center for Disease Control and Prevention,Meishan 620010,Sichuan Province,China;Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China;Hongya Center for Disease Control and Prevention,Meishan 62030,Sichuan Province,China;Emeishan Center for Disease Control and Prevention,Leshan 614200,Sichuan Province,China)

机构地区：[1]眉山市疾病预防控制中心,四川眉山620010 [2]四川省疾病预防控制中心,成都610041 [3]洪雅县疾病预防控制中心,四川洪雅620300 [4]峨眉山市疾病预防控制中心,四川乐山614200

出　　处：《预防医学情报杂志》2023年第12期1415-1420,共6页Journal of Preventive Medicine Information

基　　金：国家自然科学基金(项目编号:82041033)。

摘　　要：目的通过四川省一起新型冠状病毒(简称“新冠病毒”)感染聚集性疫情,评价新型冠状病毒灭活疫苗(简称“新冠灭活疫苗”)对Omicron变异株的保护效果。方法采用回顾性队列研究方法,选取2022年7月洪雅县一起Omicron变异株引起的新型冠状病毒肺炎聚集性疫情所涉及的18岁及以上感染者和密切接触者(密接)为研究对象,收集其人口学特征、新冠灭活疫苗接种、核酸检测、临床结局等信息。以无免疫史和基础免疫作为参照,评估不同免疫状态对预防感染和新冠病毒导致的发病、肺炎、重症3种临床结局的保护效果(VE),采用SPSS 21.0软件进行数据处理和分析,以P<0.05为差异有统计学意义。结果共有597名研究对象被纳入,其中无免疫史的有33人,未全程免疫者5人,基础免疫者70人,加强免疫者489人;临床结局中感染44人、发病22人、肺炎4人和重症1人;以无免疫史为参照,接种过新冠灭活疫苗对预防新冠感染的保护效果无统计学差异,不同免疫状态对预防新冠发病的保护效果无统计学差异,加强免疫对预防肺炎的VE为89%(35%~98%),加强免疫对预防重症的VE为96%(40%~100%);以基础免疫为参照,加强免疫对预防感染的VE为45%(4%~68%),对预防发病的VE为81%(63%~90%),对预防肺炎的VE为97%(89%~99%),对预防重症的VE为99%(92%~100%)。结论新冠灭活疫苗对Omicron变异株感染和发病没有体现出保护效果,但加强免疫对新冠导致的肺炎和重症方面保护效果明显。建议无禁忌症且符合接种条件的人群及时采取序贯接种方式开展加强免疫,同时要不断加强变异株针对疫苗的研发和运用,以便更好的保护人民健康。Objective To evaluate the protective effect of COVID-19 inactivated vaccine on Omicron mutant through a cluster epidemic of COVID-19 in Sichuan Province.Methods A retrospective cohort study was performed,and infected individuals≥18 years or older and close contacts involved in an aggregated outbreak were selected.Information about their demographic characteristics,vaccination,nucleic acid testing,and clinical outcomes was collected.No history of immunization and basal immunization group was used as references to assess the protective effect(PE)of different immunization status in preventing infection and three clinical outcomes of morbidity,pneumonia,and severe diseases.Results A total of 597 subjects were included,including 33without immunization history,5 without complete immunization,70 with basic immunization and489 with enhanced immunization.As for the clinical outcome,44 patients were infected,22patients became ill,4 patients were pneumonia,and 1 patient was in severe condition.With no immune history as a reference,there was no statistical difference in the protective effect of COVID-19vaccine on the prevention of COVID-19 infection,neither was for different immune states on the prevention of COVID-19 disease.The VE of enhanced immunization for the prevention of pneumonia was 89%(35%-98%),and the VE of enhanced immunization for the prevention of severe cases was 96%(40%-100%).Taking basic immunization as a reference,the VE of enhanced immunization for preventing infection is 45%(4%-68%),for preventing disease is 81%(63%-90%),for preventing pneumonia is 97%(89%-99%),and for preventing severe disease is 99%(92%-100%).Conclusions The inactivated COVID-19 vaccine did not show protective effect on the infection and morbidity of Omicron mutant,but the enhanced immunity had obvious protective effect on pneumonia and severe cases caused by COVID-19.It is suggested that people without contraindications and eligible for vaccination should take sequential vaccination in time to carry out enhanced immunization.Meanwhi

关 键 词：新冠肺炎 疫苗保护效果 回顾性队列研究 

分 类 号：R563.1[医药卫生—呼吸系统]