{"id":21173,"date":"2022-03-29T05:26:00","date_gmt":"2022-03-28T21:26:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=21173"},"modified":"2022-03-29T05:55:25","modified_gmt":"2022-03-28T21:55:25","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%8e%a5%e7%a7%8d3%e9%92%88mrna%e7%96%ab%e8%8b%97%e4%b8%8e%e6%96%b0%e5%86%a0%e7%97%85%e6%af%92%e5%a5%a5%e5%af%86%e5%85%8b%e6%88%8e%e5%92%8c%e5%be%b7","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=21173","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u63a5\u79cd3\u9488mRNA\u75ab\u82d7\u4e0e\u65b0\u51a0\u75c5\u6bd2\u5965\u5bc6\u514b\u620e\u548c\u5fb7\u5c14\u5854\u53d8\u5f02\u682a\u5bfc\u81f4\u7684\u6709\u75c7\u72b6\u611f\u67d3\u7684\u76f8\u5173\u6027"},"content":{"rendered":"\n

Original Investigation January 21, 2022<\/p>\n\n\n\n

Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants<\/h1>\n\n\n\n

Emma K.\u00a0Accorsi,\u00a0Amadea\u00a0Britton,\u00a0Katherine E.\u00a0Fleming-Dutra,\u00a0et al<\/h3>\n\n\n\n

JAMA.\u00a0<\/em>Published online January 21, 2022. doi:10.1001\/jama.2022.0470<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  What is the association between 3 doses of mRNA COVID-19 vaccine and symptomatic SARS-CoV-2 infection with the Omicron and Delta variants?<\/p>\n\n\n\n

Findings<\/strong>  In this test-negative case-control analysis that included 70\u202f155 tests from symptomatic adults, the likelihood of vaccination with 3 mRNA vaccine doses (vs unvaccinated) was significantly lower among both Omicron (odds ratio, 0.33) and Delta (odds ratio, 0.065) cases than SARS-CoV-2\u2013negative controls; a similar pattern was observed with 3 vaccine doses vs 2 doses (Omicron odds ratio, 0.34; Delta odds ratio, 0.16).<\/p>\n\n\n\n

Meaning<\/strong>  These findings suggest that vaccination with 3 doses of mRNA COVID-19 vaccine, compared with being unvaccinated and with receipt of 2 doses, was associated with protection against both the Omicron and Delta variants, although higher odds ratios for the association with Omicron infection suggest less protection for Omicron than for Delta.<\/a>Abstract<\/p>\n\n\n\n

Importance<\/strong>  Assessing COVID-19 vaccine performance against the rapidly spreading SARS-CoV-2 Omicron variant is critical to inform public health guidance.<\/p>\n\n\n\n

Objective<\/strong>  To estimate the association between receipt of 3 doses of Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273 vaccine and symptomatic SARS-CoV-2 infection, stratified by variant (Omicron and Delta).<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  A test-negative case-control analysis among adults 18 years or older with COVID-like illness tested December 10, 2021, through January 1, 2022, by a national pharmacy-based testing program (4666 COVID-19 testing sites across 49 US states).<\/p>\n\n\n\n

Exposures<\/strong>  Three doses of mRNA COVID-19 vaccine (third dose \u226514 days before test and \u22656 months after second dose) vs unvaccinated and vs 2 doses 6 months or more before test (ie, eligible for a booster dose).<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Association between symptomatic SARS-CoV-2 infection (stratified by Omicron or Delta variants defined using S<\/em>-gene target failure) and vaccination (3 doses vs unvaccinated and 3 doses vs 2 doses). Associations were measured with multivariable multinomial regression. Among cases, a secondary outcome was median cycle threshold values (inversely proportional to the amount of target nucleic acid present) for 3 viral genes, stratified by variant and vaccination status.<\/p>\n\n\n\n

Results<\/strong>  Overall, 23\u202f391 cases (13\u202f098 Omicron; 10\u202f293 Delta) and 46\u202f764 controls were included (mean age, 40.3 [SD, 15.6] years; 42\u202f050 [60.1%] women). Prior receipt of 3 mRNA vaccine doses was reported for 18.6% (n\u2009=\u20092441) of Omicron cases, 6.6% (n\u2009=\u2009679) of Delta cases, and 39.7% (n\u2009=\u200918\u202f587) of controls; prior receipt of 2 mRNA vaccine doses was reported for 55.3% (n\u2009=\u20097245), 44.4% (n\u2009=\u20094570), and 41.6% (n\u2009=\u200919\u202f456), respectively; and being unvaccinated was reported for 26.0% (n\u2009=\u20093412), 49.0% (n\u2009=\u20095044), and 18.6% (n\u2009=\u20098721), respectively. The adjusted odds ratio for 3 doses vs unvaccinated was 0.33 (95% CI, 0.31-0.35) for Omicron and 0.065 (95% CI, 0.059-0.071) for Delta; for 3 vaccine doses vs 2 doses the adjusted odds ratio was 0.34 (95% CI, 0.32-0.36) for Omicron and 0.16 (95% CI, 0.14-0.17) for Delta. Median cycle threshold values were significantly higher in cases with 3 doses vs 2 doses for both Omicron and Delta (Omicron N<\/em> gene: 19.35 vs 18.52; Omicron ORF1ab<\/em> gene: 19.25 vs 18.40; Delta N<\/em> gene: 19.07 vs 17.52; Delta ORF1ab<\/em> gene: 18.70 vs 17.28; Delta S<\/em> gene: 23.62 vs 20.24).<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  Among individuals seeking testing for COVID-like illness in the US in December 2021, receipt of 3 doses of mRNA COVID-19 vaccine (compared with unvaccinated and with receipt of 2 doses) was less likely among cases with symptomatic SARS-CoV-2 infection compared with test-negative controls. These findings suggest that receipt of 3 doses of mRNA vaccine, relative to being unvaccinated and to receipt of 2 doses, was associated with protection against both the Omicron and Delta variants, although the higher odds ratios for Omicron suggest less protection for Omicron than for Delta.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation January 21, 2022 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21173"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=21173"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21173\/revisions"}],"predecessor-version":[{"id":21529,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21173\/revisions\/21529"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21173"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=21173"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=21173"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}