{"id":22940,"date":"2022-11-15T04:54:00","date_gmt":"2022-11-14T20:54:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=22940"},"modified":"2022-11-15T05:45:57","modified_gmt":"2022-11-14T21:45:57","slug":"lancet%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%ae%8c%e6%88%90%e7%96%ab%e8%8b%97%e5%85%a8%e7%a8%8b%e5%8f%8a%e5%8a%a0%e5%bc%ba%e9%92%88%e6%8e%a5%e7%a7%8d%e5%90%8e%e9%87%8d%e7%97%87%e6%96%b0","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=22940","title":{"rendered":"[Lancet\u53d1\u8868\u8bba\u6587]\uff1a\u5b8c\u6210\u75ab\u82d7\u5168\u7a0b\u53ca\u52a0\u5f3a\u9488\u63a5\u79cd\u540e\u91cd\u75c7\u65b0\u51a0\u80ba\u708e\u9884\u540e"},"content":{"rendered":"\n

ARTICLES| VOLUME 400, ISSUE 10360<\/a>, P1305-1320, OCTOBER 15, 2022<\/p>\n\n\n\n

Severe COVID-19 outcomes after full vaccination of primary schedule and initial boosters: pooled analysis of national prospective cohort studies of 30 million individuals in England, Northern Ireland, Scotland, and Wales<\/h1>\n\n\n\n

Utkarsh Agrawal, Stuart Bedston, Colin McCowan,\u00a0et al<\/h3>\n\n\n\n

Lancet 2022; 400: 1305-1320<\/h3>\n\n\n\n

Summary<\/h2>\n\n\n\n

Background<\/h3>\n\n\n\n

Current UK vaccination policy is to offer future COVID-19 booster doses to individuals at high risk of serious illness from COVID-19, but it is still uncertain which groups of the population could benefit most. In response to an urgent request from the UK Joint Committee on Vaccination and Immunisation, we aimed to identify risk factors for severe COVID-19 outcomes (ie, COVID-19-related hospitalisation or death) in individuals who had completed their primary COVID-19 vaccination schedule and had received the first booster vaccine.<\/p>\n\n\n\n

Methods<\/h3>\n\n\n\n

We constructed prospective cohorts across all four UK nations through linkages of primary care, RT-PCR testing, vaccination, hospitalisation, and mortality data on 30 million people. We included individuals who received primary vaccine doses of BNT162b2 (tozinameran; Pfizer\u2013BioNTech) or ChAdOx1 nCoV-19 (Oxford\u2013AstraZeneca) vaccines in our initial analyses. We then restricted analyses to those given a BNT162b2 or mRNA-1273 (elasomeran; Moderna) booster and had a severe COVID-19 outcome between Dec 20, 2021, and Feb 28, 2022 (when the omicron (B.1.1.529) variant was dominant). We fitted time-dependent Poisson regression models and calculated adjusted rate ratios (aRRs) and 95% CIs for the associations between risk factors and COVID-19-related hospitalisation or death. We adjusted for a range of potential covariates, including age, sex, comorbidities, and previous SARS-CoV-2 infection. Stratified analyses were conducted by vaccine type. We then did pooled analyses across UK nations using fixed-effect meta-analyses.<\/p>\n\n\n\n

Findings<\/h3>\n\n\n\n

Between Dec 8, 2020, and Feb 28, 2022, 16\u2008208\u2008600 individuals completed their primary vaccine schedule and 13\u2008836\u2008390 individuals received a booster dose. Between Dec 20, 2021, and Feb 28, 2022, 59\u2008510 (0\u00b74%) of the primary vaccine group and 26\u2008100 (0\u00b72%) of those who received their booster had severe COVID-19 outcomes. The risk of severe COVID-19 outcomes reduced after receiving the booster (rate change: 8\u00b78 events per 1000 person-years to 7\u00b76 events per 1000 person-years). Older adults (\u226580 years\u00a0vs<\/em>\u00a018\u201349 years; aRR 3\u00b760 [95% CI 3\u00b745\u20133\u00b775]), those with comorbidities (\u22655 comorbidities\u00a0vs<\/em>\u00a0none; 9\u00b751 [9\u00b707\u20139\u00b797]), being male (male\u00a0vs<\/em>\u00a0female; 1\u00b723 [1\u00b720\u20131\u00b726]), and those with certain underlying health conditions\u2014in particular, individuals receiving immunosuppressants (yes\u00a0vs<\/em>\u00a0no; 5\u00b780 [5\u00b753\u20136\u00b709])\u2014and those with chronic kidney disease (stage 5\u00a0vs<\/em>\u00a0no; 3\u00b771 [2\u00b790\u20134\u00b774]) remained at high risk despite the initial booster. Individuals with a history of COVID-19 infection were at reduced risk (infected \u22659 months before booster dose\u00a0vs<\/em>\u00a0no previous infection; aRR 0\u00b741 [95% CI 0\u00b729\u20130\u00b758]).<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
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Interpretation<\/h3>\n\n\n\n

Older people, those with multimorbidity, and those with specific underlying health conditions remain at increased risk of COVID-19 hospitalisation and death after the initial vaccine booster and should, therefore, be prioritised for additional boosters, including novel optimised versions, and the increasing array of COVID-19 therapeutics.<\/p>\n\n\n\n

Funding<\/h3>\n\n\n\n

National Core Studies\u2013Immunity, UK Research and Innovation (Medical Research Council), Health Data Research UK, the Scottish Government, and the University of Edinburgh.<\/p>\n","protected":false},"excerpt":{"rendered":"

ARTICLES| VOLUME 400, ISSUE 10360, P1305-1320 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22940"}],"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=22940"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22940\/revisions"}],"predecessor-version":[{"id":23125,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22940\/revisions\/23125"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=22940"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=22940"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=22940"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}