接种Pfizer与Moderna疫苗后的选择效应和COVID-19死亡风险:来自链接死亡率和疫苗记录的证据
Vladimir Atanasov1, Natalia Barreto2, Jeff Whittle3
1Mason College of Business, William & Mary, Williamsburg, VA 23185, USA.
Vaccines
|May 27, 2023
概括
现代疫苗比瑞疫苗更好地保护COVID-19死亡率,特别是在老年人中. 提升剂量改善了所有疫苗类型的保护,特别是瑞疫苗.
科学领域:
- 免疫学 免疫学 免疫学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 之前的研究表明,Pfizer-BioNTech (BNT162b2) 和Moderna (mRNA1273) 疫苗之间存在类似的COVID-19死亡率保护.
- 比较往往忽略了在接种疫苗的人群中显著的选择效应.
- 免疫力减弱和疫苗疗效差异需要进一步调查.
研究的目的:
- 评估和比较Pfizer-BioNTech和Moderna的COVID-19疫苗在死亡率方面的实际有效性.
- 在疫苗有效性研究中解决和控制选择偏差.
- 分析不同年龄组和不同流行病学时期 (例如,Omicron变异激增) 的疫苗性能.
主要方法:
- 利用一种新的方法,采用COVID-19过度死亡率 (CEMP) 来控制选择效应.
- 分析了威斯康星州密尔沃基县所有成年人的相关死亡率和疫苗接种记录 (2021年4月至2022年6月).
- 与未接种疫苗和疫苗类型相比,接种疫苗的人的计算相对死亡风险 (RMR).
主要成果:
- 对于60岁以上的个人来说,与Moderna接收者相比,Pfizer两剂接收者RMR的两倍以上 (平均为Moderna的248%).
- 在Omicron期间,Pfizer的RMR为57%,而Moderna的RMR为23%.
- 两剂疫苗的有效性有所下降,特别是在老年人中;强剂显著减少了这一差距,特别是在瑞接种者中.
结论:
- 与Pfizer疫苗相比,Moderna疫苗在保护老年人 (60岁以上) 免受COVID-19死亡的潜在优势.
- 增剂剂量对于维持保护至关重要,特别是对于60岁以上的瑞药接收者来说.
- 研究结果表明,较高的疫苗剂量 (如Moderna的100μg与Pfizer的30μg) 可能对老年人群有益.
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