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单剂量Mpox疫苗在加拿大北克的有效性:测试负面设计,并没有自我报告暴露风险的调整
Nicholas Brousseau1,2,3, Sara Carazo1,3, Yossi Febriani2
1Biological Risks Department, Institut national de santé publique du Québec, Quebec, QC, Canada.
概括
单剂量mopox疫苗接种,仅基于行政数据,可将风险降低三分之一. 包括自我报告的风险因素显示,一剂量可将mopox风险降低三分之二,强调了准确的暴露评估对疫苗有效性的重要性.
科学领域:
- 流行病学 流行病学
- 疫苗学 疫苗学 疫苗学
背景情况:
- 在2022年的mopox疫情中,加拿大北克省优先为高风险人群提供初始疫苗剂量.
- 由于疫情期间的供应限制,第二剂疫苗被推迟了.
研究的目的:
- 为了估计单剂量mopox疫苗的有效性.
- 评估不同暴露风险调整方法对疫苗有效性估计的影响.
主要方法:
- 从2022年6月到9月进行了一项测试阴性病例控制研究.
- 数据来源于行政数据库,并通过问卷补充了自我报告的风险因素.
- 使用了根据年龄,时间和暴露风险进行调整的后勤回归模型.
主要成果:
- 仅使用暴露风险的管理数据,估计单剂量疫苗的有效性为35% (All-Admin) 和30% (Sub-Quest).
- 补充了调查问卷数据对暴露风险在子调查人口增加了VE估计到65%.
- 置信区间重叠,但调整后的估计表明基于数据源的VE有显著差异.
结论:
- 马博克斯疫苗的有效性 (VE) 估计对暴露风险调整的准确性敏感.
- 单靠管理数据可能会低估单剂量mopox疫苗的真正益处.
- 纳入自我报告的风险因素显著改善了VE估计,表明疫苗的保护作用更大.
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