在III期试验中对COVID-19疫苗的比较疗效和安全性:一个网络元分析
BMC infectious diseases
|February 21, 2024
概括
这个网络元分析发现COVID-19疫苗疗效没有显著差异,但mRNA疫苗的安全性较低. BNT162b2显示出最高的疗效,而BIV1-CovIran显示出最低的严重不良事件.
科学领域:
- 免疫学 免疫学 免疫学
- 疫苗学 疫苗学 疫苗学
- 公共卫生 公共卫生
背景情况:
- 自世卫组织宣布大流行以来,已有十多种COVID-19疫苗完成了III期试验.
- 评估疫苗的有效性和安全性对于公共卫生战略至关重要.
研究的目的:
- 根据有效性和安全性间接比较和排名COVID-19疫苗.
- 用网络元分析分析第三阶段随机对照试验 (RCT) 的数据.
主要方法:
- 在Embase,MEDLINE和Cochrane图书馆搜索到到2023年9月30日的第三阶段RCT.
- 提取了针对症状性SARS-CoV-2感染和严重不良事件 (SAE) 的疗效数据.
- 进行贝叶斯网络元分析,以计算风险比率和平均差异,以95%的置信区间.
主要成果:
- 包括25个涉及22种疫苗的RCT;没有疫苗显示出比安慰剂更高的SAE.
- 无活化病毒疫苗看起来最安全 (SUCRA:0.16),其中BIV1-CovIran具有最高的安全指数 (SUCRA:0.13).
- 没有发现有效性的显著差异,尽管mRNA疫苗显示出更高有效性的趋势 (SUCRA:0.09). BNT162b2具有最高的个体疗效 (SUCRA:0.02) 和老年人疗效 (SUCRA:0.08).
结论:
- 没有一种疫苗类型在有效性方面显著优越,但mRNA疫苗的安全性低于其他类型.
- 在成人和老年人中,BNT162b2在预防有症状的SARS-CoV-2感染方面表现出最高的疗效.
- 伊朗的BIV1-Cov显示,在成年人中,SAE的发病率最低.
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