评估肺炎球菌疾病负担和成年人疫苗接种有效性的性别差异:基于人口的研究
María José Forcadell-Peris1, Àngel Vila-Córcoles1,2, Cinta de Diego-Cabanes1
1Servicio de Atención Primaria Camp de Tarragona. Institut Català de la Salut, 43007 Tarragona, Spain.
The Journal of infectious diseases
|December 16, 2024
概括
肺炎球菌疫苗 (PPsV23/PCV13) 在预防成人肺炎球菌疾病相关住院治疗方面没有表现出有效性. 然而,PPsV23疫苗接种与女性全因死亡风险降低有关.
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:
- 关于成年人肺炎球菌疫苗有效性的性别差异的数据有限.
- 了解这些差异对于优化疫苗接种战略至关重要.
研究的目的:
- 在成年男性和女性之间比较肺炎球菌多糖体疫苗23-valent (PPsV23) 和肺炎球菌结合体疫苗13-valent (PCV13) 的临床有效性.
- 评估疫苗对肺炎球菌病相关住院病例 (PDRH) 和全因死亡率的疗效.
主要方法:
- 西班牙加泰罗尼亚的一项基于人口的队列研究包括超过200万年龄在50岁及以上的成年人.
- 关于并发病,疫苗接种状态 (PPsV23/PCV13) 和PDRH的数据从2017-2018年收集.
- 考克斯回归模型被用来根据性别分析疫苗的有效性,并对共变量进行调整.
主要成果:
- 无论是PPsV23还是PCV13都没有在预防女性PDRH方面表现出有效性. 在男性中,PCV13与PDRH风险增加有关.
- PPsV23在男性中没有显著改变PDRH风险. 在任何性别中都没有观察到与PDRH相关的死亡减少.
- PPsV23显示,女性全因死亡风险略有降低.
结论:
- 目前的肺炎球菌疫苗 (PPsV23/PCV13) 不能有效地预防任何性别的PDRH.
- 对于女性来说,PPsV23可能会对所有原因的死亡率产生轻微的生存益处,这表明潜在的性别特异性疫苗反应.
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