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▎For the editor of WuXi AppTec's content team for nearly a year, COVID-19 vaccination has provided an important means for epidemic prevention and control.
Many clinical trials and real-world observational studies have supported the protection brought by vaccines
.
However, with the global prevalence of Delta variants and the potential changes in immunity after prolonged vaccination, many countries and regions have experienced repeated epidemics
.
On the basis of completed vaccination, additional vaccination booster shots are regarded as one of the important methods to deal with weakened immunity
.
A few days ago, the global authoritative medical journal "The Lancet" published a real-world study of the new crown vaccine booster
.
Based on data analysis of more than one million people across Israel, compared with only two shots and completed vaccination for at least 5 months, the third shot of BNT162b2 mRNA new crown vaccine reduces the risk of new crown infection, hospitalization and severe illness by about 90%.
The risk of death from the new crown has also been reduced by more than 80%
.
This protective effect was obvious soon after the third dose of vaccination, and people of different genders, ages, and health conditions had similar benefits
.
Screenshot source: The Lancet Israel is the first country in the world to carry out the third dose of new crown vaccination
.
This research was completed by the Clalit Institute in Israel in collaboration with scholars from Harvard University
.
The research team’s press release pointed out that this is “the largest-scale peer-reviewed study conducted at the national level for the third intensified injection”, and it is also “the first to assess the seriousness of the third injection of mRNA COVID-19 vaccine after adjusting for various potential confounding factors.
A study on the effectiveness of the outcome"-Compared with another recent third-shot clinical trial of the mRNA new crown vaccine, this real-world study has a larger sample size, and therefore it is possible to evaluate the impact of the third-shot vaccine on serious outcomes
.
Image source: 123RF This study was carried out from July 30 to September 23, 2021.
It coincided with the fourth wave of new crown infections in Israel.
During this period, the Delta variant was the main epidemic virus for new cases of infection in the local area.
Strain
.
Based on Clalit Health Services, the largest medical institution in Israel (covering more than half of the population in Israel), the study recruited people who had completed two doses of BNT162b2 vaccination for at least 5 months, were eligible for the third dose of vaccine according to the guidelines of the local health department, and had not previously recorded a new crown infection Individuals ≥12 years old
.
After strict matching of demographic characteristics, new crown infection and severe risk, basic health status, health behavior and other factors, the study 1:1 included 728,321 people who received the third shot or only two shots
.
The median age of the study population was 52 years old, and 51% were women
.
The median follow-up time for both groups was 13 days, and the effectiveness of the vaccine was evaluated at least 7 days after the third vaccination
.
The results show that compared with the control population who completed two doses of vaccination for at least 5 months, the third dose of vaccine can effectively reduce the serious consequences related to the new crown virus: the risk of new crown hospitalization is reduced by 93% (220.
8 cases/100,000 people in the control group) vs 14.
4 cases per 100,000 people in the enhanced acupuncture group)
.
The risk of severe COVID-19 was reduced by 92% (158.
9 cases per 100,000 people vs 12.
9 cases per 100,000 people)
.
The risk of new crown-related deaths was reduced by 81% (31.
9 cases per 100,000 people vs 6.
1 cases per 100,000 people)
.
About 6 days after the third dose of vaccination, the preventive effect on hospitalization of the new crown began to be obvious; about 8-9 days after the third dose of vaccination, the severe morbidity and mortality rate of this group of people also decreased significantly
.
▲Compared with only two injections for 5 months (red line), after the third injection (blue line), the risks of hospitalization (A), severe disease (B) and related death (C) of the new crown are further reduced
.
(Image source: Reference [1]) Subgroup analysis shows that among people with different genders, different age groups (40-69 years old and over 70 years old), and people with different numbers of underlying diseases, the third dose of vaccine prevents hospitalization for new crowns The effectiveness is similar to that of severe illness
.
In the 16-39 year-old population, it is difficult to make meaningful and clear statistical estimates due to the small number of events
.
Paying more attention to the changes in the risk of infection, statistics found that among the third shot vaccinators, the recorded risk of new crown infection was reduced by 88% (3662.
3 cases/100,000 in the control group vs 422.
9 cases/100,000 in the booster group), and symptomatic patients The risk of new crown infection was reduced by 91% (1909.
6 cases per 100,000 people vs 178.
9 cases per 100,000 people)
.
Moreover, during the follow-up period, people who received the third shot generally received less nucleic acid testing
.
The data also shows that between July and September, as time goes by, shortly after each age group starts the third dose, the overall incidence rate trend decreases significantly
.
▲In different age groups, shortly after opening the third dose of vaccination (vertical dotted line), the daily incidence rate showed a downward trend
.
(Image source: Reference [1]) A review article published in the same period of "The Lancet" pointed out that "It is very difficult to conduct clinical trials of enhanced needles at this stage of the pandemic, so there is a lot of evidence on the protective effect of (enhanced needles).
valuable
.
"One of the authors, Professor Miguel Hernán of the Harvard School of Public Health, said: "This study is a perfect case of randomized trials and observational studies that complement each other, which is especially important in the new crown epidemic
.
Clinical trials have proved the effectiveness of the mRNA new crown vaccine in preventing symptomatic infections, but it has failed to accurately assess the effect on serious diseases and specific age groups
.
This analysis is based on the high-quality database of Clalit Medical System, which simulates the experimental design and expands to confirm the effectiveness of the vaccine
.
"At present, there are already some experimental data showing that vaccine booster injections can increase antibody levels, and clinical research data are also emerging
.
We hope that the accumulation of more scientific research evidence will provide reference for the planning and implementation of the third injection and help us better Prevent and control the new crown epidemic
.
Many clinical trials and real-world observational studies have supported the protection brought by vaccines
.
However, with the global prevalence of Delta variants and the potential changes in immunity after prolonged vaccination, many countries and regions have experienced repeated epidemics
.
On the basis of completed vaccination, additional vaccination booster shots are regarded as one of the important methods to deal with weakened immunity
.
A few days ago, the global authoritative medical journal "The Lancet" published a real-world study of the new crown vaccine booster
.
Based on data analysis of more than one million people across Israel, compared with only two shots and completed vaccination for at least 5 months, the third shot of BNT162b2 mRNA new crown vaccine reduces the risk of new crown infection, hospitalization and severe illness by about 90%.
The risk of death from the new crown has also been reduced by more than 80%
.
This protective effect was obvious soon after the third dose of vaccination, and people of different genders, ages, and health conditions had similar benefits
.
Screenshot source: The Lancet Israel is the first country in the world to carry out the third dose of new crown vaccination
.
This research was completed by the Clalit Institute in Israel in collaboration with scholars from Harvard University
.
The research team’s press release pointed out that this is “the largest-scale peer-reviewed study conducted at the national level for the third intensified injection”, and it is also “the first to assess the seriousness of the third injection of mRNA COVID-19 vaccine after adjusting for various potential confounding factors.
A study on the effectiveness of the outcome"-Compared with another recent third-shot clinical trial of the mRNA new crown vaccine, this real-world study has a larger sample size, and therefore it is possible to evaluate the impact of the third-shot vaccine on serious outcomes
.
Image source: 123RF This study was carried out from July 30 to September 23, 2021.
It coincided with the fourth wave of new crown infections in Israel.
During this period, the Delta variant was the main epidemic virus for new cases of infection in the local area.
Strain
.
Based on Clalit Health Services, the largest medical institution in Israel (covering more than half of the population in Israel), the study recruited people who had completed two doses of BNT162b2 vaccination for at least 5 months, were eligible for the third dose of vaccine according to the guidelines of the local health department, and had not previously recorded a new crown infection Individuals ≥12 years old
.
After strict matching of demographic characteristics, new crown infection and severe risk, basic health status, health behavior and other factors, the study 1:1 included 728,321 people who received the third shot or only two shots
.
The median age of the study population was 52 years old, and 51% were women
.
The median follow-up time for both groups was 13 days, and the effectiveness of the vaccine was evaluated at least 7 days after the third vaccination
.
The results show that compared with the control population who completed two doses of vaccination for at least 5 months, the third dose of vaccine can effectively reduce the serious consequences related to the new crown virus: the risk of new crown hospitalization is reduced by 93% (220.
8 cases/100,000 people in the control group) vs 14.
4 cases per 100,000 people in the enhanced acupuncture group)
.
The risk of severe COVID-19 was reduced by 92% (158.
9 cases per 100,000 people vs 12.
9 cases per 100,000 people)
.
The risk of new crown-related deaths was reduced by 81% (31.
9 cases per 100,000 people vs 6.
1 cases per 100,000 people)
.
About 6 days after the third dose of vaccination, the preventive effect on hospitalization of the new crown began to be obvious; about 8-9 days after the third dose of vaccination, the severe morbidity and mortality rate of this group of people also decreased significantly
.
▲Compared with only two injections for 5 months (red line), after the third injection (blue line), the risks of hospitalization (A), severe disease (B) and related death (C) of the new crown are further reduced
.
(Image source: Reference [1]) Subgroup analysis shows that among people with different genders, different age groups (40-69 years old and over 70 years old), and people with different numbers of underlying diseases, the third dose of vaccine prevents hospitalization for new crowns The effectiveness is similar to that of severe illness
.
In the 16-39 year-old population, it is difficult to make meaningful and clear statistical estimates due to the small number of events
.
Paying more attention to the changes in the risk of infection, statistics found that among the third shot vaccinators, the recorded risk of new crown infection was reduced by 88% (3662.
3 cases/100,000 in the control group vs 422.
9 cases/100,000 in the booster group), and symptomatic patients The risk of new crown infection was reduced by 91% (1909.
6 cases per 100,000 people vs 178.
9 cases per 100,000 people)
.
Moreover, during the follow-up period, people who received the third shot generally received less nucleic acid testing
.
The data also shows that between July and September, as time goes by, shortly after each age group starts the third dose, the overall incidence rate trend decreases significantly
.
▲In different age groups, shortly after opening the third dose of vaccination (vertical dotted line), the daily incidence rate showed a downward trend
.
(Image source: Reference [1]) A review article published in the same period of "The Lancet" pointed out that "It is very difficult to conduct clinical trials of enhanced needles at this stage of the pandemic, so there is a lot of evidence on the protective effect of (enhanced needles).
valuable
.
"One of the authors, Professor Miguel Hernán of the Harvard School of Public Health, said: "This study is a perfect case of randomized trials and observational studies that complement each other, which is especially important in the new crown epidemic
.
Clinical trials have proved the effectiveness of the mRNA new crown vaccine in preventing symptomatic infections, but it has failed to accurately assess the effect on serious diseases and specific age groups
.
This analysis is based on the high-quality database of Clalit Medical System, which simulates the experimental design and expands to confirm the effectiveness of the vaccine
.
"At present, there are already some experimental data showing that vaccine booster injections can increase antibody levels, and clinical research data are also emerging
.
We hope that the accumulation of more scientific research evidence will provide reference for the planning and implementation of the third injection and help us better Prevent and control the new crown epidemic
.
