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    Home > Active Ingredient News > Infection > NEJM: The infection rate has dropped by 2 times, and the severe disease rate has dropped by 3 times!

    NEJM: The infection rate has dropped by 2 times, and the severe disease rate has dropped by 3 times!

    • Last Update: 2022-05-17
    • Source: Internet
    • Author: User
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    On January 2, 2022 , Israel began administering the fourth dose of the BNT162b2 vaccine to people 60 years of age or older .
    Data are needed on the impact of the fourth dose of vaccine on confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates and severe coronavirus disease 2019 (Covid-19) infection rates .


    On January 2,

    2022 , Israel began administering the fourth dose of the BNT162b2 vaccine to people 60 years of age or older .
    Data are needed on the impact of the fourth dose of vaccine on confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates and severe coronavirus disease 2019 (Covid-19) infection rates .
    Infect

    In late December 2021 , the prevalence of confirmed infections in Israel rose sharply with the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.
    1.
    1.
    529 (omicron) variant
    .
    Contributing factors for this include increased immune evasion caused by the mutation and the fact that most adults have received their third dose of the vaccine for more than 4 months .
    To address the challenges posed by the omicron variant and reduce the burden on the healthcare system, on January 2, 2022, Israel approved the administration of immunizations to people 60 years of age or older, and those who have been at risk for more than 4 months since receiving the third dose of the vaccine, and Health care workers receive fourth dose of BNT162b2 vaccine (Pfizer-BioNTech) .
    The actual effect of the fourth dose of the vaccine on confirmed infections and serious illness is unclear .
    The study, based on data from the National Database of the Israeli Ministry of Health, examined the relative effectiveness of a fourth dose compared to three doses for confirmed infections and serious illness among the elderly in the Israeli population .





    In late December 2021 , the prevalence of confirmed infections in Israel increased dramatically with the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.
    1.
    1.
    529 (omicron) variant
    .
    Contributing factors for this include increased immune evasion caused by the mutation and the fact that most adults have received their third dose of the vaccine for more than 4 months .
    Immunization To address the challenges posed by the omicron variant and reduce the burden on the healthcare system, on January 2, 2022, Israel approved immunization for people 60 years of age or older, and those who have been at high risk for more than 4 months since receiving the third dose of the vaccine and health care workers receive fourth dose of BNT162b2 vaccine (Pfizer-BioNTech) .
    The actual effect of the fourth dose of the vaccine on confirmed infections and serious illness is unclear .
    The study, based on data from the National Database of the Israeli Ministry of Health, examined the relative effectiveness of a fourth dose compared to three doses for confirmed infections and serious illness among the elderly in the Israeli population .
    To address the challenges posed by the omicron variant and reduce the burden on the healthcare system, on January 2, 2022, Israel approved the use of 60 years of age or older, as well as those who have been more than 4 months since receiving the third dose of the vaccine, high-risk groups and Health care workers receive fourth dose of BNT162b2 vaccine (Pfizer-BioNTech) .
    The actual effect of the fourth dose of the vaccine on confirmed infections and serious illness is unclear .
    The study data from the National Database of the Israeli Ministry of Health,







    study population

    study population

    A total of 1,252,331 people met the inclusion criteria (Figure 1)
    .
    The total number of events and person-at-risk days in each study group, as well as the distribution of covariates used in the analysis, are shown in Table 1
    .
    It provides summary statistics for the weeks following the fourth dose, starting in the second week .

    Overall, the distribution of covariates in the pooled treatment group was similar to that in the internal control group .
    Compared with the three-needle group, the four-needle confluence group and the internal control group included more over-80s (24.
    9% and 25.
    1%, respectively, 16.
    2%) and more ordinary Jews (94.
    2% and 93.
    7%, respectively, 84.
    4%) person-day
    .
    The three-needle group had more risk days than the four-needle group (31 million versus 23.
    9 million person-days), but had more confirmed infections (111,780 versus 42,325) and more severe cases (1,210 versus 355)
    .



    A total of 1,252,331 people met the inclusion criteria (Figure 1)
    .
    The total number of events and person-at-risk days in each study group, as well as the distribution of covariates used in the analysis, are shown in Table 1
    .
    It provides summary statistics for the weeks following the fourth dose, starting in the second week .

    Statistics Overall, the distribution of covariates in the pooled treatment group was similar to that in the internal control group .
    Compared with the three-needle group, the four-needle confluence group and the internal control group included more over-80s (24.
    9% and 25.
    1%, respectively, 16.
    2%) and more ordinary Jews (94.
    2% and 93.
    7%, respectively, 84.
    4%) person-day
    .
    The three-needle group had more risk days than the four-needle group (31 million versus 23.
    9 million person-days), but had more confirmed infections (111,780 versus 42,325) and more severe cases (1,210 versus 355)
    .
    The three-needle group had more risk days than the four-needle group



    Figure 1.
    Research flow

    Figure 1.
    Research flow

    Table 1.
    Demographic and clinical characteristics of participants

    .

    Table 1.
    Demographic and clinical characteristics of participants

    .

    Protection given by the fourth needle

    Protection given by the fourth needle

    As shown in Table 1, the unadjusted confirmed infection rates of the four-needle group, the three-needle group, and the internal control group were 177 cases/100,000 person-days, 361 cases/100,000 person-days, and 388 cases/100,000 person-days, respectively; The adjusted incidence of severe Covid-19 was 1.
    5 cases/100,000 person-days, 3.
    9 cases/100,000 person-days, and 4.
    2 cases/100,000 person-days

    .

    As shown in Table 1, the unadjusted confirmed infection rates of the four-needle group, the three-needle group, and the internal control group were 177 cases/100,000 person-days, 361 cases/100,000 person-days, and 388 cases/100,000 person-days, respectively; The adjusted incidence of severe Covid-19 was 1.
    5 cases/100,000 person-days, 3.
    9 cases/100,000 person-days, and 4.
    2 cases/100,000 person-days

    .

    The results of quasi- Poisson regression analysis
    of confirmed infection and severe disease are shown in Table 2 and Table 3, respectively .
    Figure 2 is a graphical representation of the results of confirmed infection and severe disease
    .

    The results of quasi- Poisson regression analysis
    of confirmed infection and severe disease are shown in Table 2 and Table 3, respectively .
    Figure 2 is a graphical representation of the results of confirmed infection and severe disease
    .

    Table 2.
     
    Quasi-Poisson regression analysis results for confirmed SARS-CoV-2 infection
    .

    Table 2.
     
    Quasi-Poisson regression analysis results for confirmed SARS-CoV-2 infection
    .

    Table 3.
     
    Quasi-Poisson regression analysis results for severe Covid-19
    .

    Table 3.
     
    Quasi-Poisson regression analysis results for severe Covid-19
    .

    Figure 2.
     
    Adjusted ratios of confirmed infections and severe illness
    .

    Figure 2.
     
    Adjusted ratios of confirmed infections and severe illness
    .

     

    The adjusted confirmed infection rate of the four-needle group was lower than that of the two control groups
    .
    The adjusted rate was 2.
    0 times lower (95% CI, 1.
    9-2.
    1) in the population at the fourth week (22 to 28 days) after receiving the fourth injection than in the three-injection group and 1.
    8 times lower than in the internal control group (95% CI, 1.
    7-1.
    9) )

    .
    The adjusted confirmed infection rate (rounded) for the fourth week after the fourth dose was 171 per 100,000 days (95% CI, 165 to 177), compared with 340 per 100,000 days (95% CI, 165 to 177) in the three-dose group.
    %CI, 337 to 343), and the internal control group was 308 cases per 100,000 person-days (95%CI, 299 to 317)

    .
    In an adjusted ratio-difference analysis, the four-dose group reduced confirmed infections by 170 cases
    per 100,000 person-days (95% CI, 162-176) compared with the three-dose group at week 4, which was 137 fewer than the internal control group.
    Cases/100,000-days (95% CI, 125 to 148)

    .
    From the fifth week (days 29 to 35), the rate of confirmed infections began to decline

    .
    The adjusted infection rate at week eight after the fourth needle was very similar to the control group: the ratio of the three-needle group to the four-needle group was 1.
    1 (95% CI, 1.
    0-1.
    2), and the ratio of the internal control group to the four-needle group was only 1.
    0 ( 95%CI, 0.
    9-1.
    1)

    .

    The adjusted confirmed infection rate of the four-needle group was lower than that of the two control groups
    .
    The adjusted rate was 2.
    0 times lower (95% CI, 1.
    9-2.
    1) in the population at the fourth week (22 to 28 days) after receiving the fourth injection than in the three-injection group and 1.
    8 times lower than in the internal control group (95% CI, 1.
    7-1.
    9) )

    .
    The adjusted confirmed infection rate (rounded) for the fourth week after the fourth dose was 171 per 100,000 days (95% CI, 165 to 177), compared with 340 per 100,000 days (95% CI, 165 to 177) in the three-dose group.
    %CI, 337 to 343), and the internal control group was 308 cases per 100,000 person-days (95%CI, 299 to 317)

    .
    In an adjusted ratio-difference analysis, the four-dose group reduced confirmed infections by 170 cases
    per 100,000 person-days (95% CI, 162-176) compared with the three-dose group at week 4, which was 137 fewer than the internal control group.
    Cases/100,000-days (95% CI, 125 to 148)

    .
    From the fifth week (days 29 to 35), the rate of confirmed infections began to decline

    .
    The adjusted infection rate at week eight after the fourth needle was very similar to the control group: the ratio of the three-needle group to the four-needle group was 1.
    1 (95% CI, 1.
    0-1.
    2), and the ratio of the internal control group to the four-needle group was only 1.
    0 ( 95%CI, 0.
    9-1.
    1)

    .
    The adjusted confirmed infection rate of the four-needle group was lower than that of the two control groups
    .
    The adjusted rate was 2.
    0 times lower (95% CI, 1.
    9-2.
    1) in the population at the fourth week (22 to 28 days) after receiving the fourth injection than in the three-injection group and 1.
    8 times lower than in the internal control group (95% CI, 1.
    7-1.
    9) )

    .
    The adjusted confirmed infection rate (rounded) for the fourth week after the fourth dose was 171 per 100,000 days (95% CI, 165 to 177), compared with 340 per 100,000 days (95% CI, 165 to 177) in the three-dose group.
    %CI, 337 to 343), and the internal control group was 308 cases per 100,000 person-days (95%CI, 299 to 317)

    .
    The four-dose group reduced confirmed infections by 170 compared with the three-dose group at week four in an adjusted rate-difference analysis

    For severe Covid-19, the ratio of the control group to the four-needle group was greater and the duration was longer
    .
    For those four weeks after receiving the fourth injection, the adjusted rate of severe illness was 3.
    5 times lower (95% CI, 2.
    7-4.
    6) than the three-needle group and 2.
    3 times lower (95% CI, 1.
    7-3.
    3) than the internal control group

    .
    In the fourth week, the adjusted severe rate of the four-needle group, the three-needle group, and the internal control group were 1.
    6 cases/100,000 person-days (95% CI, 1.
    2-2.
    0), 5.
    5 cases/100,000 person-days (95% CI, 1.
    2-2.
    0), respectively.
    %CI, 5.
    2-5.
    9), 3.
    6 cases/100,000 person-days (95%CI, 3.
    0-4.
    5)

    .
    The adjusted rate difference in the four-needle group was 3.
    9 (95% CI, 3.
    4 - 4.
    5) and 2.
    1 (95% CI, 1.
    4 - 3.
    0) fewer per 100,000 days in the three-dose and internal control groups, respectively

    .
    In the weeks after receiving the fourth dose, the severe rate of the four-needle group continued to be lower than that of the control group, and there was no obvious sign of weakening in the sixth week after receiving the fourth dose (
    Figure 2 )
    .

    For severe Covid-19, the ratio of the control group to the four-needle group was greater and the duration was longer
    .
    For those four weeks after receiving the fourth injection, the adjusted rate of severe illness was 3.
    5 times lower (95% CI, 2.
    7-4.
    6) than the three-needle group and 2.
    3 times lower (95% CI, 1.
    7-3.
    3) than the internal control group

    .
    In the fourth week, the adjusted severe rate of the four-needle group, the three-needle group, and the internal control group were 1.
    6 cases/100,000 person-days (95% CI, 1.
    2-2.
    0), 5.
    5 cases/100,000 person-days (95% CI, 1.
    2-2.
    0), respectively.
    %CI, 5.
    2-5.
    9), 3.
    6 cases/100,000 person-days (95%CI, 3.
    0-4.
    5)

    .
    The adjusted rate difference in the four-needle group was 3.
    9 (95% CI, 3.
    4 - 4.
    5) and 2.
    1 fewer (95% CI, 1.
    4 - 3.
    0) cases per 100,000 days in the three-dose and internal control groups, respectively

    .
    In the weeks after receiving the fourth dose, the severe rate of the four-needle group continued to be lower than that of the control group, and there was no obvious sign of weakening in the sixth week after receiving the fourth dose (
    Figure 2 )
    .
    For those four weeks after receiving the fourth injection, the adjusted rate of severe illness was 3.
    5 times lower (95% CI, 2.
    7-4.
    6) than the three-needle group and 2.
    3 times lower (95% CI, 1.
    7-3.
    3) than the internal control group

    .
    In the fourth week, the adjusted severe rate of the four-needle group, the three-needle group, and the internal control group were 1.
    6 cases/100,000 person-days (95% CI, 1.
    2-2.
    0), 5.
    5 cases/100,000 person-days (95% CI, 1.
    2-2.
    0), respectively.
    %CI, 5.
    2-5.
    9), 3.
    6 cases/100,000 person-days (95%CI, 3.
    0-4.
    5)

    .
    The adjusted rate difference in the four-needle group was 3.
    9 (95% CI, 3.
    4 - 4.
    5) and 2.
    1 fewer (95% CI, 1.
    4 - 3.
    0) cases per 100,000 days in the three-dose and internal control groups, respectively

    .
    For several weeks after receiving the fourth dose, the severe rate of the four-needle group continued to be lower than that of the control group, and there was no obvious sign of weakening in the sixth week after receiving the fourth dose (
    Figure 2 )
    .
    Figure 2 Figure 2

    The omicron variant is genetically different from the progenitor strain of SARS-CoV-2 for which the BNT162b2 vaccine was tailored
    .
    The results presented here demonstrate that a fourth dose of the vaccine provides additional short-term protection against infection and severe disease caused by the omicron variant compared to the three doses given at least 4 months earlier
    .
    The incidence of confirmed infections was 2-fold lower and the rate of severe illness was 3-fold lower at the fourth week after receiving the fourth dose of the vaccine compared to the eligible population who did not receive the fourth dose

    .
    The rate of SARS-CoV-2 infection and severe Covid-19 severity after the fourth dose of BNT162b2 vaccine was lower than after only three doses
    .
    For confirmed infections, the fourth dose appeared to provide only short-term protection and modest absolute benefit, but protection against severe disease did not diminish over the study period

    .

    The omicron variant is genetically different from the progenitor strain of SARS-CoV-2 for which the BNT162b2 vaccine was tailored
    .
    The results presented here demonstrate that a fourth dose of the vaccine provides additional short-term protection against infection and severe disease caused by the omicron variant compared to the three doses given at least 4 months earlier
    .
    The incidence of confirmed infections was 2-fold lower and the rate of severe illness was 3-fold lower at the fourth week after receiving the fourth dose of the vaccine compared to the eligible population who did not receive the fourth dose

    .
    The rate of SARS-CoV-2 infection and severe Covid-19 severity after the fourth dose of BNT162b2 vaccine was lower than after only three doses
    .
    For confirmed infections, the fourth dose appeared to provide only short-term protection and modest absolute benefit, but protection against severe disease did not diminish over the study period

    .

    Original source:

    Bar-On YM, Goldberg Y, Mandel M, Bodenheimer O, Amir O, Freedman L, Alroy-Preis S, Ash N, Huppert A, Milo R.
    Protection by a Fourth Dose of BNT162b2 against Omicron in Israel.
    N Engl J Med .
    2022 Apr 5.
    doi: 10.
    1056/NEJMoa2201570.
    Epub ahead of print.
    PMID: 35381126.

    Bar-On YM, Goldberg Y, Mandel M, Bodenheimer O, Amir O, Freedman L, Alroy-Preis S, Ash N, Huppert A, Milo R.
    Protection by a Fourth Dose of BNT162b2 against Omicron in Israel.
    N Engl J Med .
    2022 Apr 5.
    doi: 10.
    1056/NEJMoa2201570.
    Epub ahead of print.
    PMID: 35381126.


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