Home Medizin Neue Pfizer/BioNTech-Impfstoffvariante bietet verbesserten Schutz vor COVID-19-Krankenhausaufenthalten

Neue Pfizer/BioNTech-Impfstoffvariante bietet verbesserten Schutz vor COVID-19-Krankenhausaufenthalten

von NFI Redaktion

Researchers in the United States conducted a study examining the effectiveness of a modified vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its impact on hospitalizations and outpatient visits related to the disease in individuals across the United States. They also investigated whether previous vaccine versions continue to protect individuals compared to no vaccination.

Study: Modified BNT162b2 XBB1.5 vaccine and COVID-19 hospitalizations and outpatient visits in adults in the USA. Image credit: Corona Borealis Studio / ShutterstockStudy: Modified BNT162b2 XBB1.5 vaccine and COVID-19 hospitalizations and outpatient visits in adults in the USA. Image credit: Corona Borealis Studio / Shutterstock

*Important Note: medRxiv publishes preliminary scientific reports that are not peer-reviewed and should not be considered conclusive, as a guide for clinical practice/health-related behavior, or treated as established information.

The modified monovalent messenger ribonucleic acid (mRNA) SARS-CoV-2 vaccines against the XBB1.5 strain have been authorized by the US Food and Drug Administration (US-FDA) for individuals aged 6.0 months and older since September 15, 2023, following CDC guidelines. However, the association between XBB1.5-adapted vaccinations and therapeutically relevant SARS-CoV-2 infection outcomes requires further research.

About the Study

The researchers of this study examined the association between administering the adapted lineage vaccine BNT162b2 2003–2004, XBB1.5, and the outcomes of a SARS-CoV-2 infection in adults in the USA.

The researchers investigated the probabilities of BNT162b2 SARS-CoV-2 between October 11 and December 10, 2023. The primary study exposure was a BNT162b2 SARS-CoV-2 XBB1.5-modified vaccine versus a non-XBB1.5- modified vaccine, regardless of previous COVID-19 vaccinations and a history of SARS-CoV-2 infections. The researchers also compared previous (non-SARS-CoV-2

Cases involved individuals who tested positive for SARS-CoV-2 via polymerase chain reaction (PCR) during hospitalization, urgent care (UC), emergency department (ED), and outpatient encounters. The team restricted the PCR testing to those performed two weeks before the initial exposure to an acute respiratory infection (ARI) and three days post-interaction in patients and control subjects.

The trial began two weeks after XBB1.5-adapted vaccinations became available for KPSC members, and XBB sub-lineages were mainly circulating. By mid-November, JN.1, a SARS-CoV-2-BA2.86 subvariant, began rapidly rising in frequency. Participants were enrolled in a health plan for one year to assess their medical history and comorbidities. Patients with other medical issues were not eligible to participate in the study. The team obtained data from the California Immunization Registry, where providers are required to submit COVID-19 vaccine doses within 24 hours. They conducted multivariate logistic regression modeling to determine the adjusted odds ratios (ORs).

Results

The SARS-CoV-2 PCR test yielded that 24,007 individuals out of 26,187 ARI encounters met the research selection criteria. Eighteen percent tested positive for SARS-CoV-2, 6.6% received the XBB1.5-adapted BNT162b2 vaccine. The vaccination was administered to 17% and 7.4% of individuals in the case (n=4,232) and control (n=19,775) groups, respectively. 93% of participants had never received the XBB1.5-modified COVID-19 vaccination, and 11% had no history of COVID-19 vaccination. The mean period after receiving the most recent previous dose of the COVID-19 vaccine was 363 days for recipients of the BNT162b2 SARS-CoV-2 XBB1.5-modified vaccine, and the mean period since receiving the XBB1.5-modified vaccine was 30.0 days.

The adjusted OR values for testing positive for SARS-CoV-2 were 0.4 for individuals receiving a BNT162b2 SARS-CoV-2 and 0.4 for hospitalizations related to a SARS-CoV-2 infection, UC/ED visits, and outpatient visits. Regardless of the number and type of doses, older versions of the COVID-19 vaccine provided negligible protection compared to no vaccination, even against hospitalization with COVID-19. Recipients of earlier COVID-19 vaccine versions did not have significantly lower risks for SARS-CoV-2 infection outcomes, including hospitalizations, compared to the unvaccinated.

The SARS-CoV-2 seropositivity risk was similar across all groups, including recipients of BA.4 and BA.5-modified bivalent vaccines, non-SARS-CoV-2 XBB1.5-modified vaccines, or three or two doses of the old SARS-CoV-2 strain vaccines without a booster shot tailored to SARS-CoV-2 variants. The results were largely comparable across all age groups, with trends indicating stronger risk reduction in outpatient encounters among individuals over 65 years old. Labor, delivery, urgent medical care, surgery/neurosurgery, sepsis, and other medical disorders were the most common causes of hospitalizations in the cases eliminated.

The study’s findings showed that COVID-19 vaccinations developed for XBB1.5 provide additional immune protection against the outcomes of a SARS-CoV-2 infection. After 30 days, recipients of the BNT162b2 SARS-CoV-2 were most likely XBB sub-lineages. Due to reduced immunity and the ongoing evolution of SARS-CoV-2, older COVID-19 vaccinations offered minimal protection. Regular updates to COVID-19 vaccinations are crucial to maintain protection against the virus during its spread.

*Important Note: medRxiv publishes preliminary scientific reports that are not peer-reviewed and should not be considered conclusive, as a guide for clinical practice/health-related behavior, or treated as established information.

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