medRxiv (Cold Spring Harbor Laboratory),
Год журнала:
2023,
Номер
unknown
Опубликована: Дек. 4, 2023
Abstract
This
analysis
estimates
the
economic
and
clinical
impact
of
a
Moderna
updated
COVID-19
mRNA
Fall
2023
vaccine
for
adults
≥18
years
in
Japan.
A
previously
developed
Susceptible-Exposed-Infected-Recovered
(SEIR)
model
with
1-year
analytic
time
horizon
(September
2023-August
2024)
consequences
decision
tree
were
used
to
estimate
symptomatic
infections,
COVID-19–related
hospitalizations,
deaths,
quality-adjusted
life-years
(QALYs),
costs,
incremental
cost-effectiveness
ratio
(ICER)
versus
no
additional
vaccination,
Pfizer-BioNTech
vaccine.
The
is
predicted
prevent
7.2
million
272,100
hospitalizations
25,600
related
deaths
In
base
case
(healthcare
perspective),
ICER
was
¥1,300,000/QALY
gained
($9,400
USD/QALY
gained).
Sensitivity
analyses
suggest
results
are
most
affected
by
incidence,
initial
effectiveness
(VE),
VE
waning
against
infection.
Assuming
relative
between
both
bivalent
vaccines
apply
vaccines,
suggests
version
will
an
1,100,000
27,100
2,600
compared
expected
be
highly
cost-effective
at
¥5
willingness-to-pay
threshold
across
wide
range
scenarios.
Nature Communications,
Год журнала:
2023,
Номер
14(1)
Опубликована: Март 14, 2023
Abstract
Expansion
of
the
SARS-CoV-2
BA.4
and
BA.5
Omicron
subvariants
in
populations
with
prevalent
immunity
from
prior
infection
vaccination,
associated
burden
severe
COVID-19,
has
raised
concerns
about
epidemiologic
characteristics
these
lineages
including
their
association
immune
escape
or
clinical
outcomes.
Here
we
show
that
BA.4/BA.5
cases
a
large
US
healthcare
system
had
at
least
55%
(95%
confidence
interval:
43–69%)
higher
adjusted
odds
documented
than
time-matched
BA.2
cases,
as
well
15%
(9–21%)
38%
(27–49%)
having
received
3
≥4
COVID-19
vaccine
doses,
respectively.
However,
after
adjusting
for
differences
among
each
lineage,
was
not
differential
risk
emergency
department
presentation,
hospital
admission,
intensive
care
unit
admission
following
an
initial
outpatient
diagnosis.
This
finding
held
sensitivity
analyses
correcting
potential
exposure
misclassification
resulting
unascertained
infections.
Our
results
demonstrate
reduced
severity
(BA.1
BA.2)
lineages,
relative
to
Delta
variant,
persisted
BA.4/BA.5,
despite
increased
breakthrough
previously
vaccinated
infected
individuals.
Infectious Diseases and Therapy,
Год журнала:
2024,
Номер
13(4), С. 779 - 811
Опубликована: Март 18, 2024
The
mRNA
vaccines
mRNA-1273
and
BNT162b2
demonstrated
high
efficacy
against
severe
acute
respiratory
syndrome
coronavirus
2
(SARS-CoV-2)
infection
in
phase
3
clinical
trials,
including
among
older
adults.
To
inform
disease
2019
(COVID-19)
vaccine
selection,
this
systematic
literature
review
(SLR)
meta-analysis
assessed
the
comparative
effectiveness
of
versus
We
systematically
searched
for
relevant
studies
reporting
COVID-19
outcomes
with
adults
aged
≥
50
years
by
first
cross-checking
published
SLRs.
Based
on
cutoff
date
from
a
previous
similar
SLR,
we
then
WHO
Research
Database
articles
between
April
9,
2022,
June
2,
2023.
Outcomes
interest
were
SARS-CoV-2
infection,
symptomatic
COVID-19–related
hospitalization,
death
following
doses.
Random
effects
models
used
to
pool
risk
ratios
(RRs)
across
studies.
Heterogeneity
was
evaluated
using
chi-square
testing.
Evidence
certainty
per
GRADE
framework.
Twenty-four
non-randomized
real-world
individuals
included
meta-analysis.
Vaccination
associated
significantly
lower
(RR
0.72
[95%
confidence
interval
(CI)
0.64‒0.80]),
CI
0.62‒0.83]),
0.67
0.57‒0.78]),
hospitalization
0.65
0.53‒0.79])
but
not
0.80
0.64‒1.00])
compared
BNT162b2.
There
considerable
heterogeneity
all
(I2
>
75%)
except
=
0%).
Multiple
subgroup
sensitivity
analyses
excluding
specific
generally
consistent
results.
Certainty
evidence
rated
as
low
(type
3)
or
very
4),
reflecting
lack
randomized
controlled
trial
data.
Meta-analysis
24
observational
asymptomatic,
symptomatic,
infections
hospitalizations
years.
Vaccines,
Год журнала:
2024,
Номер
12(4), С. 434 - 434
Опубликована: Апрель 18, 2024
This
analysis
estimates
the
economic
and
clinical
impact
of
a
Moderna
updated
COVID-19
mRNA
Fall
2023
vaccine
for
adults
≥18
years
in
Japan.
A
previously
developed
Susceptible-Exposed-Infected-Recovered
(SEIR)
model
with
one-year
analytic
time
horizon
(September
2023–August
2024)
consequences
decision
tree
were
used
to
estimate
symptomatic
infections,
related
hospitalizations,
deaths,
quality-adjusted
life
(QALYs),
costs,
incremental
cost-effectiveness
ratio
(ICER)
versus
no
additional
vaccination,
Pfizer–BioNTech
vaccine.
The
is
predicted
prevent
7.2
million
272,100
hospitalizations
25,600
deaths
In
base
case
(healthcare
perspective),
ICER
was
¥1,300,000/QALY
gained
($9400
USD/QALY
gained).
Sensitivity
analyses
suggest
results
are
most
affected
by
incidence,
initial
effectiveness
(VE),
VE
waning
against
infection.
Assuming
relative
between
both
bivalent
vaccines
apply
vaccines,
suggests
version
will
an
1,100,000
27,100
2600
compared
expected
be
highly
cost-effective
at
¥5
willingness-to-pay
threshold
across
wide
range
scenarios.
EClinicalMedicine,
Год журнала:
2023,
Номер
63, С. 102148 - 102148
Опубликована: Авг. 21, 2023
Older
adults
are
at
increased
risk
of
SARS-CoV-2
Omicron
infection
and
severe
disease,
especially
those
in
congregate
living
settings,
despite
high
vaccine
coverage.
It
is
unclear
whether
hybrid
immunity
(combined
vaccination
infection)
after
one
provides
protection
against
subsequent
reinfection
older
adults.Incidence
was
examined
750
vaccinated
residents
long-term
care
retirement
homes
the
observational
cohort
COVID
Long-Term
Care
Study
Ontario,
Canada,
within
a
75-day
period
(July
to
September
2022).
Risk
assessed
by
Cox
proportional
hazards
regression.
Serum
anti-spike
anti-RBD
IgG
IgA
antibodies,
microneutralization
titres,
spike-specific
T
cell
memory
responses,
were
subset
318
preceding
three
months.133
participants
(17.7%)
had
PCR-confirmed
during
observation
period.
Increased
associated
with
prior
(at
9-29
days:
47.67
[23.73-95.76]),
this
not
attributed
days
since
fourth
(1.00
[1.00-1.01])
or
residence
outbreaks
(>6
compared
≤6:
0.95
[0.37-2.41]).
Instead,
reinfected
lower
serum
neutralizing
antibodies
ancestral
BA.1
SARS-CoV-2,
their
initial
infection.Counterintuitively,
homes.
Less
robust
humoral
immune
responses
may
contribute
reinfection.COVID-19
Immunity
Task
Force
Public
Health
Agency
Canada.
Journal of Medical Virology,
Год журнала:
2023,
Номер
95(10)
Опубликована: Окт. 1, 2023
Abstract
Immunogenicity
of
the
severe
acute
respiratory
syndrome
coronavirus
2
(SARS‐CoV‐2)
bivalent
mRNA‐1273.214
vaccine
(Original/Omicron
B.1.1.529
[BA.1])
is
underreported
in
vulnerable
older
adults
congregate
care
settings.
In
residents
26
long‐term
and
retirement
homes
Ontario,
Canada,
humoral
(i.e.,
serum
anti‐spike
anti‐receptor
binding
domain
[anti‐RBD])
IgG
IgA
antibodies
live
SARS‐CoV‐2
neutralization)
cellular
CD4
+
CD8
activation‐induced
marker
spike‐specific
T
cell
memory)
responses
were
assessed
7–120
days
postvaccination
with
four
monovalent
mRNA
vaccines
(
n
=
494)
or
subsequent
vaccination
(fifth
vaccine)
557).
Within
4
months,
anti‐RBD
antibody
levels
similar
after
infection‐naïve
individuals.
Hybrid
immunity
natural
infection)
generally
increased
responses.
After
vaccination,
compared
to
hybrid
had
elevated
antibodies.
Omicron
BA.1
antibody‐mediated
neutralization,
memory
spike
protein,
also
higher
vaccination.
Humoral
were,
therefore,
noninferior
within
months
Waning
but
not
was
particularly
evident
individuals
without
immunity.
Continued
monitoring
vaccine‐associated
against
emerging
variants
concern
necessary
assess
longevity
protection.
medRxiv (Cold Spring Harbor Laboratory),
Год журнала:
2023,
Номер
unknown
Опубликована: Ноя. 11, 2023
ABSTRACT
Background
Immunocompromised
(IC)
individuals
are
at
increased
risk
of
COVID-19
infection-related
severe
outcomes.
Moderna
and
Pfizer-BioNTech
mRNA
vaccines
available
in
Canada,
differences
vaccine
effectiveness
(VE)
have
been
found
between
the
two
IC
individuals.
The
objective
this
analysis
was
to
compare
clinical
economic
impact
a
XBB.1.5
updated
Fall
2023
Canadian
aged
≥18
years.
Methods
A
static
decision-analytic
model
estimated
number
infections,
hospitalizations,
deaths,
resulting
quality-adjusted
life
years
(QALYs)
over
one-year
time
horizon
(September
2023-August
2024)
adult
population
(n=894,580).
Costs
associated
with
infection
were
from
health
care
societal
perspectives.
predicted
VE
based
on
prior
variant
versions,
which
well-matched
circulating
variant.
calculated
meta-analysis
comparative
both
(relative
for
vaccine:
infection=0.85
[95%CI
0.75-0.97],
hospitalization=0.88
0.79-0.97]).
combined
estimates
incidence
probability
related
Sensitivity
analyses
tested
uncertainty
surrounding
incidence,
hospitalization
mortality
rates,
costs,
QALYs.
Results
Given
expected
higher
against
hospitalizations
vaccine,
its
use
is
prevent
an
additional
2,411
infections
(3.6%),
275
(3.7%),
47
deaths
(4.0%)
compared
330
QALYs
gained,
savings
$7.4M
treatment
$0.9M
productivity
loss
costs.
most
sensitive
variations
parameters,
specifically
relative
vaccines,
waning
rates.
Conclusions
If
protect
similar
previous
using
would
result
substantial
public
benefits
individuals,
as
well
provide
cost
savings.
Infectious Diseases and Therapy,
Год журнала:
2024,
Номер
13(10), С. 2203 - 2206
Опубликована: Авг. 24, 2024
incorrect
estimates
that
not
only
greatly
exaggerated
the
numerical
differences
in
VE
between
two
vaccines
but
also
led
to
conclusions
directly
contradicted
those
of
original
study
authors
many
instances.As
a
brief
example
this
(see
Supplementary
Appendix
for
additional
details),
wherein
one
studies
concluded
"there
was
no
difference
BNT162b2
versus
mRNA-1273
recipients
[3]"
based
on
their
reported
adjusted
results,
Kavikondala
et
al.
instead
calculated
and
used
63%
crude
relative
as
point
estimate
meta-analysis.This
mistake-where
found
these
vaccines,
yet
random
effects
risk
ratios
by
significantly
favored
mRNA-1273-occurred
20/54
(37%)
all
(from
24
included
studies)
Fig.
3a-e.In
addition,
there
were
eligible
missed
systematic
review
(i.e.,
at
least
14
extensive
errors
data
extraction.These
concerns
are
described
detail
Appendix.Second,
set
out
compare
BNT162b2,
so
they
should
have
head-to-head
estimates.Comparative
better
account
potential
brand-specific
population
characteristics
vaccine
(e.g.,
age
or
COVID-19
status)
timing
medRxiv (Cold Spring Harbor Laboratory),
Год журнала:
2023,
Номер
unknown
Опубликована: Ноя. 22, 2023
ABSTRACT
Background
The
mRNA
vaccines
mRNA-1273
and
BNT162b2
demonstrated
high
efficacy
against
SARS-CoV-2
infection
in
phase
3
clinical
trials,
including
among
older
adults.
To
inform
COVID-19
vaccine
selection,
this
systematic
literature
review
(SLR)
meta-analysis
assessed
the
comparative
effectiveness
of
versus
Methods
We
systematically
searched
for
relevant
studies
reporting
outcomes
with
adults
aged
≥50
years
by
first
cross-checking
published
SLRs.
Based
on
cutoff
date
from
a
previous
similar
SLR,
we
then
WHO
Research
Database
articles
between
April
9,
2022
June
2,
2023.
Outcomes
interest
were
infection,
symptomatic
severe
COVID-19‒related
hospitalization,
death
following
≥2
doses.
Random-effects
models
used
to
pool
risk
ratios
(RRs)
across
studies.
Heterogeneity
was
evaluated
using
chi-squared
testing.
Evidence
certainty
per
GRADE
framework.
Results
24
non-randomized
real-world
individuals
included
meta-analysis.
Vaccination
associated
significantly
lower
(RR
0.72
[95%
confidence
interval
(CI)
0.64‒0.80]),
CI
0.62‒0.83]),
0.67
0.57‒0.78]),
hospitalization
0.65
0.53‒0.79])
0.80
0.64‒0.99])
compared
BNT162b2.
There
considerable
heterogeneity
all
(I
2
>75%)
except
=0%).
Multiple
subgroup
sensitivity
analyses
excluding
specific
generally
consistent
results.
Certainty
evidence
rated
as
low
(type
3)
or
very
4),
reflecting
lack
randomized-controlled
trial
data.
Conclusion
Meta-analysis
observational
asymptomatic,
symptomatic,
infections;
hospitalizations;
deaths
years.
SUMMARY
POINTS
pandemic
has
disproportionately
affected
adults,
population
is
more
susceptible
due
immune
senescence
underlying
comorbidities.
available
settings.
homologous
primary
booster
(including
infections),
than
vaccination
