RESUMEN
Timely evaluation of the protective effects of Coronavirus Disease 2019 (COVID-19) vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern is urgently needed to inform pandemic control planning. Based on 78 vaccine efficacy or effectiveness (VE) data from 49 studies and 1,984,241 SARS-CoV-2 sequences collected from 31 regions, we analyzed the relationship between genetic distance (GD) of circulating viruses against the vaccine strain and VE against symptomatic infection. We found that the GD of the receptor-binding domain of the SARS-CoV-2 spike protein is highly predictive of vaccine protection and accounted for 86.3% (P = 0.038) of the VE change in a vaccine platform-based mixed-effects model and 87.9% (P = 0.006) in a manufacturer-based model. We applied the VE-GD model to predict protection mediated by existing vaccines against new genetic variants and validated the results by published real-world and clinical trial data, finding high concordance of predicted VE with observed VE. We estimated the VE against the Delta variant to be 82.8% (95% prediction interval: 68.7-96.0) using the mRNA vaccine platform, closely matching the reported VE of 83.0% from an observational study. Among the four sublineages of Omicron, the predicted VE varied between 11.9% and 33.3%, with the highest VE predicted against BA.1 and the lowest against BA.2, using the mRNA vaccine platform. The VE-GD framework enables predictions of vaccine protection in real time and offers a rapid evaluation method against novel variants that may inform vaccine deployment and public health responses.
Asunto(s)
COVID-19 , Vacunas Virales , COVID-19/prevención & control , Vacunas contra la COVID-19 , Humanos , SARS-CoV-2/genética , Glicoproteína de la Espiga del Coronavirus , Eficacia de las Vacunas , Vacunas Sintéticas , Vacunas de ARNmRESUMEN
OBJECTIVE: The 2009 province-wide and 2010 nationwide supplementary immunization activities (SIAs) greatly reduced measles prevalence in Guangdong, a province in southern China with the largest migrant population. However, during 2013-2014, Guangdong experienced a resurgence of the measles epidemic. This study was performed to examine the association between infections in migrants and the resurgence of the measles epidemic. METHODS: The records of 22 362 clinically and laboratory-confirmed measles cases from the years 2009 to 2014 were extracted from the National Infectious Disease Monitoring Information System. The epidemiological characteristics of infections in migrants during 2009-2012 were compared to those during 2013-2014. RESULTS: Infections in migrants were not significantly associated with the resurgence of the measles epidemic in 2013-2014 (p=0.98). Nevertheless, for infections among locals and migrants during 2009-2012 and 2013-2014, substantial increases in the proportion of infection were detected among children aged <8 months and the unvaccinated population (p<0.01). CONCLUSIONS: The study findings suggest that infections in migrants might not have been the major cause of the epidemic resurgence of measles. Instead, the resurgence was likely due to infections among children aged <8 months and the unvaccinated. Thus, officials are advised to give higher priority to appropriate populations when formulating control measures, and to strengthen routine surveillance of vaccination coverage among them.