这项报告的题目是“Severe COVID-19 outcomes after full vaccination of primary schedule and initial boosters: pooled analysis of national prospective cohort studies of 30 million individuals in England, Northern Ireland, Scotland, and Wales”【1】。
We sought to describe the clinical and demographic characteristics and estimate risk factors for individuals who had severe COVID-19 outcomes after completing the primary vaccination schedule or subsequent booster dose during the period when the omicron variant was dominant. Therefore, we included events that occurred between Dec 20, 2021, and Feb 28, 2022.
2021-05-21: 1st dose of Comirnaty (BioNTech/Pfizer)
2021-06-13: 2nd dose of Comirnaty (BioNTech/Pfizer)
2021-06-23: 5854.4 BAU/ml
2021-09-30: 1098.1 BAU/ml
2021-11-15: 3rd dose of Comirnaty (BioNTech/Pfizer)
2021-12-22: 4949.7 BAU/ml
After the 3rd dose of Comirnaty I experienced a quite inconvenient repeating vertigo that began in the night after I got vaccinated and was lasting for more than 2 weeks. Might be related to fluctuating blood pressure. Therefore I chose Nuvaxovid for my 4th dose.
2022-08-30: 1st dose of Nuvaxovid (Novavax)
2022-10-07: 12554.0 BAU/ml
The day after Nuvaxovid I had a slightly higher temperature (37.05 °C), but no fever. My deltoid muscle was swollen for several days, like it was after the 2nd and the 3rd dose of Comirnaty. Besides that, some bilirubin showed up on the skin at my shoulder, like after a bruise (local haemolysis because of the saponins?). The bilirubin lasted about one week. This time I experienced no vertigo at all.
I was frankly surprised that the antibody count after Nuvaxovid was so much higher than after the 3rd dose of Comirnaty.
In order to get Nuvaxovid, I had to convince a doctor, who told me that this combination was off label in Europe and that she doesn't know any research on Nuvaxovid after Comirnaty (I did, but I didn't tell her), so she thougt that this combination would never get the necessary authorization. Luckily, I was able to convince her, but I had to sign her form even twice. A couple of days after she gave me my Nuvaxovid, the EMA authorized it as a heterologous booster. :D”
Older age, those with a higher number of comorbid conditions, and those with a range of specific underlying conditions were, however, found to be at increased risk of severe COVID-19 outcomes and might particularly benefit from additional, preferentially novel, COVID-19 boosters, pre-exposure prophylaxis, and COVID-19 therapeutics.
用数据，来辨清事实。
关键词：COVID-19；老年人；加强接种
导言：
2022年10月14日，Lancet今天发表了一篇大型COVID-19研究论文，十分重要。这项基于3,000万英国人口的前瞻性研究指出了在完全接种疫苗后，发生重症COVID-19的潜在危险因素。
一直在美国从事病毒新药/疫苗研发的王宇歌博士对这项研究做了简单的解读。
这项报告的题目是“Severe COVID-19 outcomes after full vaccination of primary schedule and initial boosters: pooled analysis of national prospective cohort studies of 30 million individuals in England, Northern Ireland, Scotland, and Wales”【1】。
研究来自St Andrews大学。
在2020年12月8日至2022年2月28日期间，研究中16,208,600人完成了疫苗接种，13,836,390人接受了加强接种。
疫苗主要包括BNT162b2和AZD1222。
研究主要发现：
59,510名（0.4%）的基本接种和26,100名（0.2%）加强接种者随后发生了重症COVID-19。
加强接种后发生重症的风险显著降低。
研究指出，接种疫苗后发生突破性感染而出现重症的情况，包括年龄大于80岁（aRR=3.6）；基础疾病患者尤其是5种以上基础疾病（aRR=9.51），使用免疫抑制剂患者（aRR=5.8），慢性肾病患者（第5期aRR=3.71）；男性（aRR=1.23）。而既往感染过SARS-CoV-2的患者风险显著降低（aRR=0.41）。
小结：
小结这项研究的核心结果：
年龄大于80岁、伴多种基础疾病多、使用免疫抑制剂、慢性肾病等是新冠病毒感染后发展重症的高危因素。
老年人、患有多种疾病的人在疫苗接种后依然有发生重症COVID-19的风险，因此需要进行额外加强接种。
但是最关键的是，请务必帮助老年人预约和完成疫苗的加强接种。
目前应用的疫苗大都是经过十几亿甚至几十亿人群验证过的，安全性非常好。
即使针对合并多种基础疾病的老年人，也具有很好的安全性；而虚弱的老年人是最需要通过疫苗接种保护起来的人群。
鉴于这类人群疫苗诱导的抗体水平较低，因此可以进行预防性抗体注射预防感染。
原文链接：【1】 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01656-7/fulltext
本期编辑：Henry，微信号healsan。
Hanson临床科研团队，由6位在美国的医生及医学科学家组成；目前在美国主要从事新药研发和临床科研。
作者简介：王宇歌 博士，一直在美国从事病毒新药和疫苗研发。微博：子陵在听歌。
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文章插图是无效链接，点击这里看全文：
https://mp.weixin.qq.com/s/9-qL-fF95ZV1u5O4faps4w?
另外，这个时间，是上次感染距加强针的时间。当然。这个时间越长，距离再次感染也越长。
We sought to describe the clinical and demographic characteristics and estimate risk factors for individuals who had severe COVID-19 outcomes after completing the primary vaccination schedule or subsequent booster dose during the period when the omicron variant was dominant. Therefore, we included events that occurred between Dec 20, 2021, and Feb 28, 2022.
https://www.reddit.com/r/Novavax_vaccine_talk/comments/y3aggm/1x_novavax_after_3x_pfizer_gave_me_a_way_higher/
“My data:
2021-05-21: 1st dose of Comirnaty (BioNTech/Pfizer)
2021-06-13: 2nd dose of Comirnaty (BioNTech/Pfizer)
2021-06-23: 5854.4 BAU/ml
2021-09-30: 1098.1 BAU/ml
2021-11-15: 3rd dose of Comirnaty (BioNTech/Pfizer)
2021-12-22: 4949.7 BAU/ml
After the 3rd dose of Comirnaty I experienced a quite inconvenient repeating vertigo that began in the night after I got vaccinated and was lasting for more than 2 weeks. Might be related to fluctuating blood pressure. Therefore I chose Nuvaxovid for my 4th dose.
2022-08-30: 1st dose of Nuvaxovid (Novavax)
2022-10-07: 12554.0 BAU/ml
The day after Nuvaxovid I had a slightly higher temperature (37.05 °C), but no fever. My deltoid muscle was swollen for several days, like it was after the 2nd and the 3rd dose of Comirnaty. Besides that, some bilirubin showed up on the skin at my shoulder, like after a bruise (local haemolysis because of the saponins?). The bilirubin lasted about one week. This time I experienced no vertigo at all.
I was frankly surprised that the antibody count after Nuvaxovid was so much higher than after the 3rd dose of Comirnaty.
In order to get Nuvaxovid, I had to convince a doctor, who told me that this combination was off label in Europe and that she doesn't know any research on Nuvaxovid after Comirnaty (I did, but I didn't tell her), so she thougt that this combination would never get the necessary authorization. Luckily, I was able to convince her, but I had to sign her form even twice. A couple of days after she gave me my Nuvaxovid, the EMA authorized it as a heterologous booster. :D”
我呸。早知道你就留在上海。清零多厉害。
昨天去costco预约了一哈.
https://bbs.wenxuecity.com/health/1059847.html
(发自我的文学城离线浏览器)
Older age, those with a higher number of comorbid conditions, and those with a range of specific underlying conditions were, however, found to be at increased risk of severe COVID-19 outcomes and might particularly benefit from additional, preferentially novel, COVID-19 boosters, pre-exposure prophylaxis, and COVID-19 therapeutics.
原文最后的总结，这样的结论，能不能平衡掉副作用，都很难说了。