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2030-12-31
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- INI - Artigos de Periódicos [3648]
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COVID-19 VACCINE EFFICACY IN PARTICIPANTS WITH WEAKENED IMMUNE SYSTEMS FROM 4 RANDOMIZED CONTROLLED TRIALS
Author
Sherman, Amy C.
Tuan, Jessica
Cantos, Valeria D.
Adeyiga, Oladunni
Mahoney, Scott
Ortega-Villa, Ana M.
Tillman, Amy
Whitaker, Jennifer
Davis, Amanda S. Woodward
Leav, Brett
Hirsch, Ian
Sadoff, Jerald
Dunkle, Lisa M.
Gilbert, Peter B.
Janes, Holly E.
Kublin, James G.
Goepfert, Paul A.
Kotloff, Karen
Rouphael, Nadine
Falsey, Ann R.
El Sahly, Hana M.
Sobieszczyk, Magdalena E.
Huang, Yunda
Neuzil, Kathleen M.
Corey, Lawrence
Grinsztejn, Beatriz
Gray, Glenda
Nason, Martha
Baden, Lindsey R.
Gay, Cynthia L.
Tuan, Jessica
Cantos, Valeria D.
Adeyiga, Oladunni
Mahoney, Scott
Ortega-Villa, Ana M.
Tillman, Amy
Whitaker, Jennifer
Davis, Amanda S. Woodward
Leav, Brett
Hirsch, Ian
Sadoff, Jerald
Dunkle, Lisa M.
Gilbert, Peter B.
Janes, Holly E.
Kublin, James G.
Goepfert, Paul A.
Kotloff, Karen
Rouphael, Nadine
Falsey, Ann R.
El Sahly, Hana M.
Sobieszczyk, Magdalena E.
Huang, Yunda
Neuzil, Kathleen M.
Corey, Lawrence
Grinsztejn, Beatriz
Gray, Glenda
Nason, Martha
Baden, Lindsey R.
Gay, Cynthia L.
Affilliation
Department of Medicine. Division of Infectious Diseases. Brigham and Women's Hospital. Harvard Medical School. Boston, Massachusetts, USA.
Yale School of Medicine. Section of Infectious Diseases. New Haven, Connecticut, USA.
Emory University. Division of Infectious Diseases. Atlanta, Georgia, USA.
University of California. Department of Medicine. Division of Infectious Diseases. Los Angeles, California, USA.
University of Cape Town. Desmond Tutu HIV Centre. Department of Medicine. Cape Town, South Africa.
National Institute of Allergy and Infectious Diseases. National Institutes of Health. Bethesda, Maryland, USA.
Frederick National Laboratory for Cancer Research. Clinical Monitoring Research Program Directorate. Frederick, Maryland, USA.
Department of Molecular Virology and Microbiology and Section of Infectious Diseases. Department of Medicine. Baylor College of Medicine. Houston, Texas, USA.
Fred Hutchinson Cancer Center. Vaccine and Infectious Disease Division. Seattle, Washington, USA.
Moderna Inc. Cambridge, Massachusetts, USA.
Vaccines & Immune Therapies. BioPharmaceuticals R&D. AstraZeneca. Cambridge, United Kingdom.
Janssen Vaccines and Prevention. Leiden, Netherlands.
Novavax. Gaithersburg, Maryland, USA.
Fred Hutchinson Cancer Center. Vaccine and Infectious Disease Division. Seattle, Washington, USA.
Fred Hutchinson Cancer Center. Vaccine and Infectious Disease Division. Seattle, Washington, USA.
Fred Hutchinson Cancer Center. Vaccine and Infectious Disease Division. Seattle, Washington, USA.
University of Alabama at Birmingham. Department of Medicine. Birmingham, Alabama, USA.
University of Maryland School of Medicine. Department of Pediatrics and the Center for Vaccine Development and Global Health. Baltimore, Maryland, USA.
Emory University. Hope Clinic. Atlanta, Georgia, USA.
University of Rochester. Infectious Disease Division. Rochester, New York, USA.
Department of Molecular Virology and Microbiology and Section of Infectious Diseases. Department of Medicine. Baylor College of Medicine. Houston, Texas, USA.
Columbia University Irving Medical Center. Department of Medicine. New York, USA.
Fred Hutchinson Cancer Center. Vaccine and Infectious Disease Division. Seattle, Washington, USA.
University of Maryland School of Medicine. Center for Vaccine Development and Global Health. Baltimore, Maryland, USA.
Fred Hutchinson Cancer Center. Vaccine and Infectious Disease Division. Seattle, Washington, USA / University of Washington. Department of Laboratory Medicine and Pathology. Seattle, Washington, USA.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory on STD and AIDS. Rio de Janeiro, RJ, Brazil.
University of the Witwatersrand. Faculty of Health Sciences. Perinatal HIV Research Unit. Johannesburg, South Africa / South African Medical Research Council. Cape Town, South Africa.
National Institute of Allergy and Infectious Diseases. National Institutes of Health. Bethesda, Maryland, USA.
Department of Medicine. Division of Infectious Diseases. Brigham and Women's Hospital. Harvard Medical School. Boston, Massachusetts, USA.
University of North Carolina at Chapel Hill School of Medicine. UNC HIV Cure Center. Department of Medicine. Division of Infectious Diseases. Chapel Hill, North Carolina, USA.
Yale School of Medicine. Section of Infectious Diseases. New Haven, Connecticut, USA.
Emory University. Division of Infectious Diseases. Atlanta, Georgia, USA.
University of California. Department of Medicine. Division of Infectious Diseases. Los Angeles, California, USA.
University of Cape Town. Desmond Tutu HIV Centre. Department of Medicine. Cape Town, South Africa.
National Institute of Allergy and Infectious Diseases. National Institutes of Health. Bethesda, Maryland, USA.
Frederick National Laboratory for Cancer Research. Clinical Monitoring Research Program Directorate. Frederick, Maryland, USA.
Department of Molecular Virology and Microbiology and Section of Infectious Diseases. Department of Medicine. Baylor College of Medicine. Houston, Texas, USA.
Fred Hutchinson Cancer Center. Vaccine and Infectious Disease Division. Seattle, Washington, USA.
Moderna Inc. Cambridge, Massachusetts, USA.
Vaccines & Immune Therapies. BioPharmaceuticals R&D. AstraZeneca. Cambridge, United Kingdom.
Janssen Vaccines and Prevention. Leiden, Netherlands.
Novavax. Gaithersburg, Maryland, USA.
Fred Hutchinson Cancer Center. Vaccine and Infectious Disease Division. Seattle, Washington, USA.
Fred Hutchinson Cancer Center. Vaccine and Infectious Disease Division. Seattle, Washington, USA.
Fred Hutchinson Cancer Center. Vaccine and Infectious Disease Division. Seattle, Washington, USA.
University of Alabama at Birmingham. Department of Medicine. Birmingham, Alabama, USA.
University of Maryland School of Medicine. Department of Pediatrics and the Center for Vaccine Development and Global Health. Baltimore, Maryland, USA.
Emory University. Hope Clinic. Atlanta, Georgia, USA.
University of Rochester. Infectious Disease Division. Rochester, New York, USA.
Department of Molecular Virology and Microbiology and Section of Infectious Diseases. Department of Medicine. Baylor College of Medicine. Houston, Texas, USA.
Columbia University Irving Medical Center. Department of Medicine. New York, USA.
Fred Hutchinson Cancer Center. Vaccine and Infectious Disease Division. Seattle, Washington, USA.
University of Maryland School of Medicine. Center for Vaccine Development and Global Health. Baltimore, Maryland, USA.
Fred Hutchinson Cancer Center. Vaccine and Infectious Disease Division. Seattle, Washington, USA / University of Washington. Department of Laboratory Medicine and Pathology. Seattle, Washington, USA.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory on STD and AIDS. Rio de Janeiro, RJ, Brazil.
University of the Witwatersrand. Faculty of Health Sciences. Perinatal HIV Research Unit. Johannesburg, South Africa / South African Medical Research Council. Cape Town, South Africa.
National Institute of Allergy and Infectious Diseases. National Institutes of Health. Bethesda, Maryland, USA.
Department of Medicine. Division of Infectious Diseases. Brigham and Women's Hospital. Harvard Medical School. Boston, Massachusetts, USA.
University of North Carolina at Chapel Hill School of Medicine. UNC HIV Cure Center. Department of Medicine. Division of Infectious Diseases. Chapel Hill, North Carolina, USA.
Abstract
Background: Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are highly efficacious at preventing severe disease in the general population, current data are lacking regarding vaccine efficacy (VE) for individuals with mild immunocompromising conditions. Methods: A post hoc, cross-protocol analysis of participant-level data from the blinded phase of four randomized, placebo-controlled, coronavirus disease 2019 (COVID-19) vaccine phase 3 trials (Moderna, AstraZeneca, Janssen, and Novavax) was performed. We defined a "tempered immune system" (TIS) variable via a consensus panel based on medical history and medications to determine VE against symptomatic and severe COVID-19 cases in TIS participants versus non-TIS individuals starting at 14 days after completion of the primary series through the blinded phase for each of the 4 trials. An analysis of participants living with well-controlled human immunodeficiency virus was conducted using the same methods. Results: A total of 3852/30 351 (12.7%) Moderna participants, 3088/29 868 (10.3%) Novavax participants, 3549/32 380 (11.0%) AstraZeneca participants, and 5047/43 788 (11.5%) Janssen participants were identified as having a TIS. Most TIS conditions (73.9%) were due to metabolism and nutritional disorders. Vaccination (vs placebo) significantly reduced the likelihood of symptomatic and severe COVID-19 for all participants for each trial. VE was not significantly different for TIS participants versus non-TIS for either symptomatic or severe COVID-19 for each trial, nor was VE significantly different in the symptomatic endpoint for participants with human immunodeficiency virus. Conclusions: For individuals with mildly immunocompromising conditions, there is no evidence of differences in VE against symptomatic or severe COVID-19 compared with those with non-TIS in the 4 COVID-19 vaccine randomized controlled efficacy trials.
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