학술논문

Efficacy and Safety of NVX-CoV2373 in Adults in the United States and Mexico
Document Type
article
Source
New England Journal of Medicine. 386(6)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Emerging Infectious Diseases
Clinical Trials and Supportive Activities
Immunization
Vaccine Related
Genetics
Prevention
Infectious Diseases
Clinical Research
Lung
Evaluation of treatments and therapeutic interventions
6.1 Pharmaceuticals
Infection
Good Health and Well Being
Adolescent
Adult
Aged
COVID-19
COVID-19 Nucleic Acid Testing
COVID-19 Vaccines
Humans
Incidence
Male
Mexico
Middle Aged
SARS-CoV-2
Single-Blind Method
United States
Vaccine Efficacy
2019nCoV-301 Study Group
Medical and Health Sciences
General & Internal Medicine
Biomedical and clinical sciences
Health sciences
Language
Abstract
BackgroundNVX-CoV2373 is an adjuvanted, recombinant spike protein nanoparticle vaccine that was shown to have clinical efficacy for the prevention of coronavirus disease 2019 (Covid-19) in phase 2b-3 trials in the United Kingdom and South Africa, but its efficacy had not yet been tested in North America.MethodsWe conducted a phase 3, randomized, observer-blinded, placebo-controlled trial in the United States and Mexico during the first half of 2021 to evaluate the efficacy and safety of NVX-CoV2373 in adults (≥18 years of age) who had not had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Participants were randomly assigned in a 2:1 ratio to receive two doses of NVX-CoV2373 or placebo 21 days apart. The primary objective was to determine vaccine efficacy against reverse-transcriptase-polymerase-chain-reaction-confirmed Covid-19 occurring at least 7 days after the second dose. Vaccine efficacy against moderate-to-severe disease and against different variants was also assessed.ResultsOf the 29,949 participants who underwent randomization between December 27, 2020, and February 18, 2021, a total of 29,582 (median age, 47 years; 12.6% ≥65 years of age) received at least one dose: 19,714 received vaccine and 9868 placebo. Over a period of 3 months, 77 cases of Covid-19 were noted - 14 among vaccine recipients and 63 among placebo recipients (vaccine efficacy, 90.4%; 95% confidence interval [CI], 82.9 to 94.6; P