Journal of thoracic disease · 2026
Effectiveness of heterologous mRNA vaccine boosters during an Omicron wave of COVID-19: a cross-sectional study in Macao (China).
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Zhang Jinghua, Wang Boyuan, Lau Eric, Zeng Zhiqi, He Wei, Chen C L Philip, Chang Chiwai, Yang Zifeng, Tong Ka-Lok, Zhong Nanshan, Hon Chitin
Аннотация
BACKGROUND: Inactivated vaccines have been widely used in China and many low- and middle-income countries, but real-world evidence on the protective effectiveness of heterologous mRNA boosters after a SinoPharm primary regimen during Omicron waves in Chinese populations remains limited. This study aimed to evaluate the real-world infection protection effectiveness of a SinoPharm primary regimen with mRNA boosters during the 2022 Omicron (BF.7 and BA5.2 variants) wave in Macao, China.
METHODS: An online survey conducted for two days among Macao residents towards the end of the 2022 Omicron wave gathered 4,879 responses (61.7% female, n=3,010). Among the participants, 83.2% (n=4,052) reported receiving the SinoPharm primary vaccination regimen, while 20% (n=827) reported receiving mRNA boosters; 71.4% of respondents reported confirmed infections, with an average duration of 5.4 days testing positive. Logistic and Ordinary Least Squared regressions were utilized to analyze the infection risk and the number of days testing positive.
RESULTS: When compared to those who received a three-dose inactivated vaccine, those with one-dose mRNA booster shows a significantly lower likelihood of confirmed infection [odds ratio (OR) =0.421, P<0.01]. In the event of an infection, they also experienced a decreased likelihood of developing fever (OR =0.290, P<0.01), and fewer sick days (-0.931, P<0.05).
CONCLUSIONS: Heterologous vaccination is recommendable for both the Chinese population and other low-to-middle-income countries that have predominantly adopted inactivated vaccines as their primary regimen. Future studies are needed to examine the long-term effects, which could not be assessed in this survey.
METHODS: An online survey conducted for two days among Macao residents towards the end of the 2022 Omicron wave gathered 4,879 responses (61.7% female, n=3,010). Among the participants, 83.2% (n=4,052) reported receiving the SinoPharm primary vaccination regimen, while 20% (n=827) reported receiving mRNA boosters; 71.4% of respondents reported confirmed infections, with an average duration of 5.4 days testing positive. Logistic and Ordinary Least Squared regressions were utilized to analyze the infection risk and the number of days testing positive.
RESULTS: When compared to those who received a three-dose inactivated vaccine, those with one-dose mRNA booster shows a significantly lower likelihood of confirmed infection [odds ratio (OR) =0.421, P<0.01]. In the event of an infection, they also experienced a decreased likelihood of developing fever (OR =0.290, P<0.01), and fewer sick days (-0.931, P<0.05).
CONCLUSIONS: Heterologous vaccination is recommendable for both the Chinese population and other low-to-middle-income countries that have predominantly adopted inactivated vaccines as their primary regimen. Future studies are needed to examine the long-term effects, which could not be assessed in this survey.