Tesis

Efektivitas Vaksin COVID-19 mRNA Booster Kedua Pasca Coronavac dan Booster mRNA-1273 pada Tenaga Kesehatan di RSCM dan Faktor-faktor yang Memengaruhinya = The Effectiveness of the Second COVID-19 mRNA Booster Vaccine after Coronavac and mRNA-1273 Booster in Health Workers at Cipto Mangunkusumo National General Hospital and Factors that Influence It.

Latar Belakang Munculnya varian Omicron saat pandemi, memberikan dampak pada efektivitas vaksin COVID-19. Penyebaran Omicron meningkat pesat bahkan pada populasi yang telah divaksinasi dengan dosis booster, menyebabkan tingginya kejadian infeksi. Meskipun vaksin booster COVID-19 meningkatkan perlindungan terhadap infeksi, efek perlindungan berkurang seiring berjalannya waktu. Tujuan Mengetahui efektivitas dan faktor yang berhubungan dengan efektivitas serta kadar antibodi pasca vaksin mRNA booster kedua pada tenaga kesehatan di RSCM. Metode Penelitian ini menggunakan desain kohort. Sebanyak 271 tenaga kesehatan dipilih dari total sampling dari penelitian sebelumnya dan dilanjutkan dengan consecutive sampling. Subjek yang terpilih kemudian dilakukan wawancara dan pengambilan sampel darah untuk menilai kadar antibodi IgG sRBD. Subjek dibagi menjadi kelompok, yaitu kelompok booster kedua dan tidak booster kedua. Dinilai infeksi dan dihitung efektivitas vaksin, kemudian dilakukan analsisis bivariat dan multivariat untuk menilai variabel yang berpengaruh terhadap efektivitas vaksin mRNA booster kedua. Hasil Sebanyak 9 orang (5,6%) terinfeksi COVID-19 pada kelompok vaksin booster kedua dan 11 orang (9,7%) pada kelompok tidak vaksin booster kedua. Efektivitas vaksin terhadap kejadian infeksi COVID-19 sebesar 42% (IK 95% -37% – 75%), p = 0,215. Usia, jenis kelamin, hipertensi, DM tipe 2, obesitas, merokok, infeksi COVID-19 sebelum booster tidak mempunyai pengaruh terhadap efektivitas vaksin mRNA booster kedua. Median kadar antibodi ± 6 bulan pasca vaksin booster kedua adalah 8921 AU/ml (IQR: 11.142,5). Pada 48 orang yang melakukan pemeriksaan kadar antibodi saat booster pertama dan kedua, terjadi peningkatan, yaitu dari 4743 AU/ml (IQR 6053,3) menjadi 8532 AU/ml (IQR 8040,3). Simpulan Efektivitas vaksin mRNA booster kedua terhadap pencegahan kejadian infeksi COVID- 19 pada tenaga kesehatan sebesar 42%. Tidak ditemukan faktor yang berpengaruh terhadap efektivitas vaksin mRNA booster kedua. Kadar antibodi IgG sRBD pasca vaksin booster lebih tinggi dibandingkan pasca vaksin booster pertama.
Kata kunci: efektivitas, vaksin, COVID-19, antibodi, tenaga kesehatan


Background The emergence of the Omicron variant during the pandemic had an impact on the effectiveness of the COVID-19 vaccine. The spread of Omicron is increasing rapidly even in populations that have been vaccinated with booster doses, causing a high incidence of infection. Although the COVID-19 booster vaccine increases protection against infection, the protective effect decreases over time. Objective To determine the effectiveness and factors related to the effectiveness of the second mRNA booster vaccine (mRNA-1273 or BNT162b2) as well as antibody levels after the second mRNA booster vaccine in health workers at Cipto Mangunkusumo National General Hospital. Method This study used a cohort design. 271 health workers were selected from total sampling from previous research and continued with consecutive sampling. Selected subjects were then interviewed and blood samples were taken to assess IgG sRBD antibody levels. Subjects were divided into groups, the second booster group and the first booster group. From the existing results, the effectiveness of the vaccine was calculated, bivariate and multivariate analysis was carried out to assess the factors that influenced the effectiveness of the second mRNA booster vaccine. Results A total of 9 people (5.6%) were infected with COVID-19 in the second booster vaccine group and 11 people (9.7%) in the group without the second booster vaccine. The effectiveness of the vaccine against the incidence of COVID-19 infection was 42% (IK 95% -37% – 75%), p = 0,215. Age, gender, hypertension, type 2 DM, obesity, smoking and COVID-19 infection before booster have no relationship to the effectiveness of the second booster mRNA vaccine. Antibody levels 6 months after the second booster vaccination had a high value with a median of 8921 AU/ml. In 48 people who had their antibody levels checked during the first and second boosters, there was an increase, from 4743 AU/ml (QIR 6053.3) to 8532 AU/ml (QIR 8040.3). Conclusion The effectiveness of the second mRNA booster vaccine against COVID-19 infection in healt workers was 42%. There were no factors related to the effectiveness of the second booster mRNA vaccine. The IgG sRBD antibody levels after the second booster higher than after first booster.
Key words: effectiveness, vaccine, COVID-19, antibody, health workers