The effectiveness of COVID-19 vaccines against severe cases and deaths in Brazil from 2021 to 2022: a registry-based study

被引:32
作者
Brito dos Santos, Cleber Vinicius [1 ]
Morais Valiati, Naiara Cristina [2 ]
de Noronha, Tatiana Guimaraes [3 ]
Gomes Porto, Victor Bertollo [4 ]
Pacheco, Antonio Guilherme [2 ,5 ]
Freitas, Lais Picinini [2 ]
Coelho, Flavio Codeco [6 ]
da Costa Gomes, Marcelo Ferreira [2 ]
Bastos, Leonardo Soares [2 ]
Cruz, Oswaldo Goncalves [2 ]
Lana, Raquel Martins [2 ,7 ]
Luz, Paula Mendes [8 ]
Fagundes de Carvalho, Luiz Max [6 ]
Werneck, Guilherme Loureiro [1 ,9 ]
Struchiner, Claudio Jose [1 ,6 ]
Maciel Villela, Daniel Antunes [2 ]
机构
[1] Univ Estado Rio de Janeiro UERJ, Dept Epidemiol, Inst Med Social, Rio De Janeiro, Brazil
[2] Fundagao Oswaldo Cruz Fiocruz, Programa Computagao Cient, Rio De Janeiro, Brazil
[3] Fundagao Oswaldo Cruz Fiocruz, Inst Tecnol Imunobiol Biomanguinhos, Rio De Janeiro, Brazil
[4] Univ Fed Fluminense UFF, Fac Med, Programa Posgrad Ciencias Med, Rio De Janeiro, Brazil
[5] Minist Saude, Programa Nacl Imunizacao, Brasilia, DF, Brazil
[6] Fundacao Getulio Vargas FGV, Escola Matemat Aplicada, Rio De Janeiro, Brazil
[7] Barcelona Supercomp Ctr BSC, Barcelona, Spain
[8] Fundagao Oswaldo Cruz Fiocruz, Inst Nacl Infectol Evandro Chagas, Rio De Janeiro, Brazil
[9] Univ Fed Rio de Janeiro UFRJ, Inst Estudos Saude Colet, Rio De Janeiro, Brazil
来源
LANCET REGIONAL HEALTH-AMERICAS | 2023年 / 20卷
关键词
COVID-19; vaccines; Effectiveness; Registry-based study; Brazil; Latin America; Pandemic; COHORT;
D O I
10.1016/j.lana.2023.100465
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background Brazil started the COVID-19 mass vaccination in January 2021 with CoronaVac and ChAdOx1, followed by BNT162b2 and Ad26.COV2.S vaccines. By the end of 2021, more than 317 million vaccine doses were administered in the adult population. This study aimed at estimating the effectiveness of the primary series of COVID-19 vaccination and booster shots in protecting against severe cases and deaths in Brazil during the first year of vaccination.Methods A cohort dataset of over 158 million vaccination and severe cases records linked from official national registries was analyzed via a mixed-effects Poisson model, adjusted for age, state of residence, time after immunization, and calendar time to estimate the absolute vaccine effectiveness of the primary series of vaccination and the relative effectiveness of the booster. The method permitted analysis of effectiveness against hospitalizations and deaths, including in the periods of variant dominance.Findings Vaccine effectiveness against severe cases and deaths remained over 25% and 50%, respectively, after 19 weeks from primary vaccination of BNT162b2, ChAdOx1, or CoronaVac vaccines. The boosters conferred greater protection than the primary series of vaccination, with heterologous boosters providing marginally greater protection than homologous. The effectiveness against hospitalization during the Omicron dominance in the 60+ years old population started at 61.7% (95% CI, 26.1-86.2) for ChAdOx1, 95.6% (95% CI, 82.4-99.9) for CoronaVac, and 72.3% (95% CI, 51.4-87.4) for the BNT162b2 vaccine. Interpretation This study provides real-world evidence of the effectiveness of COVID-19 vaccination in Brazil, including during the Omicron wave, demonstrating protection even after waning effectiveness. Comparisons of the effectiveness among different vaccines require caution due to potential bias effects related to age groups, periods in the pandemic, and eventual behavioural changes.
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页数:13
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