Effectiveness of CoronaVac, ChAdOx1 nCoV-19, BNT162b2, and Ad26.COV2.S among individuals with previous SARS-CoV-2 infection in Brazil: a test-negative, case-control study

被引:88
作者
Cerqueira-Silva, Thiago [1 ,3 ]
Andrews, Jason R. [5 ]
Boaventura, Viviane S. [1 ,3 ]
Ranzani, Otavio T. [6 ,7 ]
Oliveira, Vinicius de Araujo [1 ,2 ,3 ]
Paixao, Enny S. [8 ]
Bertoldo Junior, Juracy [2 ,4 ]
Machado, Tales Mota [10 ]
Hitchings, Matt D. T. [11 ]
Dorion, Murilo [14 ]
Lind, Margaret L. [14 ]
Penna, Gerson O. [15 ,16 ]
Cummings, Derek A. T. [12 ,13 ]
Dean, Natalie E. [17 ]
Werneck, Guilherme Loureiro [18 ]
Pearce, Neil [9 ]
Barreto, Mauricio L. [2 ,4 ]
Ko, Albert, I [1 ,14 ]
Croda, Julio [14 ,19 ,20 ]
Barral-Netto, Manoel [1 ,2 ,3 ]
机构
[1] Fiocruz MS, Inst Goncalo Moniz, Salvador, BA, Brazil
[2] Fiocruz MS, Ctr Data & Knowledge Integrat Hlth, Salvador, BA, Brazil
[3] Univ Fed Bahia, Fac Med, Salvador, BA, Brazil
[4] Univ Fed Bahia, Inst Saude Colet, Salvador, BA, Brazil
[5] Stanford Univ, Div Infect Dis & Geog Med, Stanford, CA 94305 USA
[6] Barcelona Inst Global Hlth, Barcelona, Spain
[7] Fac Med, Hosp Clin, Heart Inst, Pulm Div, Sao Paulo, SP, Brazil
[8] London Sch Hyg & Trop Med, Dept Infect Dis Epidemiol, London, England
[9] London Sch Hyg & Trop Med, Dept Med Stat, London, England
[10] Univ Fed Ouro Preto, Diretoria Tecnol Informacao, Ouro Preto, MG, Brazil
[11] Univ Florida, Coll Publ Hlth & Hlth Profess, Dept Biostat, Gainesville, FL USA
[12] Univ Florida, Dept Biol, Gainesville, FL USA
[13] Univ Florida, Emerging Pathogens Inst, Gainesville, FL USA
[14] Yale Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT USA
[15] Univ Brasilia, Nucleo Med Trop, Brasilia, DF, Brazil
[16] Fiocruz Brasilia, Escola Fiocruz Governo, Brasilia, DF, Brazil
[17] Emory Univ, Dept Biostat & Bioinformat, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA
[18] Univ Estado Rio de Janeiro, Dept Epidemiol, Rio De Janeiro, RJ, Brazil
[19] Univ Fed Mato Grosso do Sul, Campo Grande, MS, Brazil
[20] Fiocruz MS, Fiocruz Mato Grosso do Sul, Campo Grande, MS, Brazil
关键词
HOSPITAL ADMISSIONS; MESSENGER-RNA; COVID-19; VACCINATION; RISK;
D O I
10.1016/S1473-3099(22)00140-2
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background COVID-19 vaccines have proven highly effective among individuals without a previous SARS-CoV-2 infection, but their effectiveness in preventing symptomatic infection and severe outcomes among individuals with previous infection is less clear. We aimed to estimate the effectiveness of four COVID-19 vaccines against symptomatic infection, hospitalisation, and death for individuals with laboratory-confirmed previous SARS-CoV-2 infection. Methods Using national COVID-19 notification, hospitalisation, and vaccination datasets from Brazil, we did a testnegative, case-control study to assess the effectiveness of four vaccines (CoronaVac [Sinovac], ChAdOx1 nCoV-19 [AstraZeneca], Ad26.COV2.S [Janssen], and BNT162b2 [Pfizer- BioNtech]) for individuals with laboratory-confirmed previous SARS-CoV-2 infection. We matched cases with RT-PCR positive, symptomatic COVID-19 with up to ten controls with negative RT-PCR tests who presented with symptomatic illnesses, restricting both groups to tests done at least 90 days after an initial infection. We used multivariable conditional logistic regression to compare the odds of test positivity and the odds of hospitalisation or death due to COVID-19, according to vaccination status and time since first or second dose of vaccines. Findings Between Feb 24,2020, and Nov 11,2021, we identified 213 457 individuals who had a subsequent, symptomatic illness with RT-PCR testing done at least 90 days after their initial SARS-CoV-2 infection and after the vaccination programme started. Among these, 30910 (14.5%) had a positive RT-PCR test consistent with reinfection, and we matched 22566 of these cases with 145 055 negative RT-PCR tests from 68426 individuals as controls. Among individuals with previous SARS-CoV-2 infection, vaccine effectiveness against symptomatic infection 14 or more days from vaccine series completion was 39.4% (95% CI 364-42.6) for CoronaVac, 56.0% (51.4-60.2) for ChAdOxi nCoV-19, 44.0% (31.5-54.2) for Ad26.COV2.S, and 64.8% (54.9-72.4) for BNT162b2. For the two-dose vaccine series (CoronaVac, ChAdOx1 nCoV-19, and BNT162b2), effectiveness against symptomatic infection was significantly greater after the second dose than after the first dose. Effectiveness against hospitalisation or death 14 or more days from vaccine series completion was 81.3% (75.3-85.8) for CoronaVac, 89.9% (83.5-93.8) for ChAdOx1 nCo'V-19, 57.7% (-2.6 to 82.5) for Ad26.COV2.S, and 89.7% (54.3-97.7) for BNT162b2. Interpretation All four vaccines conferred additional protection against symptomatic infections and severe outcomes among individuals with previous SARS-CoV-2 infection. The provision of a full vaccine series to individuals after recovery from COVID-19 might reduce morbidity and mortality. Copyright (C) 2022 Elsevier Ltd. All rights reserved.
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收藏
页码:791 / 801
页数:11
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