Orellana Jesem Douglas Yamall, Cunha Geraldo Marcelo da, Marrero Lihsieh, Leite Iuri da Costa, Domingues Carla Magda Allan Santos, Horta Bernardo Lessa
Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Brasil.
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2022 May 16;38(5):PT192321. doi: 10.1590/0102-311XPT192321. eCollection 2022.
The impact of COVID-19 vaccination in the elderly has received relatively little attention, particularly in a scenario predominated by the gamma variant. The aim of this study was to assess vaccination coverage and its relationship to changes in the pattern of COVID-19 hospitalizations and deaths in the elderly in Manaus, Amazonas State, Brazil. This was an ecological study with Brazilian Ministry of Health data on hospitalizations and deaths, assessing vaccination coverage based on a two-dose regimen, in addition to two vaccination regimens associated with a significant protective effect, one partial (35 days or more after the first dose of the Oxford/AstraZeneca vaccine) and the other complete (14 days or more after the second dose of the Sinovac-CoronaVac vaccine). Based on the date of initial symptoms, patterns of COVID-19 hospitalizations and deaths were assessed comparatively in elderly 60-69 years and 70 years or more in two groups of Epidemiological Weeks (EW) in 2020 (unvaccinated) and 2021 (vaccinated). Hospitalization and death rates were estimated with Poisson regression. In the groups 60-69 and 70 years or more, vaccination coverage rates were 41.8% and 54.8%, as well as 53.5% and 90.1%, in the EW groups 18-20/2021 and 21-23/2021, respectively. Both EW groups in 2021 showed a substantial change in the patterns of COVID-19 hospitalizations and deaths, with an increase in the risk of hospitalization and death in unvaccinated younger individuals and an important reduction in vaccinated elderly, especially those 60-69 years of age, besides overall reductions of 62% (95%CI: 52-69) and 63% (95%CI: 43-75) in hospitalization and death rates, respectively. Our results emphasize the importance of mass vaccination, especially during an epidemic such as in Manaus, marked by high circulation of the gamma variant.
新冠疫苗接种对老年人的影响相对较少受到关注，尤其是在以伽马变异株为主导的情况下。本研究的目的是评估巴西亚马孙州玛瑙斯市老年人的疫苗接种覆盖率及其与新冠住院和死亡模式变化的关系。这是一项生态学研究，利用巴西卫生部关于住院和死亡的数据，除了评估基于两剂接种方案的疫苗接种覆盖率外，还评估了两种具有显著保护作用的接种方案，一种是部分接种（牛津/阿斯利康疫苗第一剂接种后35天或更长时间），另一种是全程接种（科兴新冠疫苗第二剂接种后14天或更长时间）。根据初始症状出现日期，比较评估了2020年（未接种）和2021年（接种）两个流行病学周（EW）组中60 - 69岁和70岁及以上老年人的新冠住院和死亡模式。采用泊松回归估计住院率和死亡率。在60 - 69岁组和70岁及以上组中，2021年第18 - 20周/2021年和第21 - 23周/2021年EW组的疫苗接种覆盖率分别为41.8%和54.8%，以及53.5%和90.1%。2021年的两个EW组在新冠住院和死亡模式上均出现了显著变化，未接种疫苗的年轻个体住院和死亡风险增加，而接种疫苗的老年人，尤其是60 - 69岁的老年人风险大幅降低，此外住院率和死亡率分别总体降低了62%（95%CI：52 - 69）和63%（95%CI：43 - 75）。我们的结果强调了大规模疫苗接种的重要性，尤其是在玛瑙斯这样以伽马变异株高传播为特征的疫情期间。
