Public Health and Tuberculosis Division, Tibetan Delek Hospital, Dharamsala, Himachal Pradesh, India.
Department of Pathology, Dr. Rajendra Prasad Govt. Medical College, Tanda, Himachal Pradesh, India.
BMJ Glob Health. 2022 May;7(5). doi: 10.1136/bmjgh-2021-008271.
This study aimed to determine the effectiveness of Covishield vaccine among residents of congregate residential facilities.
A prospective cohort study in congregate residential facilities.
Dharamshala, Himachal Pradesh, India, from December 2020 to July 2021.
Residents of all ages in seven facilities-three monasteries, two old age homes and two learning centres-were enrolled.
First and second doses of Covishield vaccine against SARS-CoV-2 infection.
Primary outcome was development of COVID-19. Secondary outcome was unfavourable outcomes, defined as a composite of shortness of breath, hospitalisation or death. Vaccine effectiveness (%) was calculated as (1-HR)×100.
There were 1114 residents (median age 31 years) participating in the study, 82% males. Twenty-eight per cent (n=308/1114) were unvaccinated, 50% (n=554/1114) had received one dose and 23% (n=252/1114) had received two doses of Covishield. The point prevalence of COVID-19 for the facilities ranged from 11% to 57%. Incidence rates (95% CI) of COVID-19 were 76 (63 to 90)/1000 person-months in the unvaccinated, 25 (18 to 35)/1000 person-months in recipients of one dose and 9 (4 to 19)/1000 person-months in recipients of two doses. The effectiveness of first and second doses of Covishield were 71% (adjusted HR (aHR) 0.29; 95% CI 0.18 to 0.46; p<0.001) and 80% (aHR 0.20; 95% CI 0.09 to 0.44; p<0.001), respectively, against SARS-CoV-2 infection and 86% (aHR 0.24; 95% CI 0.07 to 0.82; p=0.023) and 99% (aHR 0.01; 95% CI 0.002 to 0.10; p<0.001), respectively, against unfavourable outcome. The effectiveness was higher after 14 days of receiving the first and second doses, 93% and 98%, respectively. Risk of infection was higher in persons with chronic hepatitis B (aHR 1.78; p=0.034) and previous history of tuberculosis (aHR 1.62; p=0.047).
Covishield was effective in preventing SARS-CoV-2 infection and reducing disease severity in highly transmissible settings during the second wave of the pandemic driven by the Delta variant.
本研究旨在确定 Covishield 疫苗在群居场所居民中的有效性。
在群居场所进行的前瞻性队列研究。
印度喜马偕尔邦达兰萨拉，2020 年 12 月至 2021 年 7 月。
招募了来自七个设施（三个寺院、两个养老院和两个学习中心）的所有年龄段的居民。
针对 SARS-CoV-2 感染的第一剂和第二剂 Covishield 疫苗。
主要结局是 COVID-19 的发生。次要结局是不良结局，定义为呼吸急促、住院或死亡的综合症状。疫苗有效率（%）计算为（1-HR）×100。
共有 1114 名居民（中位数年龄 31 岁）参加了这项研究，其中 82%为男性。28%（n=308/1114）未接种疫苗，50%（n=554/1114）接种了一剂，23%（n=252/1114）接种了两剂 Covishield。设施的 COVID-19 点患病率范围为 11%至 57%。未接种疫苗者的 COVID-19 发病率（95%置信区间）为 76（63 至 90）/1000 人月，接种一剂者为 25（18 至 35）/1000 人月，接种两剂者为 9（4 至 19）/1000 人月。第一剂和第二剂 Covishield 的有效性分别为 71%（调整后的 HR（aHR）0.29；95%置信区间 0.18 至 0.46；p<0.001）和 80%（aHR 0.20；95%置信区间 0.09 至 0.44；p<0.001），分别针对 SARS-CoV-2 感染和 86%（aHR 0.24；95%置信区间 0.07 至 0.82；p=0.023）和 99%（aHR 0.01；95%置信区间 0.002 至 0.10；p<0.001），分别针对不良结局。接种第一剂和第二剂后 14 天，有效性分别提高到 93%和 98%。患有慢性乙型肝炎（aHR 1.78；p=0.034）和既往结核病史（aHR 1.62；p=0.047）的人感染风险更高。
在由 Delta 变异驱动的第二波大流行期间，Covishield 疫苗在高度传染性环境中预防 SARS-CoV-2 感染和降低疾病严重程度方面非常有效。
