Paternina-Caicedo Angel, Jit Mark, Alvis-Guzmán Nelson, Fernández Juan Carlos, Hernández José, Paz-Wilches Justo Jesus, Rojas-Suarez José, Dueñas-Castell Carmelo, Alvis-Zakzuk Nelson J, Smith Adrian D, Hoz-Restrepo Fernando De La
Universidad del Sinú, Cartagena, Colombia.
London School of Hygiene & Tropical Medicine, London, United Kingdom.
Lancet Reg Health Am. 2022 Aug;12:100296. doi: 10.1016/j.lana.2022.100296. Epub 2022 Jul 1.
In February 2021, Colombia began mass vaccination against COVID-19 using mainly BNT162b2 and CoronaVac vaccines. We aimed to estimate vaccine effectiveness (VE) to prevent COVID-19 symptomatic cases, hospitalization, critical care admission, and deaths in a cohort of 796,072 insured subjects older than 40 years in northern Colombia, a setting with a high SARS-CoV-2 transmission.
We identified individuals vaccinated between March 1st of 2021 and August 15th of 2021. We included symptomatic cases, hospitalizations, critical care admissions, and deaths in patients with confirmed COVID-19 as main outcomes. We calculated VE for each outcome from the hazard ratio in Cox proportionally hazards regressions (adjusted by age, sex, place of residence, diabetes, human immunodeficiency virus, cancer, hypertension, tuberculosis, neurological diseases, and chronic renal disease), with 95% confidence intervals (CI).
A total of 719,735 insured participants of 40 and more years were followed. We found 21,545 laboratory-confirmed symptomatic COVID-19 among unvaccinated population, along with 2874 hospitalizations, 1061 critical care admissions, and 1329 deaths, for a rate of 207.2 per million person-days, 27.1 per million person-days, 10.0 per million person-days, and 12.5 per million person-days, respectively. We found CoronaVac was not effective for any outcome in subjects above 80 years old; but for people 40-79 years of age, we found two doses of CoronaVac reduced hospitalization (33.1%; 95% CI, 14.5-47.7), critical care admission (47.2%; 95% CI, 18.5-65.8), and death (55.7%; 95% CI, 32.5-70.0). We found BNT162b2 was effective for all outcomes in the entire population of subjects above 40 years of age, significantly declining for subjects ≥80 years.
Two doses of either CoronaVac in population between 40 and 79 years of age, or BNT162b2 among vaccinated above 40 years old significantly reduced deaths of confirmed COVID-19 in a cohort of individuals from Colombia. Vaccine effectiveness for CoronaVac and BNT162b2 declined with increasing age.
UK National Institute for Health Research, the European Union's Horizon 2020 research and innovation programme, and the Bill & Melinda Gates Foundation.
2021年2月，哥伦比亚开始大规模接种新冠疫苗，主要使用BNT162b2和科兴疫苗。我们旨在评估在哥伦比亚北部796,072名40岁以上参保人群中，疫苗预防新冠症状性病例、住院、重症监护入院和死亡的有效性（VE），该地区新冠病毒传播率很高。
我们确定了2021年3月1日至2021年8月15日期间接种疫苗的个体。我们将确诊新冠患者的症状性病例、住院、重症监护入院和死亡作为主要结局。我们根据Cox比例风险回归中的风险比（按年龄、性别、居住地点、糖尿病、人类免疫缺陷病毒、癌症、高血压、结核病、神经系统疾病和慢性肾病进行调整）计算每个结局的VE，并给出95%置信区间（CI）。
共对719,735名40岁及以上的参保参与者进行了随访。我们在未接种疫苗人群中发现21,545例实验室确诊的有症状新冠病例，以及2874例住院病例、1061例重症监护入院病例和1329例死亡病例，发病率分别为每百万人口日207.2例、每百万人口日27.1例、每百万人口日10.0例和每百万人口日12.5例。我们发现科兴疫苗对80岁以上人群的任何结局均无效；但对于40-79岁的人群，我们发现两剂科兴疫苗可降低住院率（33.1%；95%CI，14.5-47.7）、重症监护入院率（47.2%；95%CI，18.5-65.8）和死亡率（55.7%；95%CI，32.5-70.0）。我们发现BNT162b2对40岁以上的所有人群的所有结局均有效，但对80岁及以上人群的有效性显著下降。
在哥伦比亚的一组人群中，40至79岁人群接种两剂科兴疫苗或40岁以上人群接种BNT162b2疫苗可显著降低确诊新冠患者的死亡率。科兴疫苗和BNT162b2疫苗的有效性均随年龄增长而下降。
英国国家卫生研究院、欧盟“地平线2020”研究与创新计划以及比尔及梅琳达·盖茨基金会。
